Panadol

Panadol - Side Effects | Dose | Use

Panadol is a medicine that contains the active substance called paracetamol. It has analgesic and antipyretic properties (relieves pain and fever). It is safe to use in children. 1 The mechanism of action of this medicine is based on inhibition of enzymes called cyclooxygenase 1 (COX 1) and cyclooxygenase 2 (COX 2). 2

It is used to treat pain (mild to moderate) and fever. 1

Precautions

Panadol should be used only with extra precautions in patients who have liver damage, because this medicine can cause damage to the liver (hepatotoxicity) if taken in large doses.3 Liver damage may be severe and can lead even to death!4,5 Immediately call your doctor if you are experiencing symptoms of liver damage, such as: pain in the right upper abdomen, loss of appetite, dark urine and jaundice. Fortunately, this medicine rarely causes liver damage, but you should be aware of possible abovementioned side effects.

People with alcohol dependence should not use this medicine, since they have higher risk of liver damage.6 Avoid use of alcoholic beverages while using this medicine.

This medicine should be avoided in patients who are allergic to the active substance paracetamol. It should be used only with extra precautions in patients with renal impairment.

Use of Panadol during pregnancy and breastfeeding

Panadol can be used during pregnancy only if the benefit to the mother outweighs the risk to the fetus. It is considered to be the safest painkiller and antipyretic to take during pregnancy and it is recommended as a drug of first choice to treat pain and fever in pregnant women. However, it should be used only if doctor recommended because some studies have shown that children whose mothers took this medicine during pregnancy had increased risk for asthma and attention deficit disorder (i.e. ADHD - attention deficit hyperactivity disorder).7,8 Talk to your doctor first before you start using this medicine during pregnancy.

This medicine passes into breast milk in small amounts and it is safe for use while breastfeeding.

How to use

Panadol dosage forms include: Panadol 500 mg tablets, Panadol Baby syrup 120 mg/5 ml and Panadol Extra tablets (combination of paracetamol-acetaminophen with caffeine).

Dosage for Panadol 500 mg tablets (according to the Patient Information Leaflet Panadol 500 mg tablets):

Panadol 500 mg tablets can be used in patients above the age of 12.

Age Dose
Children aged 12-18 years Take one tablet, as needed (if you are experiencing pain or have a fever), whereby the interval between doses should be at least 4 hours. The maximum daily dose is 3000 mg or 6 tablets.
Patients above the age od 18 Take one or two tablets, as needed (if you are experiencing pain or have a fever), whereby the interval between doses should be at least 4 hours. The maximum daily dose is 4000 mg or 8 tablets.

* Note: Taking more than the recommended dose increases the risk of side effects.

Swallow the tablet whole with a glass of water. Do not crush or chew the tablet. Panadol tablet can be taken regardless of meals.

Dosage for Panadol Baby syrup 120 mg/5 ml, according to the Patient Information Leaflet Panadol Baby syrup 120 mg/5 ml:

Age Dose
Babies 2 to 3 months of age 2.5 ml every 4-6 hours, not more than 2 timer a day!
Babies 3 to 6 months of age 2.5 ml every 6 hours
Babies 6 to 24 months of age 5 ml every 6 hours
Children aged 2-4 years 7.5 ml every 6 hours
Children aged 4-8 years 10 ml every 6 hours
Children aged 8-10 years 15 ml every 6 hours
Children aged 10-12 years 20 ml every 6 hours

Use with other medicines (Interactions)

Panadol should be avoided in combination with the following medicines:

  • Anticoagulant medicines, such as:
    • warfarin,
    • acenocoumarol and others. Concomitant use of Panadol with these medicines increases the risk of bleeding.
  • Medicines used in the treatment of nausea, such as: metoclopramide (Reglan) and domperidone. These medicine may increase the absorption of this medicine from the gut and increase its blood level and effects, which increases the risk of side effects.
  • Medicines used to treat high cholesterol, such as: cholestyramine. This medicine may decrease the absorption of this medicine from the gut and decrease its blood level and effects.

Tell your doctor about all medications and herbal products you are taking.

Side effects

Panadol may cause the following side effects: damage to the liver (pain in the right upper abdomen, loss of appetite, dark urine and jaundice), stomach upset, low platelet count (thrombocytopenia), allergy and others.

Fortunately, this medicine is well tolerated and rarely cause side effects.

However, you should call your doctor if you are experiencing any side effects.

References:

  1. Martino dM, Chiarugi A. Recent Advancies in Pediatric use of Oral Paracetamol in Fever and Pain Manegement. Pain Ther. 2015: 4(2): 149-168.
  2. Graham GG, Davies MJ, Day RO, and others. The modern pharmacology of paracetamol: therapeutic actions, mechanism of action, metabolism, toxicity and recent pharmacological findings. Inflammopharmacology. 2013: 21(3): 201-32.
  3. Mahadevan SBK, McKiernan PJ, Davies P, Kelly DA. Paracetamol induced hepatotoxicity. Arch Dis Child. 2006. 91(7): 598-603.
  4. Proudfoot AT, Wright N. Acute Paracetamol Poisoning. Br Med J. 1970: 3(5722): 557-558.
  5. Larson AM, Polson J, Fontana RJ, and others. Acetaminophen-induced acute liver failure: results of a United States mullticenter, prospective study. Hepatology. 2005: 42(6): 1364-72.
  6. Prescott LF. Paracetamol, alcohol and liver. Br J Clin Pharmacol. 2000: 49(4): 291-301.
  7. Magnus CM, Karlstad, Siri EH, and others. Prenatal and infant paracetamol exposure and development of asthma: the Norwegian Mother and Child Cohort Study. Int J Epidemiol. 2016: doi. 10.1093.
  8. Liew Z, Ritz B, Rebordosa C, and others. Acetaminophen use during pregnancy, behavioral problems, and hyperkinetic disorders. JAMA Pediatr. 2014: 168(4): 313-20.

Information on this website are provided for educational purposes only and are not intended for medical advice, diagnosis or treatment.

If you have any concerns or questions about your health, you should always consult with a physician or other health-care professional.