Dangers of the common drug Paracetemol

Dangers of the common drug Paracetemol

People take the drug for everything from headaches, fevers, cramps, allergies & even hangovers, but few understand the safety rules for making sure paracetemol doesn't really hurt you.


The Dangers of Paracetemol

Experts suggest a common household painkiller like paracetemol should be personalized to prevent overdose and toxicity
Adapted from Muse article by Arusa Pisuthipan

Thai people take an estimated 100 million pills of paracetamol pain reliever per year. 

Tylenol, Sara and Panadol are some of the brands it is sold under in Thailand and in the United States, Canada (and in Japan it is called acetaminophen).

Paracetemol is sold as a cure for everything from headaches, fevers, cramps and even hangovers with the standard instructions: two tablets every four hours.

Paracetamol is found in such combination drugs as Tiffy and Decolgen used as a cure for several complaints including pain, fever, as well as allergies.

Due to the over-consumption and misuse of paracetamol among Thais, the Food and Drug Administration (FDA) has recently raised concerns over its use. There have been several reported cases of paracetamol toxicity — a consequence of unintentional drug overdose where ignorance about dosage is mainly to blame.

Some of the major reasons behind paracetamol overdose are patients receiving a dosage of paracetemol from several different drugs and also a wrong dosage that doesn't match the person's body weight.

Most of us understand that two tablets of 500mg paracetamol is to be taken every four hours when we get a fever or experience pain. But such a dosage is not necessarily correct. Paracetamol dosage should be adjusted on a case-by-case basis, based on a person's weight.

People should also be encouraged to take the 325mg version of paracetamol instead of 500mg.

One common problem is that many paracetemol products have no dosage instructions or the instructions are printed too small.

Finally, when you take paracetamol, ask yourself if it is really necessary. If not, then don't take it.


To work out the correct dosage of paracetamol, simply multiply the body weight by 10, and the result is the amount in milligrammes of paracetamol a person should take each time. For example, if your body weight is 50kg, the right dose of paracetamol is 500mg. This means you are only required to take one tablet of 500mg paracetamol for each dose. If you, however, weigh 65kg, you may take two tablets of the 325mg version per dose which is equivalent to 650mg of paracetamol.

The maximum amount of paracetamol intake in a 24-hour period should not exceed 4,000mg, equivalent to eight tablets of 500mg each. And the drug should be taken every six hours — instead of four — to prevent overdose.


Apart from body weight, whether a person drinks alcohol or not should also be taken into account when it comes to working out the right paracetamol dosage

In a healthy person, paracetamol is eliminated from the body in the liver and finally passed out of the body through the urine. A substance called glucoronide is required as part of the excretion of toxins and drugs. So in the case of people who drink a lot of alcohol, the body already uses glucoronide to rid alcohol and subsequently the body’s ability to remove paracetamol might not be as good as the non-drinkers.

Even the right dosage of paracetamol based on body weight can become toxic for drinkers because the process of getting rid of paracetamol from the body cannot function in full.


Excessive use of paracetamol is likely to cause liver injury. People with paracetamol toxicity may develop no symptoms at all in the first 24 hours following overdose. Others may initially have non-specific symptoms such as abdominal pain, nausea or breathing difficulty. In some serious cases, nonetheless, when paracetamol overload leads to liver inflammation followed by liver failure, patients may develop jaundice.

In relatively healthy people, the excess amount of drug will be passed out (excreted) through the urine. But if this process fails, doctors might consider administering medication to help the body flush out paracetamol.


