1. Introduction
Paracetamol is one of the most commonly used medications for treating pain and fever in children. It is considered safe and effective when used within the recommended doses. Paracetamol works by inhibiting prostaglandin synthesis in the central nervous system, providing relief from mild to moderate pain and reducing fever.
2. Indications
- Fever (pyrexia) associated with infections or vaccinations
- Mild to moderate pain (e.g., teething, headache, earache, sore throat)
- Post-immunisation fever
- Pain from minor injuries or conditions like colds and flu
3. Dosage
Infants and Children:
- Oral (Suspension): 10–15 mg/kg per dose every 4–6 hours as needed.
- Maximum daily dose: 60 mg/kg/day (not to exceed 4 g/day).
- Rectal (Suppositories): 15–20 mg/kg per dose every 6 hours.
- Maximum: 4 doses per day.
Post-Immunisation Fever (Babies ≥2 months):
- 60 mg (2.5 mL of 120 mg/5 mL suspension) as a single dose.
- A second dose may be given after 4–6 hours if needed. Do not exceed 2 doses in 24 hours for post-immunisation fever without medical advice.
Weight-Based Dosing Guide:
Weight | Oral Dose | Frequency |
---|---|---|
4–8 kg | 60 mg | Every 4–6 hours |
8–12 kg | 120 mg | Every 4–6 hours |
12–16 kg | 180 mg | Every 4–6 hours |
16–24 kg | 240 mg | Every 4–6 hours |
24–30 kg | 360 mg | Every 4–6 hours |
Neonates (≤3 months):
- 10 mg/kg every 6–8 hours as needed (maximum: 30 mg/kg/day).
4. Administration
- Use a calibrated measuring syringe or spoon for accurate dosing when giving liquid formulations.
- Rectal suppositories should be inserted after ensuring the area is clean and dry.
- Do not exceed the recommended number of doses in 24 hours.
5. Forms Available
- Oral Suspension: 120 mg/5 mL, 250 mg/5 mL
- Rectal Suppositories: 125 mg, 250 mg
- Tablets (for older children): 250 mg, 500 mg (chewable or dispersible options available)
6. Side Effects
6.1 Common Side Effects:
- Nausea
- Rash (rare allergic reaction)
6.2 Rare but Serious Side Effects:
- Liver toxicity (in overdose cases)
- Severe allergic reactions, including swelling and breathing difficulties
7. Warnings
- Overdose Risk: Accidental overdose can cause liver damage. Always double-check the dose, especially when using different formulations.
- Combination Products: Avoid giving multiple medications containing paracetamol simultaneously to prevent overdose.
8. Precautions
- Use cautiously in children with liver disease or chronic malnutrition.
- Ensure proper weight-based dosing to avoid under- or overdosing.
9. Interactions
- Enzyme-inducing drugs (e.g., rifampin, phenytoin): May increase the risk of liver toxicity.
- Warfarin: Prolonged use of paracetamol may enhance its anticoagulant effects; monitor closely.
10. Monitoring Parameters
- Monitor for symptom relief (e.g., fever reduction, pain relief).
- Watch for signs of overdose, such as nausea, vomiting, lethargy, or jaundice.
11. Use in Neonates and Infants
- Safe for use in neonates and infants when dosed correctly. For babies younger than 2 months, use under medical supervision.
12. Use in Pregnancy and Breastfeeding
- Not applicable for children; however, paracetamol is safe for breastfeeding mothers when taken within recommended doses.
13. Use in Kidney and Liver Disease
- Use with caution in children with liver or kidney disease. Adjust doses as needed under medical supervision.
14. Patient Counselling Points for Parents
- Measure the dose accurately using the provided measuring syringe or spoon. Avoid using household teaspoons.
- Ensure the child completes the full course if prescribed for a specific condition, but do not use for more than 3 days without consulting a doctor.
- Monitor for side effects or worsening symptoms, such as persistent fever or pain.
- Store the medication out of reach of children to prevent accidental ingestion.
- Do not combine with other medications containing paracetamol.
15. Table of Brand Names, Manufacturer, and Prices in USD
Brand Name | Manufacturer | Strength/Dosage Form | Price (USD) |
---|---|---|---|
Calpol | GSK | 120 mg/5 mL Suspension | $4 (100 mL) |
Panadol Children’s | GSK | 250 mg/5 mL Suspension | $5 (100 mL) |
Tempra | Various | 120 mg/5 mL Syrup | $3 (60 mL) |
Generic Paracetamol | Various | 125 mg Suppository | $2 (10 suppositories) |
16. 15 FAQs (Frequently Asked Questions)
1. What is Paracetamol used for in children?
It is used to relieve pain and reduce fever in children.
2. How do I calculate the correct dose for my child?
Use 10–15 mg per kg of body weight per dose, up to a maximum of 60 mg/kg/day.
3. Can I give Paracetamol to my newborn?
Yes, but only under medical supervision, especially for babies under 2 months.
4. How long does it take for Paracetamol to work?
It usually starts working within 30–60 minutes.
5. Can I give Paracetamol for teething pain?
Yes, Paracetamol is commonly used for teething pain in children.
6. Can I use Paracetamol with ibuprofen?
Yes, they can be alternated for fever or pain relief, but consult your doctor first.
7. What happens if I accidentally give too much Paracetamol?
Seek immediate medical attention, as overdose can cause severe liver damage.
8. Can Paracetamol cause drowsiness in children?
No, Paracetamol does not typically cause drowsiness.
9. Can I use Paracetamol for post-vaccination fever?
Yes, it is effective for post-vaccination fever.
10. Can I give Paracetamol on an empty stomach?
Yes, Paracetamol can be taken with or without food.
11. How often can I give Paracetamol to my child?
Every 4–6 hours as needed, but do not exceed 4 doses in 24 hours.
12. Can Paracetamol be given for a cold?
Yes, it can help relieve fever and body aches associated with colds.
13. Is it safe to use Paracetamol daily?
Paracetamol should not be used daily unless prescribed by a doctor.
14. What should I do if my child spits out the dose?
Wait a few minutes and try again with the same dose.
15. Can I combine Paracetamol with antibiotics?
Yes, Paracetamol can be used alongside antibiotics if needed for fever or pain.