What is paracetamol?

Paracetamol is a medicine used to reduce pain. It can be bought over-the-counter in pharmacies, supermarkets and other shops.

How does paracetamol work?

The way paracetamol works to reduce pain and fever is not fully understood.

What is paracetamol used for?

Paracetamol is a medicine used to help ease mild to moderate pain and to lower a fever (high temperature). You can also take paracetamol for stronger pain relief in combination with codeine.

It doesn’t treat the cause of your pain, it just eases the feeling of pain.

Paracetamol can be used for:

• backache and joint pain
• headache
• migraine
• muscle strains
• period pain
• toothache
• aches and pains due to colds and flu

Taking paracetamol begins to ease pain and lower a high temperature about 30 minutes after a dose is taken. Its effects usually last for about 4 hours.

What forms of paracetamol are available?

Paracetamol comes in the following forms:

• tablets
• capsules
• suppositories
• soluble powders
• liquids

Paracetamol is made by lots of different companies and sold using different names.

It’s also often combined with other medicines and found in cold and flu medicines and headache tablets. This makes it easy to take too much paracetamol by mistake. This can be dangerous and may cause death.

Modified release paracetamol

Modified release paracetamol has a higher dose of paracetamol than standard paracetamol tablets. This can also be called:

• controlled release paracetamol
• extended-release paracetamol
• slow-release paracetamol
• sustained release paracetamol

This type of paracetamol is often used to help manage pain associated with osteoarthritis.

Modified release paracetamol is released into your body more slowly than normal paracetamol products. It is designed to be taken less often than normal paracetamol. You take a dose every 8 hours (3 times a day).

LOOKING FOR A MEDICINE? — To search by brand name or active ingredient, use the Medicines information search feature.

What are the possible side effects or risks of paracetamol?

Taking any medicine can sometimes lead to side effects, but side effects with paracetamol are rare.

Rare side effects of paracetamol may include hypersensitivity reactions, like rashes and itching, and lower than normal levels of red or white blood cells or platelets.

People react differently to medicines. Just because a side effect is listed doesn't mean you will get that side effect. It’s important to be careful when taking any medicine.

How do I take paracetamol?

It's dangerous to take more than the recommended dose of paracetamol. This may damage your liver, which can be fatal (cause death).

The suggested dose of paracetamol for adults and children 12 years and over is:

• no more than 1 gram every 4 to 6 hours
• a total of 4 grams daily

Paracetamol is sold under different brand names. This can be confusing and might make you take too much paracetamol. Always check the packet before taking any medicine.

What should I do if I forget to take a dose of paracetamol?

If you forget to take your dose of paracetamol, you should:

• take the dose as soon as you remember
• skip that dose if it’s within 4 hours of your next dose

Do not take an extra dose to make up for a missed one.

Doses of paracetamol should be taken at least 4 hours apart. Do not take more than the recommended dose over a 24-hour period.

Check the directions on your medicine package. It will tell you what to do.

What happens if I take too much paracetamol?

Liver failure can happen if you take too much paracetamol and do not get help. This can lead to death.

Symptoms of paracetamol overdose are:

• abdominal pain, nausea, vomiting
• liver problems
• seizures
• coma and death

These symptoms usually happen 24 hours after taking the drug.

You can be given an antidote if you get medical help soon after taking paracetamol. Paracetamol overdose is treated with an intravenous medicine (through a drip) called N-acetylcysteine (NAC).

How can I avoid taking too much paracetamol?

You can make sure that you don’t take too much paracetamol by:

• carefully following the directions for using paracetamol-containing medicines
• learning how to identify paracetamol as the active ingredient in medicines
• checking with your pharmacist or doctor if you’re unsure

Long-term use of paracetamol can cause:

• tiredness
• breathlessness
• your fingers and lips to go blue
• anaemia (low red blood cell count)
• liver and kidney damage
• heart disease and stroke if you have high blood pressure

Can I take paracetamol with my other medicines?

Do not take paracetamol if you are also taking other medicines that contain paracetamol. These might be:

• paracetamol and ibuprofen combination medicines
• migraine preparations
• some cough and cold remedies
• medicines prescribed by your doctor

Paracetamol is safe to take for a few days with other medicines that don’t contain paracetamol. It’s also safe to take paracetamol if you are on antibiotics.

