Prakt. lékáren. 2012; 8(5): 214-216 [Interní Med. 2011; 13(3): 140-142]

How to increase analgesic efficacy of paracetamol?

prof.MUDr.Miloslav Kršiak, DrSc.
Ústav farmakologie 3. lékařské fakulty Univerzity Karlovy v Praze

A usual single dose of paracetamol (500 mg per os) represents a subthreshold dose (< 10 mg/kg) in patiens with body weight over 50 kg

(i. e. in most adults). A single dose of 1 g of paracetamol is therefore recommended in patients over 60 kg in weight. If paracetamol does

not inhibit pain sufficiently even at this dose (1 g), then another analgesic is to be selected or combinations of paracetamol with other

drugs can be used, e. g. those with opioids, NSAIDs (if possible), caffeine or others. Sometimes it may be helpful to speed up absorption

of paracetamol by using effervescent or well soluble paracetamol preparations per os.

Keywords: paracetamol (acetaminophen), pain, dosage, plasma concentrations, analgesic combinations

Published: November 1, 2012  Show citation

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Kršiak M. How to increase analgesic efficacy of paracetamol? Praktické lékárenství. 2012;8(5):214-216.
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    References

    1. Kršiak M, Švihovec J, Zupanets I, Kriška M. Optimální dávkování paracetamolu při léčbě bolesti a horečky. Praktické lékárenství 2009; 5: 168-171.
    2. Moore A, Edwards J, Barden J, McQuay H. Bandolier's Little book of pain. Oxford: Oxford University Press, 2003. 453 s.
    3. de Maat MM, Tijssen T, Bruggemann R, Ponssen H. Paracetamol for intravenous use in medium - and intensive care patients: pharmacokinetics and tolerance. European Journal of Clinical Pharmacology 2010; 66: 713-719. Go to original source... Go to PubMed...
    4. Dart RC, Bailey E. Does therapeutic use of acetaminophen cause acute liver failure? Pharmacotherapy 2007; 27: 1219-1230. Go to original source... Go to PubMed...
    5. Heard K, Green JL, Bailey JE, et al. A randomized trial to determine the change in alanine aminotransferase during 10 days of paracetamol (acetaminophen) administration in subjects who consume moderate amounts of alcohol. Alimentary Pharmacology & Therapeutics 2007; 26: 283-290. Go to original source... Go to PubMed...
    6. Watkins PB, Kaplowitz N, Slattery JT, et al. Aminotransferase elevations in healthy adults receiving 4 grams of acetaminophen daily - A randomized controlled trial. Jama-Journal of the American Medical Association 2006; 296: 87-93. Go to original source... Go to PubMed...
    7. Oxfordská liga analgetik. http://www.jr2.ox.ac.uk/bandolier/booth/painpag/Acutrev/Analgesics/Leagtab.html. 2010.
    8. Laska EM, Sunshine A, Mueller F, et al. Caffeine as an analgesic adjuvant. JAMA 1984; 251: 1711-1718. Go to original source...
    9. Palmer H, Graham G, Williams K, Day R. A Risk-Benefit Assessment of Paracetamol (Acetaminophen) Combined with Caffeine. Pain Medicine 2010; 11: 951-965. Go to original source... Go to PubMed...
    10. Kršiak M, Tomašíková Z, Líkařová E, et al. Analgetická účinnost a toxicita směsi paracetamolu s guaifenesinem. [Analgesic activity and toxicity of a combination of paracetamol with guaifenesin]. Čs. fysiol. 1980; 29: 56.
    11. Dolezal T, Krsiak M. Guaifenesin enhances the analgesic potency of paracetamol in mice. Naunyn-Schmiedebergs Archives of Pharmacology 2002; 366: 551-554. Go to original source... Go to PubMed...
    12. Miranda HF, Puig MM, Prieto JC, Pinardi G. Synergism between paracetamol and nonsteroidal anti-inflammatory drugs in experimental acute pain. Pain 2006; 121: 22-28. Go to original source... Go to PubMed...
    13. Moore A, Collins S, Carroll D, McQuay H. Paracetamol with and without codeine in acute pain: A quantitative systematic review. Pain 1997; 70: 193-201. Go to original source... Go to PubMed...
    14. Filitz J, Ihmsen H, Gunther W, et al. Supra-additive effects of tramadol and acetaminophen in a human pain model. Pain 2008; 136: 262-270. Go to original source... Go to PubMed...
    15. Moore RA, Mcquay HJ. Single-patient data meta-analysis of 3453 postoperative patients: Oral tramadol versus placebo, codeine and combination analgesics. Pain 1997; 69: 287-294. Go to original source... Go to PubMed...
    16. Toms L, Derry S, Moore RA, Mcquay HJ. Single dose oral paracetamol (acetaminophen) with codeine for postoperative pain in adults. Cochrane Database of Systematic Reviews 2009 Go to original source...
    17. Forrest JAH, Clements JA, Prescott LF. Clinical pharmacokinetics of paracetamol. Clinical Pharmacokinetics 1982; 7: 93-107. Go to original source... Go to PubMed...
    18. Anderson B, Kanagasundarum S, Woollard G. Analgesic efficacy of paracetamol in children using tonsillectomy as a pain model. Anaesthesia and Intensive Care 1996; 24: 669-673. Go to original source... Go to PubMed...
    19. Anderson BJ, Pons G, Autret-Leca E, Allegaert K, Boccard E. Pediatric intravenous paracetamol (propacetamol) pharmacokinetics: a population analysis. Pediatric Anesthesia 2005; 15: 282-292. Go to original source... Go to PubMed...
    20. Rawlins MD, Henderson DB, Hijab AR. Pharmacokinetics of Paracetamol (Acetaminophen) After Intravenous and Oral-Administration. European Journal of Clinical Pharmacology 1977; 11: 283-286. Go to original source... Go to PubMed...

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