Are you overusing paracetamol? What a doc wants you to know

There’s no doubt about it – the demand for paracetamol-based products has been on the upward trend in Singapore, in line with the rise in Covid-19 cases, especially during the Omicron wave in the first quarter of 2022. 

Paracetamol, which is offered by brands such as Panadol, Tylenol and Nuromol, has been recommended in Singapore as the default medication to take for post-vaccination aches and pains, as well as for patients recovering from Covid.

Dr Raymond Ong, senior doctor at Doctor Anywhere explains: “More recently, we are seeing a local demand for paracetamol products during Covid-19 and the Omicron wave. This comes especially as home recovery is encouraged for those who had mild symptoms of the virus, and paracetamol is a helpful medicine to have at home to alleviate Covid-19 symptoms such as fever or headaches.”

So, how exactly does paracetamol work?

“Paracetamol, also known as acetaminophen, is a medicine that is well-established with few reported side effects, and can be used to reduce fever, headaches, body aches as well as general pain,” says Dr Ong. “The medicine has been available for over 70 years and is one of the most commonly used pain relievers worldwide.”

“Paracetamol is an analgesic and an antipyretic. To put it simply, it is a medication that can relieve pain and lower body temperature,” he adds. 

When our body is in pain, it produces prostaglandins (chemicals that control the immune process of the body) in response to injuries and diseases. Dr Ong says that paracetamol presumably reduces prostaglandins and makes us feel less pain, thereby increasing pain tolerance. 

Is there any difference between Panadol, Tylenol, Nuromol, and other paracetamol brands then?

All these brands contain the active ingredient paracetamol or acetaminophen, so theoretically, they share this basic purpose, which is to relieve pain.

Are you taking the right dose?

While the recommended maximum dosage for paracetamol is no more than eight tablets a day, bear in mind that you should only take it when needed, and it is not required to be taken daily. The recommended dosage for adults is two 500mg paracetamol tablets at a time.

Dr Ong warns that you should not pop more than two tablets at any time and ensure that there is a gap of at least four hours between each dose.

It is important to note that different paracetamol brands come in different dosages and you should read the product information to be informed of the recommended dosage. If you're unsure, reach out to a healthcare professional for clarity.

You should know this by now: Consuming too much paracetamol – whether intentional or not – would result in overdose and side effects, such as liver problems. This can be identified with nausea, sudden weight loss, yellowing of eye and skin or unexplained bruising or bleeding.

There’s also the issue of overreliance on medication.

“With overdosages of medications of any kind, the body can, in the long run, develop a stronger reliance on the product and this can lead to more dependence on the medicine and possibly an addiction,” Dr Ong shares. 

To avoid overdosing, he recommends the following:

1. Be mindful of the dosage recommendations of the product 
2. Observe any side effects that the body may be signalling (i.e. swelling, loss of appetite, diarrhoea) 
3. Consult a doctor if you are unsure of how to consume the product in a safe manner 

Other things you should know about paracetamol

There’s a lot of information out there about paracetamol, and it’s important to know what’s true and what isn’t. “It is definitely challenging to get the right source of information, especially as patients are subject to misinformation as websites, emails and text messages can also falsely claim health information," says Dr Ong.

Here are 5 things Dr Ong wants you to know about paracetamol.

#1: Paracetamol is not a quick fix for all medical conditions

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This is a common misconception that should be dispelled. Paracetamol is typically prescribed to those who require relief for mild or moderate pain, such as body aches, headaches and reducing fevers. However, it is not a one-size-fits-all solution and should still be subjected to a health professional’s advice.

#2: The role of paracetamol in treating Covid

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While paracetamol does not treat Covid-19, it is safe for Covid-19 patients to use paracetamol for pain management.

“For mild to moderate symptoms in particular, paracetamol can be a supportive tool to reduce discomfort and pain from symptoms such as fever and headaches. In addition to sufficient rest and plenty of water, patients who have Covid can use paracetamol as part of home treatments for the virus,” Dr Ong advises.

#3: How long it takes for paracetamol to take effect

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Paracetamol can be a supportive tool to help reduce discomfort and pain for mild to moderate symptoms such as fever and headaches. It usually comes in tablet form and upon consumption, typically takes 15 to 30 minutes to provide relief. The effects typically last for four to six hours, depending on the dosage for each paracetamol product, which vary from brand to brand. It is important to refer to the product information or consult a medical professional for advice if you’re unsure.

#4: When not to take paracetamol

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It is not recommended to consume paracetamol with other paracetamol products as this may lead to an increased risk of overdose, which may result in a detrimental health impact. If you're also taking other medications – including supplements and herbal remedies – inform your healthcare professional before taking paracetamol.

Paracetamol may also not be suitable for those with existing health problems such as liver problems, kidney disease or allergic reactions to ingredients of paracetamol products.

#5: Taking paracetamol while pregnant or breastfeeding

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Paracetamol is safe to take during pregnancy. Pregnant women may experience several body aches or headaches and paracetamol may be helpful to alleviate mild pains.