If you take other medicines, it is important to:

• check with your doctor or pharmacist that you can take your medicine with paracetamol
• read the information leaflet that comes with your medicine

Warfarin and paracetamol

Paracetamol is the suggested painkiller for people taking warfarin.

You should take the lowest dose that helps your pain. If you're still in pain after taking paracetamol for 3 or 4 days, speak with your doctor.

Long-term use of paracetamol may increase the effect of warfarin. This can increase your chance of bleeding. However, this is unlikely to happen if you only take paracetamol occasionally.

ASK YOUR DOCTOR — Preparing for an appointment? The Pain Question Planner can help you create a list of questions for your doctor.

When should I not take paracetamol?

Do not take paracetamol if you have:

• an allergy to paracetamol
• taken other medicines that contain paracetamol
• already taken the recommended dose within a 24-hour period

Check with your doctor or a pharmacist before taking paracetamol if you:

• have liver problems
• have kidney problems
• drink more than the recommended amounts of alcohol
• are very underweight — you will need a smaller dose

Paracetamol, food, alcohol and driving

Will paracetamol affect my driving?

Paracetamol is unlikely to affect your driving.

Read more about medicines and driving.

Is it okay to drink alcohol when I’m taking paracetamol?

Drinking a small amount of alcohol is unlikely to be harmful if you are taking paracetamol.

Read more about medicines and alcohol.

Are there any foods I should avoid?

You can eat normally when taking paracetamol.

Can paracetamol be given to children?

Don't give paracetamol to babies younger than one month old.

You can give your child paracetamol if they have a high temperature, and this is making them uncomfortable. Talk to a doctor if the fever does not get better.

You can give paracetamol to your child after their vaccinations (shots) to treat pain and fever.

How much paracetamol should I give my child?

For children aged 1 month to 12 years old, the dose is 15 milligrams per kilogram. Paracetamol can be given every 4 to 6 hours if needed. Do not give children more than 4 doses in 24 hours.

Check the label on your liquid paracetamol product for dosing instructions.

Learn more about giving paracetamol to babies and children.

Paracetamol comes in different strengths for different ages. It’s important to choose the right paracetamol product for your child's age.

Make sure that you:

• always read the medicine label and packaging before use
• know your child's weight as the recommended dose of paracetamol is based on their weight

When giving your child paracetamol:

• never give more than the maximum recommended dose
• never give more doses than recommended in a 24-hour period

When giving your child medicines, you should:

• measure liquid medicines accurately using the syringe that comes with the medicine
• write down all the medicines you give them and the time when you give them

Don't give your child paracetamol for more than 48 hours unless told to do so by a doctor.

Always keep medicines in a safe place, out of the reach of children.

Can I take paracetamol if I’m pregnant?

Paracetamol can be used during pregnancy. Paracetamol crosses the placenta but doesn’t appear to raise the chance of birth differences or bad pregnancy outcomes.

As with any medicine taken during pregnancy, you should get medical advice before taking paracetamol.

If you take paracetamol when pregnant, make sure that you take it:

• at the lowest effective dose
• for the shortest possible time

Can I take paracetamol if I’m breastfeeding?

Paracetamol is the first choice of painkiller if you are breastfeeding.

If you take paracetamol when breastfeeding, make sure you take the recommended dose, for the shortest possible time.

It appears in breast milk in very small amounts, which is very unlikely to harm your baby.

When should I see my doctor?

Talk to your doctor or pharmacist if you:

• experience side effects that trouble you
• have signs of an allergic reaction
• find that paracetamol isn’t relieving your pain or fever
• are pregnant or breastfeeding

You should also talk to your doctor if you have been taking paracetamol for a long time.

FIND A HEALTH SERVICE — The Service Finder can help you find doctors, pharmacies, hospitals and other health services.

Resources and support

• If you are worried that you have taken too much paracetamol, call the Poisons Information Centre on 13 11 26.
• Asking your doctor about your treatment or medicine is important. Read our guide of important questions to ask your pharmacist or doctor before taking a medicine.
• You can also see healthdirect's list of medicines that contain paracetamol. This shows all drugs that contain paracetamol as an active ingredient.
• Learn about what to do if you have a problem with a medicine.

You can also call the healthdirect helpline on 1800 022 222 (known as NURSE-ON-CALL in Victoria). A registered nurse is available to speak with 24 hours a day, 7 days a week.