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Therapeutic dose ranges of parenteral acetaminophen

Aims & objectives

1)tackle drug therapy problem

2) pharmaco-economics of paracetamol use


  • Paracetamol (aka Acetaminophen)

Paracetamol – otherwise known as acetaminophen – is a mild pain killer (analgaesic), but it also acts to reduce fevers (antipyretic). The exact mechanism of action of Paracetamol is as yet unconfirmed, although scientists are currently working on various hypotheses. Paracetamol should be used to reduce pain caused by toothache, headaches, joint and muscle pain – such as mild arthritis pain.

  • Paracetamol does not need to be taken after food and can usually be safely taken with other medications
  • Many at times it’s involved in therapy for pain and used as a combination to achieve synegism.
  • Synegistic effects :As a concept of synegism, which is the interaction or cooperation of two or more  substances,  to produce a combined effect greater than the sum of their separate effects.
  • The combination of analgesics of proven efficacy is a
    strategy intended to achieve one or more therapeutic
    goals, such as facilitating patient compliance, simplifying
    prescribing, improving efficacy without increasing
    adverse effects or decreasing adverse effects without loss of efficacy (Raffa, 2001; Hyllested et al., 2002).
  • the data of the present study demonstrated that paracetamol combined with NSAIDs produces a supra-additive or synergic analgesic effect.
  • Hence ,It is possible to take paracetamol and ibuprofen at the same time, as they work in the body in different ways. Therefore avoiding to tackle adverse effects produced by high dose of pcm or NSAIDs.
  • Hence as stated by Mark Twain ‘ synergy is the bonus that is achieved when things work together

 ‘Let’s achieve our goal through synegy’


One of the intrinsic factor in DTP is dose to high.

Which may not necessary mean it’s at a toxic dose ,may just be a dose not simply necessary.

The recommended /ideal dose of parenteral acetaminophen as described in emdex to be administered for adults is 300-600mg. A dose higher than this can be used as a loading dose to tackle the immediate problem but an idepl maintenance is at this range.

As the saying goes “there’s an exception to every rule”

There are instances where higher doses are maintained such as in trauma, and cases associated with severe pain.

Never the less it’s benefitiary to start every antipyretic or analgesic treatment using acetaminophen by starting with the least effective dose.

Despite the fact that the highest dose to be taken in a day should not be more than 4gms it’s not necessary to play around within the safe zone.


As a matter of pharmaco-economics, maximum benefits is reached with limited cost /use of medicines..

More paracetamol injections available to treat other cases while still being able to tackle the immediate need for pain relieve and analgesia.


Hepatotoxicity is the most prevalent outcome for paracetamol toxicity,but meta-analysis of paracetamol use has also been linked to kidney disease.Acute tubular necrosis has been found to be the adverse effects found with use of toxic dose paracetamol.



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