Paracetamol: Uses, Side Effects and Safety Tips

5 min read · Medicines · By the Asthra Health Care team

What paracetamol is used for

Paracetamol, also called acetaminophen, is a common medicine for fever and pain. In Indian homes it is often the first medicine reached for during viral fevers, dengue season, colds and body aches after the monsoon. Doctors also use it for headache, toothache, period pain, muscle aches and pain after vaccinations or minor procedures.

It does not treat the cause of an illness. It only makes you more comfortable while your body recovers or while the real cause, such as an infection, is being treated. A fever that keeps coming back for several days still needs a doctor's check and sometimes a blood test.

• Fever from viral infections, flu, dengue or typhoid
• Headache, toothache and body pain
• Period cramps and mild joint or muscle pain
• Pain and fever after vaccination in children and adults

How paracetamol works

Paracetamol acts mainly in the brain and spinal cord. It lowers the body's temperature set-point, so fever comes down, and it reduces how strongly pain signals are felt. Unlike ibuprofen or diclofenac, it has very little effect on swelling, so it is less helpful when a joint is red, hot and swollen.

Because it does not irritate the stomach lining the way many other painkillers do, it is usually preferred for people with acidity, ulcers or asthma. It is also the fever medicine of choice when dengue is suspected, because it does not thin the blood or raise the risk of bleeding.

Paracetamol side effects: common and serious

At the right amount, paracetamol rarely causes side effects. A few people get nausea or a mild skin rash. Very rarely, a serious skin reaction with blistering, peeling and mouth sores can occur. This is an emergency, so stop the medicine and get medical care at once if it happens.

The biggest risk is liver damage from overdose. Early signs can be mild or completely absent for the first day, so a person may feel fine even though the liver is being harmed. This is why any suspected overdose, even a small extra amount, must be taken to a hospital straight away, even without symptoms.

Who should avoid paracetamol or take extra care

People with liver disease, those who drink alcohol regularly, people who are very underweight or poorly nourished, and those taking medicines that affect the liver should ask a doctor before using paracetamol. Elderly people who are frail or eat little may also need extra care, and people with kidney disease should check with their doctor.

Paracetamol is generally considered suitable in pregnancy and breastfeeding when used for short periods, but it is still wise to check with your doctor. For children, the right amount depends on body weight, not just age. Always use the measuring device that comes with the syrup and follow the label or your pharmacist's advice.

Paracetamol interactions to know

The most common problem is double-dosing. Many cold and flu tablets, sinus medicines and some painkiller combinations already contain paracetamol. Taking these together with plain paracetamol can push you over the safe limit without realising it. Always read the ingredients list on every strip or bottle, or ask your chemist.

People on the blood thinner warfarin should tell their doctor if they need paracetamol regularly, as it can affect blood clotting test results. Some epilepsy and tuberculosis medicines can make the liver more sensitive to paracetamol. Regular alcohol use has a similar effect, so tell your doctor about all medicines and drinking habits.

Practical tips for safe use

Follow the label or your pharmacist's advice for how much to take and how often, and keep a proper gap between doses. Write down the times if several family members are looking after a sick child, so doses are not repeated by mistake. Store all medicines out of children's reach, as sweet syrups are easy to over-drink.

During fever, drink plenty of fluids such as water, buttermilk, coconut water or oral rehydration solution, rest well and wear light clothing. Sponging with lukewarm water can add comfort. Do not use paracetamol to hide a fever for days while carrying on as usual, because the underlying illness may need treatment.

• Check every combination medicine for hidden paracetamol
• Use only the dosing cup or syringe given with syrups
• Keep a written log of doses for children and elderly relatives

When to talk to your doctor about paracetamol

If a fever lasts more than two to three days, keeps returning, or comes with rash, bleeding, severe headache, breathlessness or unusual drowsiness, stop relying on home care and see a doctor. Babies under three months with any fever need to be seen the same day. Ask your doctor or pharmacist if you are unsure whether paracetamol is right for you.

This article is general health information, not medical advice. Do not start, stop or combine medicines on your own — always follow your doctor's prescription and ask your pharmacist if unsure.