Examples of branded paracetamol: Panadol®
Examples of generic products for paracetamol
Introduction
"Panadol®", which consists of paracetamol (name
used in UK) or acetaminophan (name used in US), is a commonly used brand in the
current market. Almost everyone is aware of the existence of this medication
due to its extensive advertisement in the television and internet with its
original brand name "Panadol®". But how well do you know
about this medication?
Paracetamol, which is usually available as a 500mg/650mg tablet, syrup
or suppositories, is indicated for fever or as a mild painkiller. Paracetamol
may be combined with other medications to provide a 3-in-1 effect, for example,
with pseudoephedrine and chlorpheniramine for congested and running nose
symptoms, or with codeine/tramadol as a stronger painkiller.
For adolescents (age more than 12 years old) or adults with normal
kidney and liver function, the maximum tolerable dose of paracetamol will be
4000mg or 4g (e.g. 2 tablets of 500mg paracetamol, 4 times a day or 1 tablet of
650mg paracetamol 6 times a day). Paracetamol can be taken with or without
food. For infants to children dosing, please refer to the external labeling of
the paracetamol syrup.
I believe this brief introduction provides you a better understanding on
paracetamol. Now, I would to clarify some of your doubts and myths regarding
this medication, namely paracetamol.
Doubts and Myths
1. Will
all painkillers, including paracetamol, lead to gastric problems?
Painkillers, such as non-steroidal
anti-inflammatory drugs (NSAIDs), will have a higher risk of gastric problems
due to their acidic properties in nature. However, paracetamol is a very weak
acid compared to NSAIDs and hence it is very unlikely to cause gastric problem
even it is being given on an empty stomach.
2. Will
long-term intake of paracetamol damages the liver and kidney?
There is a report showing that paracetamol
under recommended dosing can cause liver dysfunction which is very rare (less
than 1/10000). As long as paracetamol is taken as instructed, it will not lead
to liver damage. There are no evidences showing that paracetamol can lead to
kidney damage. However, paracetamol should be used with caution in patient with
impaired liver and/or kidney function.
3. Why
do I develop rashes after I take paracetamol?
There may be chances that you will be
allergic to paracetamol although the chances are very rare (less than 1/10000).
It is considered as mild allergy, if you develop rashes after taking it. For a
more severe allergic response, the patient might develop difficulties in
breathing. For patients who might develop mild allergies, it will be advisable
to choose other medications over paracetamol as discomfort may still occur.
4. Will paracetamol stay in my body forever?
The elimination half-life of paracetamol
varies from 1 hour to 3 hours. But first of all, what is half life? Elimination
half-life basically refers to the time required to eliminate half the amount of
drug from the body (eg. from 100% to 50%). It takes around 5 half lives to
eliminate almost all of it. So hence, paracetamol takes around 5 to 15 hours to
be completely being eliminated from the body. Therefore, the myth regarding
that paracetamol will stay in the body forever is not true!
The elimination half-life of paracetamol
(1 to 3 hours) also explains why the patient has to take paracetamol every 4-6
hours. For medication with long elimination half-life (eg. 12-18 hours) may
explain why that particular medication just requires once daily intake.
5. Will
paracetamol cause cancer?
There are researches showing paracetamol
could post a risk in developing blood cancer but it is yet to be
confirmed.
6. Can
I take paracetamol if I am pregnant or breastfeeding?
Paracetamol is categorized as Pregnancy
Category A. This means that Paracetamol has been taken by a large number of
pregnant women and women of childbearing age without any proven increase in the
frequency of malformations. Hence, it is considered safe to be taken as normal
dose by pregnant woman, regardless of the pregnancy trimester.
Paracetamol will be excreted in
breast milk but the amount exposed to the infant is less than 0.1% of a single
dose of paracetamol 500 mg and as 0.04 to 0.23% of a single 650 mg dose. Hence,
as long as the breastfeeding mother is taking the paracetamol without exceeding
the recommended dose, it will not be a risk to the breastfed infant.
7. What is the difference between Panadol®
and other brands of paracetamol?
Panadol®, is the original brand
of paracetamol, it is manufactured and patented by GlaxoSmithKline (GSK). Other
brands, such as Paracil®, Dymadon®, Febridol®
and Paralgin®, are generic brands patented by other companies. All
of them contain paracetamol as the active ingredient but their excipients
(inactive ingredients, such as preservatives) can be different. The generic
brands of paracetamol have to meet with the requirement of bioequivalence
before they are released into the market. If two products are
said to be bioequivalent, it means that they would be expected to be,
for all intents and purposes, the same.
8. What
should I do if a person exceeded the recommended dosage of paracetamol?
Paracetamol overdose may cause
liver failure which can lead to liver transplant or death.
If an overdose is confirmed or
suspected, the National Poisons Centre should be contacted immediately for
advice. The patient should also be sent to a hospital as soon as possible, even
if there are no symptoms of overdosing as there is a risk of delayed, serious
liver damage.
National
Poisons Centre (in Malaysia)
Office
Hours : 1-800-88-8099 /
+604-657 0099
(Monday-Friday: 8.10am-5.10pm)
(Monday-Friday: 8.10am-5.10pm)
After
Office Hours : +6012-430-9499
(Including weekends and public holidays)
The Author
Jordy
Wong Der Yuan
BPharm
(Hons) (IMU)
Date:
27/3/2016
Editors
Chang Jen
Nee, Ong Jijien
