No shortage here: Paracetamol trivia to know before your next drugstore visit

MANILA, Philippines — Also known as "acetaminophen," paracetamol is a generic drug commonly used to treat fever and mild to moderate pain.

According to the 2017 medical book "Pharmacology Application in Athletic Training," paracetamol was probably invented either in 1877 as an analgesic or in 1852 as a synthesized drug in Johns Hopkins University in Maryland, USA.

Maryland's National Center for Biotechnology Information added that paracetamol was first clinically used by German pharmacologist Joseph von Mering in 1893, but it did not appear commercially in the United States until 1950. 

In light of recent claims that there is a paracetamol shortage in Philippine drugstores, which the Department of Health denied, here are some facts about the much-talked about drug:

Reportedly the most used medicine in the Philippines

In the Philippines, paracetamol is reportedly the most used medicine for children’s fever and pain, claimed paracetamol label Calpol in a statement sent to Philstar.com.

According to the 2016 study "Essentials of Emergency Medicine," paracetamol is the most commonly used medication in US and Europe for pain and fever.

It is included in World Health Organization's List of Essential Medicines as treatment for inflammation and acute attack.

Not only for fever 

“Paracetamol is a useful medicine for treating fever and providing pain relief. Understanding and checking the correct doses is vitally important if parents are to use it safely and effectively,” shared Dr. Carmina De Los Reyes, Pediatrician and Infectious Disease Specialist, in a Calpol statement sent to Philstar.com.

Headache, body aches, or fever usually accompany a common cold and flu as well as dengue and other serious cold season illnesses. "To manage the pain and bring down a fever, you need to have paracetamol and ibuprofen,” said Dr. Jose Sanchez, Makati Medical Center's General Medicine Section Chief, in a separate statement e-mailed to Philstar.com.

“If you have children at home, it’s important that you also have pediatric non-aspirin product on hand, too.”

Like all medicines, COVID-19 vaccines may have side effects, most of which are mild and short-term, and not everyone experiences them. Common adverse effects, such as numbness or pain at injection site, usually last for one to three days. If you experience fever, or flu-like symptoms, pain, or muscle aches, you may take paracetamol every four to six hours as needed, said Dr. Nina Gloriani, head of the vaccine development expert panel of the Department of Science and Technology (DOST), in an AXA Philippines press statement sent to Philstar.com.

Proper dosage is key

Children are no stranger to coughs, colds and fevers. You probably know the drill when your child gets sick — check the temperature, give medicine, make sure they rest and drink water, and so on. But, have you really ticked all the boxes?

When managing fevers, it is not enough to give them the correct medication. You also need to ensure that the medicine is given in the right dosage to achieve optimal results. This helps avoid prolonging your child’s discomfort.

Experts, however, say that Filipino parents frequently make dosing mistakes, despite 53% of them claiming confidence in administering the medicine, a recent study by Calpol showed.

“Ensure the dosage is correct. The correct dose of paracetamol for a child depends on their weight. You should always give the dose according to your child’s weight to ensure the efficacy of paracetamol," De Los Reyes advised.

Calpol's pediatric study found that measuring dosage with teaspoon/tablespoon doubles the risk of dosing errors among children below nine years old. This is because the sizes and volumes of kitchen spoons vary. For example, the capacity of a normal kitchen teaspoon can range between 1.5 mL to 9mL, which results in a huge difference in the intended dosage. 

According to doctors, some parents also do not understand or are confused by measurement abbreviations such as tsp (teaspoon) and tbsp (tablespoon). This confusion can be attributed to the markings on the supplied dosing device, which can be inconsistent with the instructions. Without knowing what the abbreviations mean, it can be difficult to measure the dose correctly even if you know the prescription for your child.

Now that you are aware of these common mistakes, how can you make sure your child receives the right dosage?

The World Health Organization (WHO) recommends the use of the measuring device provided with the medication. Similarly, expert groups, such as American Academy of Pediatrics (AAP), also recommend measuring dosage in milliliters (ml) to avoid confusion. 

Other medicines also contain paracetamol

In a Calpol press statement, the paracetamol brand advised that it should not be taken with other medicines that contain paracetamol.

Paracetamol is also found in other medicines used to treat pain, fever, symptoms of cold and flu, and sleep medications.

Consult a physician first

Although paracetamol can be bought without prescription, if the patient has especially been diagnosed with a liver or kidney disease, it’s best to consult a doctor before taking paracetamol. 

According to the US Food and Drug Administration, paracetamol can potentially cause liver damage if taken beyond the recommended maximum daily dose of three to four grams. Paracetamol toxicity has been reported by many medical journals as the foremost cause of acute liver failure and accounts for most drug overdoses in the US, United Kingdom, New Zealand and Australia.