PCM @ Tylenol

Myth of Paracetamol


Seen by a pediatric patient's mother today. Worried and anxious, she asked regarding the dose and myth of Paracetamol before giving it to her child. 
 

" Legends says that, when Paracetamol is taken, it will remain in the body until the day one dies. "


*Staring at her in disbelief*  (  O_O)


This is what was told by her, with a concern that her newborn child will have to bear the Paracetamol in its body until the day it passes away.


Sounds funny and unbelievable, but this is what happens right now in reality due to misinformation.


Paracetamol (PCM) @ Panadol®, also known as Acetaminophen (AAP) @ Tylenol® in some regions, especially in the US, is a wonderful drug. It is can be found worldwide in different brands and strength.


PCM can be used as either mild analgesic or antipyretic for treating fever. However, how it actually works is still a mystery itself. 


Some debate that it works through prostaglandin synthesis inhibition, whereas some say that it interacts with cannabinoid receptors located in the brain.


So, how to determine the dose for PCM through weight-based dosing?


It's very simple. 


For pediatrics, Ideal Body Weight or Actual Body Weight can be used, whichever is lower:
15mg/kg per dose with a maximum of 60mg/kg daily dose.

i.e. Weight = 12kg         Age = 3 years old

Ideal body weight (IBW) = 15kg

Amount of PCM per dose = 180mg

Maximum daily dose = 720mg

For Adults, one should be counseled that PCM should not be taken more than 4g per day (i.e. total of 8 x 500mg tablets in divided doses such as 1000mg four times daily)


To answer regarding the myth about PCM remains lifelong in the body. We must first understand one thing. 

What is a half-life?



A half-life is the time taken for a particular drug to have its original concentration by halves.


To estimate whether a drug has been eliminated from our body, it usually takes around 4 to 5 half-lives.


PCM has a half life of approximately 2 hours. Theoretically, it will be left in negligible amount within our body after a day. 

In short, it is safe to take PCM as long as the maximum dose is not exceeded.

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