Paracetamol IV

Indications

Paracetamol IV is used for: Mild to moderate pain and high fever

Adult Dose

Intravenous Mild to moderate pain and fever Adult >50 kg: 1g up to 4 times a day. Max: 4 g daily. Admin by infusion over 15 min. Adult 33 to 50 kg: 15 mg/kg body wt, up to 4 times a day. Max: 60 mg/kg (up to 3 g) daily

Child Dose

Intravenous Mild to moderate pain and fever Child >12 years, >50 kg: 1g up to 4 times a day. Max: 4 g daily. Admin by infusion over 15 min. Child 2-12 years: upto 33kg: 15 mg/kg body wt, up to 4 times a day. Max: 75 mg/kg daily. Children: <10 kg: 7.5 mg/kg body wt, up to 4 times a day.

Renal Dose

Administration

The paracetamol solution is administered as a 15-minutes intravenous infusion. Paracetamol solution for infusion can be diluted in a 0.9% Sodium Chloride or 5% Glucose solution up to one tenth. In this case, use the diluted solution within the hour following its preparation (infusion time included).

Contra Indications

Paracetamol is contraindicated in patients with severe renal impairment and hepatic disease (Viral Hepatitis). Known hypersensitivity to paracetamol.

Precautions

Hepatocelluar insufficiency. Severe renal insufficiency (creatinine clearance <30 mL/min), Glucose-6-Phosphate Dehyrogenase (G6PD) deficiency, Chronic alcoholism, Anorexia, cachexia, chronic malnutrition, Dehydration, hypovolemia.

Pregnancy-Lactation

Pregnancy Published epidemiological studies with oral acetaminophen use during pregnancy have not reported a clear association with acetaminophen use and birth defects, miscarriage, or adverse maternal or fetal outcomes Lactation There is no information regarding the presence of acetaminophen in human milk, effects on breastfed infant, or effects on milk production; the developmental and health benefits of breastfeeding should be considered along with the mother’s clinical need for therapy and any potential adverse effects on the breastfed infant from therapy or from underlying maternal condition

Interactions

Hepatotoxic drugs, liver microsomal enzyme inducers. Metoclopramide. Probenecid. Colestyramine (w/in 1 hr of paracetamol administration).

Adverse Effects

Side effects of Paracetamol IV : Side effects of paracetamol are usually mild, though haematological reactions including thrombocytopenia, leukopenia, pancytopenia, neutropenia, and agranulocytosis have been reported. Pancreatitis, skin rashes, and other allergic reactions occur occasionally.

Mechanism of Action

Paracetamol exhibits analgesic action by peripheral blockage of pain impulse generation. It produces antipyresis by inhibiting the hypothalamic heat-regulating centre. Its weak anti-inflammatory activity is related to inhibition of prostaglandin synthesis in the CNS.