What is the use of Panadol (Paracetamol)?

From the Guidelines

Panadol, also known as paracetamol or acetaminophen, is recommended as the first-line oral analgesic for pain management due to its efficacy, safety, and low cost, with a standard adult dose of 500-1000 mg every 4-6 hours as needed, not exceeding 4000 mg in 24 hours 1.

Key Points to Consider

• The use of Panadol is supported by evidence from various studies, including a study published in the Annals of the Rheumatic Diseases, which found that paracetamol is effective in relieving pain due to osteoarthritis, with an effect size of 0.21 and a number needed to treat of 2 1.
• Panadol works by inhibiting prostaglandin synthesis in the central nervous system, reducing pain signals and lowering fever by affecting the hypothalamic heat-regulating center.
• It's generally well-tolerated but can cause liver damage at high doses or with long-term use, especially when combined with alcohol.
• Unlike NSAIDs such as ibuprofen, Panadol doesn't reduce inflammation significantly and has minimal effects on stomach lining or blood clotting.

Important Considerations

• Always follow package directions and consult a healthcare provider for persistent symptoms.
• Be aware that acetaminophen is found in many combination cold and flu medications, so track your total daily intake to avoid accidental overdose.
• A recent study published in the World Journal of Emergency Surgery found that acetaminophen in a multimodal regimen is a valid and effective option for postoperative pain management, with a cost-effective strategy to improve outcomes and patient satisfaction 1.

Potential Side Effects and Interactions

• Liver damage at high doses or with long-term use, especially when combined with alcohol.
• Potential increase in alanine aminotransferase levels with intravenous acetaminophen infusion 1.
• Caution is needed in frail patients, especially in the context of coexisting liver disease.

From the FDA Drug Label

Temporarily relieves minor aches and pains due to: headache muscular aches backache minor pain of arthritis the common cold toothache premenstrual and menstrual cramps Temporarily reduces fever The answer to the question about Panadol is that it is used for relieving minor aches and pains and reducing fever, as it is another name for paracetamol.

• Key uses include:
  • Relieving headache
  • Relieving muscular aches
  • Relieving backache
  • Relieving minor pain of arthritis
  • Relieving toothache
  • Relieving premenstrual and menstrual cramps
  • Reducing fever 2

From the Research

Panadol Overview

• Panadol, also known as paracetamol or acetaminophen, is a widely used analgesic for mild to moderate acute pain 3.
• It is generally well tolerated at recommended doses (≤4 g/day) in healthy adults and may be preferable to non-steroidal anti-inflammatory drugs (NSAIDs) that are associated with undesirable gastrointestinal, renal, and cardiovascular effects 3.

Comparison with Ibuprofen

• Ibuprofen is consistently superior to paracetamol at conventional doses in a range of painful conditions, including acute post-operative pain, dysmenorrhoea, tension-type headache, migraine, osteoarthritis, and rheumatoid arthritis 4.
• However, paracetamol is often the first line analgesic recommended, without consensus about which is the better analgesic 4.
• A study comparing the efficacy of paracetamol, ibuprofen, and a combination of the two drugs in relieving pain and fever in the pediatric age group found that the combination of paracetamol and ibuprofen showed enhanced effectiveness in fever and pain relief, with minimal adverse effects and no significant derangements in biochemical parameters 5.

Safety Profile

• Paracetamol is a suitable first-line analgesic for mild to moderate acute pain in many adults with liver, kidney or cardiovascular disease, gastrointestinal disorders, asthma, and/or who are older 3.
• However, hepatotoxicity is a concern, although it is rare among adults who use paracetamol as directed, including people with cirrhotic liver disease 3.
• Ibuprofen has a good safety profile comparable with paracetamol at low doses (800-1,200 mg day(-1)), but higher prescription doses (circa 1,800-2,400 mg day(-1)) may be associated with greater risks of gastrointestinal, renal, and cardiovascular events 6.

Clinical Use

• Pharmacologic management of acute pain should be tailored for each patient, including a review of treatment expectations and a plan for the time course of prescriptions 7.
• Acetaminophen and NSAIDs, such as ibuprofen, are first-line treatment options for most patients with acute mild to moderate pain 7.
• Topical NSAIDs are recommended for non-low back, musculoskeletal injuries, and adjunctive medications may be added as appropriate for specific conditions if the recommended dose and schedule of first-line agents are inadequate 7.