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  • abdominal (adj): involving the part of your body between your chest and legs which contains your stomach and other organs - ช่องท้อง (ช่องพระนาภี)
  • adjust: to change something slightly, especially to make it more correct, effective, or suitable - ปรับ
  • administer (verb): to give drugs, medicine, etc. to somebody - ให้ (ยา), จ่ายยา
  • alcohol: drinks such as whiskey, beer, wine, etc that make people feel good and become drunk - เหล้า, สุรา
  • allergy: a medical condition in which you become sick or your skin becomes covered with red marks as a reaction to something you eat, breathe or touch - อาการแพ้  ภูมิแพ้
  • apart from (prep): except for - นอกเหนือจาก
  • based on (verb): information or facts used to make a story, calculation, judgement or decision - ตั้งอยู่บน,ยึดเป็นหลัก
  • blame: to be responsible for something bad - เหตุขัดข้อง
  • brand: a type of product made by a particular company - ตรา, ยี่ห้อ
  • breathing (noun): bringing air in and out of the lungs - การหายใจ
  • case: a particular situation or a situation of a particular type - กรณี, เหตุการณ์, สถานการณ์
  • case-by-case basis: considering cases one by one - โดยพิจารณาเป็นกรณีไป
  • combination (noun): the mixture you get when two or more things are combined - การรวมกัน
  • common: ordinary; not unusual or special - ที่เกิดขึ้นทุกวัน, ธรรมดา
  • complaint: when someone says that something is wrong or not satisfactory - การร้องเรียน
  • concern: a worry - ความกังวล
  • consequence: result of effect of something - ผลที่ตามมา
  • consumption: using, eating or drinking something - การบริโภค
  • correct (adjective): right, done the right way, without any mistakes or errors - ถูกต้อง, ไม่มีผิดพลาด
  • cramp: a condition in which you experience a sudden pain when the muscles in a particular part of your body contract, usually caused by cold or too much exercise - ตะคริว
  • cure: to make someone with an illness healthy again - รักษา, รักษาให้หาย
  • dosage: an amount of drug that you take at a single time - ปริมาณยาที่ให้ต่อครั้ง
  • dose (noun): an amount of drug or something else that you take at a single time or affects you at a single time - ปริมาณที่ให้ต่อครั้ง
  • eliminate: to get rid of completely - กำจัดหรือขจัดให้หมดไป
  • encouraged: having more confidence or hope about something - มีกำลังใจ
  • equivalent: the same as; equal to - เท่าเทียมกันกับ
  • estimated: thought to be a particular amount, size, etc. based on a guess or the best information available - ประมาณการ
  • exceed: to be more than something; to go beyond a limit - เกินกว่าที่กำหนด
  • excess: an amount by which something is larger than something else - ส่วนเกิน
  • excessive: much greater than is usual; too much of something   - มากเกินปริมาณที่พอดี
  • excretion: getting rid of something from the body, through the urine, for example -
  • experience (verb): to have something happen to you or to live through some event - ประสบ
  • expert: someone who has a particular skill or who knows a lot about a particular subject - ผู้เชี่ยวชาญ
  • FDA (noun): the Food and Drug Administration, a government agency responsible for food and drug safety - อย. , สำนักงานคณะกรรมการอาหารและยา
  • fever: an abnormally high body temperature - ไข้
  • flush (verb): (of a large amount of water) to suddenly (cause to) flow through or out - ทำให้น้ำไหลพุ่ง,
  • function: to work or operate in a normal way - เป็นปกติ  ใช้การได้ปกติ
  • hangover (noun): the bad feeling the day after drinking a lot of alcohol - อาการเมาค้าง, เมาค้าง
  • headache: a person or thing that causes worry or trouble - ปัญหา
  • household: a group of people, often a family, who live together - ครัวเรือน
  • ignorance: a lack of knowledge or information about something - ความไม่รู้
  • inflammation: a red, painful and often swollen area in or on a part of your body - การอักเสบ
  • initially: at first - ในเบื้องต้น
  • injury (noun): physical damage done to a person or a part of their body - อาการบาดเจ็บ
  • instructions: something that somebody tells you to do - คำสั่ง
  • intake: the amount that goes into someone or something -
  • liver: a large organ in the body that cleans the blood and produces bile - ตับ
  • major: very large or important - สำคัญมาก
  • match: to be the same as or very similar to something else - เท่าเทียมกันกับ, เท่ากันกับ
  • maximum: the most possible - ที่สูงสุด ที่มากที่สุด
  • medication: a medicine, or a set of medicines or drugs used to improve a particular condition or illness - ยารักษาโรค
  • misuse (verb): to use something in an unsuitable way or in a way that was not intended - ใช้ในทางที่ผิด
  • nausea: the feeling that you are going to vomit (throw up food from the stomach) - อาการคลื่นไส้
  • necessary (adj.): essential, needful, something that you must do or have - จำเป็น, ซึ่งเลี่ยงไม่ได้, ซึ่งเป็นที่ต้องการ, สำคัญ
  • not necessarily: possibly true but not definitely or always true -
  • overload: having too much of something to be able to handle or process it - ใช้งานมากไป
  • pain: the feelings that you have in your body when you have been hurt or when you are ill/sick; mental or emotional suffering - ความเจ็บปวด
  • patient: someone who is receiving medical treatment - คนป่วย, คนไข้
  • period: a particular length of time - ระยะเวลา
  • personalized: made personal, made private - มีลักษณะส่วนบุคคล
  • prevent (verb): to stop somebody from doing something; to stop something from happening - ขัดขวาง, ป้องกัน, กัน, กีดขวาง
  • purge: to remove, often violently - กำจัด
  • raise: to increase the amount or level of something - ทำให้สูงขึ้น, ส่งเสริม, ยกระดับ
  • reason (noun): why something happened or exists - เหตุผล
  • recently (adverb): not long ago - เมื่อไม่นานมานี้, เมื่อเร็วๆ นี้
  • relatively: somewhat; in comparison with someone or something similar - ค่อนข้าง
  • report (verb): to tell someone officially that something exists or happened - รายงาน
  • results (noun): what you get in the end when activity is completed (test results, research results, etc) - ผล
  • rid: to cause to be free of somebody/something that has been annoying you or that you do not want - ขจัด, กำจัด, ทำให้หมดไป
  • specific: involving or relating to only one particular thing or type of thing - เฉพาะเจาะจง, โดยเฉพาะ
  • standard: average or normal rather than having special or unusual features - ซึ่งเป็นมาตรฐาน
  • subsequently: happening or coming after something else - ซึ่งตามมา
  • substance: a particular type of liquid, solid, or gas - สาร
  • suggest: to mention an idea or a plan for somebody else to think about - เสนอ, เสนอแนะ
  • symptom: a sign that someone has an illness - อาการ
  • tablet: a small round solid piece of medicine or other substance that you swallow - ยาเม็ดแบน
  • take into account: to consider; to think carefully about the various factors involved before making a decision or developing an opinion - พิจารณา, คิดอย่างละเอียด
  • toxic: poisonous and harmful to people, animals or the environment - เป็นพิษ  (toxicity is the level or degree to which something is poisonous)
  • toxicity (noun): being poisonous and harmful to people, animals or the environment; the level or degree to which something is poisonous - เป็นพิษ
  • toxins: poisonous substances, especially ones which are produced by bacteria and which cause disease - พิษ
  • unintentional: not done deliberately, but happening by accident - โดยไม่เจตนา
  • urine: liquid waste passed from your body - น้ำปัสสาวะ
  • version: a particular form of something which varies slightly from other forms of the same thing - ชุด, เวอร์ชั่น
  • work out (verb): solve problems - แก้ปัญหา
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