Indications :
Symptomatic treatment of mild to moderate pain and/or feverish states.
Dosage:
From 50 kg: 1 gram 3 to 4 times a day with a delay, between 2 intakes, of at least 4 hours.
In children: The recommended daily dose of paracetamol is approximately 60 mg/kg/day, to be divided into 4 or 6 doses, i.e. approximately 15 mg/kg every 6 hours.
In severe renal failure, the intervals between 2 doses will be at least 8 hours.
Contraindications:
Hypersensitivity to paracetamol or other constituents.
Severe hepatocellular insufficiency.
Suppository: recent history of anal or rectal inflammation
Warning and precautions for use:
In children under 40 kg, the total dose of paracetamol should not exceed 80 mg/kg/day.
In children 41 to 50 kg, the total dose of paracetamol should not exceed 3 g per day.
In adults and children over 50 kg, the total dose of paracetamol should not exceed 4 g per day.
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Suppository:
With the suppository form, there is a risk of local toxicity, which is all the more frequent and intense as the duration of treatment is prolonged, the rate of administration high and the dosage high.
In case of diarrhea, the suppository form is not suitable.
Precautions for use:
The administration of paracetamol can exceptionally lead to hepatic toxicity, even at therapeutic doses, after a short-term treatment and in patients without a history of hepatic disorders.
Paracetamol should be used with caution without exceeding 3 g/day in the following situations:
– weight < 50 kg;
– mild to moderate hepatocellular insufficiency;
– severe kidney failure
– chronic alcoholism;
– dehydration;
– chronic malnutrition, fasting, recent weight loss,
– subject over 75 years old or over 65 years old and polypathological,
– chronic viral hepatitis and HIV, cystic fibrosis, Gilbert’s disease.
Consumption of alcoholic beverages during treatment is not recommended.
In case of recent withdrawal from chronic alcoholism, the risk of liver damage is increased.
If acute viral hepatitis is discovered, treatment should be stopped.
Side effects :
Rare cases of sometimes severe allergic reaction have been reported. In this case paracetamol is to be avoided.
Reactions such as erythema, skin rash, urticaria are possible but exceptional. Treatment should be stopped and avoided.
Mild to severe liver damage is possible.
Anal irritation is possible with the suppository form.
Overdose:
The risk of serious intoxication can be particularly high in the elderly, in young children, in patients with liver damage, in the event of chronic alcoholism, in patients suffering from chronic malnutrition. In these cases, poisoning can be fatal.
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Symptoms :
Nausea, vomiting, anorexia, pallor, abdominal pain usually appear within the first 24 hours.
Paracetamol overdose may cause hepatic cytolysis which may lead to hepatocellular insufficiency, metabolic acidosis, encephalopathy, coma and death.
In the event of an acute overdose, an increase in hepatic transaminases, lactate dehydrogenase, bilirubin and a decrease in prothrombin level can be observed within 12 to 48 hours.
Overdose can also lead to pancreatitis, hyperamylasemia and acute renal failure.
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Emergency driving:
Immediate transfer to hospital.
Collect a tube of blood for the initial plasma paracetamol assay. This dosage will be interpreted according to the delay between the supposed time of intake and the time of sampling.
Rapid evacuation of the ingested product by gastric lavage, in the event of oral intake.
The treatment of overdose typically includes the administration, as early as possible, of the antidote N-acetylcysteine by IV or oral route, if possible before the tenth hour.
Symptomatic treatment in the intensive care unit if severe damage and in a liver transplant service if the damage is potentially lethal.
Pregnancy and breast feeding :
No contraindication in these 2 cases.