CETAMOL (Paracetamol syrup and tablets)

CETAMOL (Paracetamol syrup and tablets)

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CETAMOL (Paracetamol syrup and tablets)

Prostaglandins are associated with the development of pain. Paracetamol inhibits the synthesis of prostaglandins, thus producing analgesia.

In fever prostaglandins acts within the hypothalamus to produce the resultant elevation of body temperature by processes that appear to be mediated by cyclic AMP. Paracetamol suppresses this response by inhibiting the synthesis of PGE2.

Pharmacokinetics

Paracetamol is metabolised primarily by the hepatic microsomal enzymes. Paracetamol is rapidly and almost completely absorbed from the gastrointestinal tract. The concentration in plasma reaches a peak in 10 to 60 minutes, and the half-life in plasma is about 1 to 3 hours after therapeutic doses. Paracetamol is relatively uniformly distributed throughout most body fluids. Binding of the drug to plasma proteins is variable; only 20 to 50% may be bound at the concentrations encountered during acute intoxication.

After therapeutic doses, 90 to 100% of the drug may be recovered in the urine within the first day, primarily after hepatic conjugation with glucuronic acid (about 60%), surfuric acid (about 35%), or cysteine (about 3%); small amounts of hydroxylated and deacetylated metabolites have also been detected. Children have less capacity for glucuronidation of the drug than do adults. A small proportion of paracetamol undergoes cytochrome P450-mediated N-hudroxylation to form N-acetyl-benzoquinoneimine, a highly reactive intermediate. This metabolite normally reacts with sulfhydryl droups in glutathione. However, after large doses of paracetamol the metabolite is formed in amounts sufficient to deplet hepatic glutathione; under these circumstances, reaction with sulfhdryl groups in hepatic proteins is increased and hepatic necrosis can result.

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Indication

Paracetamol has analgesic and antipyretic properties and weak anti-inflammatory activity.

Cetamol is recommended for the treatment of most painful and febrile conditions, for example headache including migraine headache, toothache, sore throat, colds, influenza, rheumatic pain and dysmenorrhoea.

Dosage and administration

To be taken every four to six hours

Adults and children over 12 years: one to two tablets

6 to 12 years: one tablet or two to four 5ml spoonfuls

1 to 5 years: one to two 5ml spoonfuls

3 months to 1 year: half to one 5ml spoonfuls

under 3 months: on medical advice only

Or as directed by a doctor

Maximum dosage: Not more than four doses should be taken in 24 hours.

Contraindications

Patients with known hypersensitivity to paracetamol.

Precautions

Cetamol should be given with care to patients with impaired kidney or liver function or patients with alcohol dependence

Side effects

These are usually mild though it may cause haematological reactions including thrombocytopenia, leucopenia, pancytopenia, neutropenia and agranulocytosis

Skin rashes and other hypersensitiivity reactions occur occasionally.

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