Paracetamol-

Reduced absorption  of cholestyramine  within 1 hour of administration

Accelerated  absorption with metoclopromide

Decreased effects of barbiturates, carbamazepines, hydantoins, ripampicin,
and sulfinpyrazone

Paracetamol increase effect of warfarin

Paracetamol increase risk of liver damage in chronic alcoholics ,

Increased risk of toxicity with other hepatotoxic drugs or drugs which induce
microsomal enzymes eg. barbiturates , carbamazepine , hydantoins,
ripampicin, sulfinpyrazone

Moderate to severe pain

INFORMATION -UPDATE

US- PARACETAMOL DOSE REDUCED IN FDCs

The United  States Food and Drug Administration (USFDA) has ordered the reduction of
paracetamol to 325mg per dose for adults in Fixed-Dose Combination (FDCs)  products
to reduce liver toxicity.

Paracetamol is permitted to be combined with  aspirin and opiods ( codeine, pentazocaine
and tramadol ) only in the United States

The action has been taken since both paracetamol and opiods cause liver injury. (MIMS).
 

Nausea,    allergic reactions,   skin rashes,   acute renal tubular necrosis

Very rare dyscrasias eg. thrombocytopenia, agranulocytosis, liver damage

Special precautions/warnings-

Renal or hepatic impairment

Alcohol-dependent patients

G6PD deficiency

Date of Approval     1972

Indication-

Moderate to severe pain

Dosage-
Paracetamol-

Adult- 0.5 to 1g 4-6 hourly as necessary. Max  4g daily

Child-  neonate- 28 to 32 weeks
 post menstrual age- 20mg/kg as a single dose
then 10-15mg /kg  8-12 hourly  ( max 60mg/kg  daily in divided doses

child - 1-3 mths - 30mg  8 hourly (max 60mg/kg daily in divided doses )
3mth to 1 year - 60-120mg 4-6 hrly 9max 4 doses in 24 hours
1-5 years - 120-250mg 4-6 hourly  (max 4 doses  in 24 hours )
6-12 years - 250- 500mg 4-6 hourly 9max 4 doses  in 24 hours 

 Acetoaminophen - commonly used names are APAP and Paracetamol

1. Allergies-  Tell your doctor if ever you had any unusaual allergic reactions to
acetoaminophen or aspirin. Also tell, your doctor if you are allergic to any other substances
 such as foods, preservatives or dyes.

2. Pregnancy - acetoaminophen has not been reported to cause birth defects or other
problems.

3. Breast feeding- it has not been reported to cause problems in nursing babies

4. Elderly- acetoaminophen has not shown to cause different side effects or problems
in older people than it does in younger adults.

5. Other medicines- certain other medicines should not be used together at all, in other
cases two different medicines may be used together even if interaction might occur.
Tell your doctor if you are taking any other prescription or non-prescription ( OTC )
medicines.

6. Other medical problems - presence of other medical problems may affect the use of
acetoaminophen . Make sure you tell your doctor if you have any other medical
problems -
Alchol abuse, Kidney disease,
Hepatitis or other liver disease - chance of serious side effects may be increased.
Phenylketonuria - some brands of acetoaminophen may contain aspartame, which
can make the condition worse.
 
7. Dosing- follow your doctors advice or directions given on the label. If your dose
is different do not change it unless your doctor tells you to do so