Paracetamol (Panadol) and side effects

Paracetamol was first produced in 1877 and was approved for use by the US Food and Drug Administration (FDA), in 1951. It has gained a reputation as an affordable pain reliever with fewer side effects.

Paracetamol is a common medicine used by people of different age groups. When you are running a fever or experiencing mild pain e.g., body ache, you will most likely check your medicine cabinet for paracetamol first. It is often included in first aid kits too. This puts paracetamol up for easy abuse or misuse.

This article will discuss all about paracetamol, its side effects and effects on the liver, the health risks associated with its abuse as well as how to reduce the danger it poses to organs like the liver.

 What is paracetamol?

Paracetamol is called acetaminophen in the United States. It is an analgesic (i.e. drug used to reduce pain and fever). Paracetamol is sold under other brand names like Tylenol, Panadol and Mapap.

This means there is no difference between paracetamol, acetaminophen, and Tylenol; they are all the same thing. Acetaminophen is just a different generic name of paracetamol while Tylenol is its brand name.

Paracetamol is typically used in treating mild to moderate pain and fever. It can also be used in treating severe pain when used in combination with some opioid pain medications.

Because pain and fever are common symptoms of many ailments, it is easy for people to abuse paracetamol without considering its side effects. When misused, paracetamol can cause dangerous side effects. Paracetamol misuse can also cause damage to vital organs of the body like the liver.

Paracetamol is available in the following forms:

• Capsules
• Tablets
• Liquids
• Soluble powders
• Suppositories

Paracetamol can be administered orally, rectally, or intravenously although the oral route is more common. Its effects typically last within a duration of 2 to 4 hours. It comes as a generic mediation with other trade names like Panadol and Tylenol. It is an active ingredient in many flu and cold medicines.

Common symptoms and health conditions acetaminophen is used to treat include: headache, fevers, arthritis, toothache, muscle aches, and general body pain.

 Paracetamol side effects

When taken at the right dosage, paracetamol rarely has side effects. However, just like any other drug, it could cause adverse effects depending on different factors such as the age of the person taking it.

Paracetamol also affects people differently depending on other factors like health status, weight, size, time of drug intake, amount of drug taken, and whether it was taken alongside substances/medicines that can interact with it.

Common paracetamol side effects include:

• Rashes
• Itches
• Drowsiness and fatigue

Rare side effects of Paracetamol include:

• Sore throat
• Bloody or cloudy urine
• Unusual bruising or bleeding
• Yellow eyes or skin
• Sores or ulcers

In children, paracetamol may cause hunger and tremors. Help should be gotten immediately if any of these signs manifest after paracetamol use.

 Side effects of paracetamol overdose

Exceeding the recommended daily dose or taking too much dose of paracetamol can cause severe side effects. If such happens, an ambulance should be called or an emergency number should be dialed. Side effects of Paracetamol overdose can be life-threatening.

Some side effects of Paracetamol overdose include:

• Seizures
• Abdominal pain
• Nausea and vomiting
• Swelling, tenderness, or pain in the upper abdomen
• Liver problems
• Coma and death

Death from Paracetamol overdose is usually due to liver failure.

 Effects of paracetamol on the liver

Paracetamol is one of the most commonly abused drugs. It is abused just the way people abuse antibiotics. Sadly, many people are ignorant of the damages this can cause to body organs and systems.

Generally, paracetamol is safe but only if taken appropriately and in the proper dosage. Otherwise, it could lead to toxicity, and this includes liver failure.

The liver is most affected because the liver is one major organ with the role of metabolizing drugs. Drug metabolism involves the breakdown and elimination of the parent drug via a detoxification pathway.

However, when drugs like paracetamol are taken more than the recommended dosage, they can cause hepatotoxicity, which in turn causes drug-induced liver injury.

This means that one can experience paracetamol poisoning, which will present as severe liver damage and even death when consumed in excess amount. In fact, its overdose would need immediate medical attention to prevent further damage.

Paracetamol poisoning is one of the major causes of acute liver failure in the Western world, and frequent consumption of alcohol may heighten its risk.

Some symptoms of liver damage include:

• yellowing of skin and eyes (also called jaundice)
• fatigue
• loss of appetite
• pain in the abdomen
• nausea and vomiting
• pale skin color
• dark-colored urine and stools
• excessive sweating
• unusual bleeding and bruising

 Health risks associated with Paracetamol abuse

Aside from liver damage, paracetamol toxicity can be associated with other health risks. Some health complications can arise, especially when paracetamol interacts with other drugs such as birth control pills, antibiotics, non-steroidal anti-inflammatory drugs, antifungals, etc.

The FDA, in August 2013, issued a new warning about acetaminophen, stating that it has the tendency to cause rare and fatal skin reactions like Steven-Johnson's syndrome.

It can cause skin reactions. Some studies have also associated paracetamol use with an increase in asthma symptoms. Therefore, some experts have recommended that it shouldn't be used for asthmatic children.

A 2014 study also linked paracetamol use to a slight increase in kidney cancer.

An overdose of acetaminophen can result in liver failure or even death; thus, you should be wary of taking medications that contain acetaminophen as an active ingredient. See your doctor as soon as you notice any of the signs of liver damage.

 Mitigating the risk of liver damage due to paracetamol misuse

Now, that you know the danger of paracetamol abuse, how do you lower your risk of developing liver failure while ingesting this drug?

Here are ways to reduce the risk of liver (and other organs) damage caused by paracetamol use:

• It is better to take paracetamol as a prescription drug and not take it for more than the days directed.
• Follow the right dosage prescribed by your physician (note that dosage will vary according to age).
• Don't take more than one drug that contains acetaminophen as an active ingredient at a time.

The question is, "How do you identify medicines that contain acetaminophen as an active ingredient?"

Typically, ingredients are listed on drug labels. Check the 'Drug Facts' for over-the-counter medications. If the drug contains acetaminophen, it should be listed under the "Active Ingredients" section.