Uses of Paracetamol

Paracetamol is an active ingredient with analgesic and antipyretic effects that is widely used. Currently there are many products containing this active ingredient and one of them is Paracetamol Choay 500mg. So what does Paracetamol Choay do?

Paracetamol Choay 500mg contains the active ingredient Paracetamol, 500mg content. In addition, this product also has some other excipients such as Maize starch, Colloidal anhydrous silica, Nipagin, Nipasol, Gelatin, Sodium lauryl sulfate, Talc and Magnesium stearate.

Paracetamol Choay is indicated for the symptomatic treatment of mild to moderate pain and/or fever.
Active ingredient Paracetamol is a group of antipyretic and peripheral analgesic drugs, also known as Acetaminophen or N-acetyl-p-aminophenol. Paracetamol Choay is an active metabolite of Phenacetin, providing effective analgesic and antipyretic effects and can replace Aspirin but has no anti-inflammatory activity. When used in similar doses, Paracetamol has similar analgesic and antipyretic effects as Aspirin.
The hypothermia effect of Paracetamol in febrile patients is rare in normal subjects. The analgesic and antipyretic effects of Paracetamol Choay come from the inhibition of prostaglandin biosynthesis in the central nervous system.
At therapeutic doses, Paracetamol has the following advantages:
Less impact on cardiovascular and respiratory systems; Does not alter acid-base balance; Does not cause irritation, ulcers or stomach bleeding; Therefore, Paracetamol is preferred as an analgesic and antipyretic in the elderly and has contraindications to salicylates or other NSAIDs.
Paracetamol used at the recommended dose is mainly metabolised by sulfate and glucuronide conjugation. A small part is converted to the potentially toxic N-acetyl-p-benzoquinonimin (NAPQ1) but NAPQ1 is detoxified with glutathione for excretion in the urine and/or bile. In case NAPQ1 is not conjugated with glutathione, it will be toxic to hepatocytes and cause cell necrosis. Therefore, when overdosed or given to some sensitive subjects (such as malnutrition, alcoholism, genetics), the concentration of NAPQ1 will accumulate, causing toxicity and necrosis of hepatocytes.

Paracetamol Choay is only used for adults and children weighing over 25kg (about 8 years old).
Adults and children weighing over 50kg (about 15 years old):
The recommended dose is 1-2 Paracetamol Choay 500mg tablets / time, can be repeated after at least 4 hours; In general, it is not recommended to take more than 3g Paracetamol Choay 500mg (6 tablets) per day. However, in case of severe pain and prescribed by a doctor, the total dose can be increased to 4g/day. Paracetamol dosage for children depends on weight, refer to age and require more appropriate drug form, specifically as follows:
Recommended dose 60mg/kg/day, divided into 4 or 6 oral doses, equivalent 15 mg/kg/dose every 6 hours or 10 mg/kg/time every 4 hours; Children weighing from 27 to 40kg (about 8 to 13 years old): Take 1 tablet of Paracetamol Choay 500mg, can be repeated every 6 hours and not more than 4 tablets/day; Children weighing 41 to 50 kg (approximately 12 to 15 years old); Take 1 tablet of Paracetamol Choay 500mg, can be repeated every 4 hours and not more than 6 tablets/day. Dosage of Paracetamol Choay for patients with impaired renal function:
Creatinine clearance less than 10 ml/min need to adjust the interval between 2 doses to 8 hours and at least 4 hours; The absolute dose of Paracetamol should not exceed 3g (6 Paracetamol Choay 500mg tablets) per day.

Paracetamol Choay should not be used in the following cases:
Allergy to Paracetamol or to any component of Paracetamol Choay; Patients with glucose-6-phosphate dehydrogenase deficiency; Patients with severe liver failure.

Although rare, the active ingredient Paracetamol can cause serious skin reactions, such as Steven Johnson syndrome (SJS), toxic epidermal necrolysis (TEN) or Lyell's syndrome, exanthematous acne syndrome. acute systemic pustulosis (AGEP); Paracetamol Choay contains the active ingredient Paracetamol and some other medicines may also contain this active ingredient. Therefore, it should be noted not to use concurrently with products containing Paracetamol due to the risk of overdose and poisoning; People with liver disease or severe kidney failure should consult a doctor before taking Paracetamol Choay; Paracetamol should be used with caution in people with pre-existing anemia, as it may obscure cyanosis due to high levels of methemoglobin in the blood; Heavy use of alcohol can increase the risk of liver toxicity of Paracetamol Choay, so it is necessary to limit or avoid drinking alcohol.

When you see a rash or unusual skin manifestations during the use of Paracetamol Choay, the patient should immediately stop the drug and contact the doctor for an examination.
Skin rash and allergic manifestations occasionally occur, usually urticaria , sometimes more severe and accompanied by fever, mucosal lesions. If you see unusual signs such as fever, blisters around natural cavities when taking Paracetamol Choay, you should think of Stevens-Johnson syndrome, a dangerous condition that requires appropriate medical intervention.
In rare cases, Paracetamol Choay 500mg has been reported to reduce neutrophils, thrombocytopenia and pancytopenia, manifested by nosebleeds or bleeding gums.

Anticonvulsants (including phenytoin, barbiturates, carbamazepine) induce enzymes in hepatocytes microsomes, thereby increasing hepatotoxicity by increasing metabolism into toxic substances; Excessive and prolonged use of alcohol may increase the risk of hepatotoxicity of Paracetamol Choay ; Metoclopramide, Domperidone may increase the rate of absorption of Paracetamol; Cholestyramine reduces the absorption of Paracetamol if used within 1 hour after taking Paracetamol Choay ; Combining Isoniazid with Paracetamol Choay increases the risk of hepatotoxicity, but the exact mechanism of this interaction has not been determined. However, patients must limit the use of Paracetamol during treatment with Isoniazid.

Paracetamol overdose can occur from a single dose or from repeated administration of high doses of Paracetamol (eg 7.5-10g daily for 1-2 days) or from prolonged use causing liver necrosis with manifestations such as: Nausea, vomiting, abdominal pain (usually occurring within 2-3 hours after taking a toxic dose of Paracetamol), Methemoglobinemia leading to cyanosis of the skin - mucous membranes and nails, agitation, delirium, hypothermia, respiratory-circulatory failure.
Manage Paracetamol overdose with active supportive treatment, gastric lavage in all cases, preferably within 4 hours after ingestion. Paracetamol detoxification therapy is the use of sulfhydryl compounds to replenish glutathione reserves in the liver, the commonly used antidote is N-acetylcysteine ​​which is effective when taken orally or intravenously., used immediately if the time is too long. Paracetamol dose less than 36 hours.
N-acetylcysteine: The first dose is 140 mg/kg, then 17 more doses, each dose is 70 mg/kg every 4 hours. If N-acetylcysteine ​​is not available, methionine can be used. Alternatively, activated charcoal and/or salt bleach can be used to reduce Paracetamol absorption.
Paracetamol Choay is indicated for the symptomatic treatment of mild to moderate pain and/or fever. To ensure the effectiveness of treatment and avoid side effects, patients need to take medicine according to prescription or consult a doctor, pharmacist for advice.
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