Recommended Interval Between 1g Paracetamol Doses
The minimum interval between 1g paracetamol doses is 4 hours, with a maximum of 6 doses (6g total) in 24 hours, though for safety reasons you should limit the daily maximum to 4g (4 doses) in routine practice. 1, 2
Standard Dosing Intervals
The minimum gap between any paracetamol dose is 4 hours, which applies to the 1g dose specifically. 1
The typical dosing regimen is 650-1000 mg every 4-6 hours, meaning you can dose as frequently as every 4 hours or space it out to every 6 hours depending on pain control needs. 1, 2
While technically 6 doses of 1g (6000 mg total) could be given in 24 hours at 4-hour intervals, the FDA maximum daily limit is 4000 mg per day, which effectively limits you to 4 doses of 1g in 24 hours. 1, 2
Critical Safety Considerations
Never exceed 4000 mg total daily from all sources combined - this includes over-the-counter cold remedies, sleep aids, and opioid combination products that contain paracetamol. 1, 2, 3
For chronic daily use, limit to 3000 mg per day maximum to minimize hepatotoxicity risk with long-term administration. 1, 2
Repeated supratherapeutic ingestions (taking doses too close together or slightly above recommended amounts) carry a worse prognosis than acute single overdoses, accounting for approximately 30% of paracetamol overdose admissions. 1, 3
Practical Dosing Algorithm
For acute pain: Give 1g every 4-6 hours as needed, with minimum 4-hour intervals between doses, not exceeding 4 doses (4g) in 24 hours. 1, 2
For chronic pain management: Use 1g every 6 hours (maximum 3g daily) rather than every 4 hours to stay within the safer 3000 mg daily limit. 1, 2
If pain control is inadequate at 3-4g daily: Add adjuvant therapies such as topical lidocaine, NSAIDs, or regional nerve blocks rather than exceeding the daily maximum or shortening the dosing interval below 4 hours. 1
High-Risk Populations Requiring Modified Intervals
Patients with liver disease or cirrhosis: Maintain the 4-hour minimum interval but reduce total daily dose to 2000-3000 mg (2-3 doses of 1g maximum). 2, 3
Chronic alcohol users: Use the same 4-hour minimum interval but limit to 2000-3000 mg daily total, as hepatotoxicity can occur at lower doses in this population. 2, 3
Elderly patients (≥60 years): The 4-hour minimum interval remains unchanged, but consider reducing total daily dose to 3000 mg maximum (3 doses of 1g). 1, 2
Common Pitfalls to Avoid
Failing to account for combination products: Many prescription opioid combinations now contain ≤325 mg paracetamol per tablet, but patients may not realize they're taking paracetamol when using these alongside standalone paracetamol tablets. 1, 2
Taking doses too close together: Even if total daily dose stays under 4000 mg, taking doses closer than 4 hours apart increases risk of toxicity. 1
Using multiple OTC products simultaneously: Cold remedies, sleep aids, and pain relievers often contain paracetamol - explicitly counsel patients to check all product labels. 3