Paracetamol: All You Need to Know

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The next time you have the headache, joint-ache or period pain, you’re most likely to reach a pain killer and that pain killer might be paracetamol or Ibuprofen as they are the most used pain killers in the world. But how does paracetamol work? Paracetamol and Ibuprofen are anti-inflammatory drugs. So, why do we use an anti-inflammatory drug to treat pain? When you have an injury, or when a cell is damaged, prostaglandin is activated. Prostaglandin has a key place in inflammation. And when they’re released in the nerves, they cause pain. Prostaglandins act on nerves and the nerves send the pain messages to the brain. Ibuprofen blocks that pain signal by stopping the formation of prostaglandin in the first place and that pain killing action works as long as the ibuprofen is blocking the gland.


Paracetamol is a more mysterious drug. It was initially thought that paracetamol works in a similar way to ibuprofen. But recently, science has shown that it might not be the case. Paracetamol is easily absorbed in the body after intake into the gastrointestinal tract (the gut, yeah scientifically it is the same as the “guts” we talk about when you get into some demanding job :P ). It is easily distributed throughout the body homogeneously and thus can reach wherever there’s its real need. There it can be broken down to form active compounds and some of these compounds can act as pain killers. A few of them act to the spinal cord to incept the pain signal from your head or from your joints so that they can’t be transmitted to the brain. So, the next time you take those pills for your head ache, or joint pain, or your periods, you know exactly how they’ll be working.


Paracetamol is one of the most famous antipyretic and analgesic drug. Antipyretic are the substances that reduce fever, while analgesic are those substances that reduce pain. It’s literally the most popular medicine to cure the fever and reduce pain. Paracetamol is widely available in the market under different brand names and many times in a mix with various other chemicals like caffeine or codeine.


Apart from its usage in fevers, researchers have also found its various other positive effects on our body. In some studies, it has been found that it acts on a few brain cells that actually help in recalling. There was an experiment done in the United States upon paracetamol. It was found that people who consumed a paracetamol tablet daily were better in memory tests than those who didn’t.

Well, keeping this memory-aid finding aside, another set of studies have revealed that it boosts the formation of a chemical called “serotonin” in the brain. Serotonin is a neurotransmitter, that is, the chemicals which help in signaling between the brain cells. It usually helps in relieving the brain from tension.

Despite of its wonderful effects, paracetamol is also the number one or the foremost cause of acute liver failure in the United States. Um, well actually in the whole western world! It’s the number one agent in all the pharmacological compounds. Number one in all poison control system. And it’s the most used drugs too in the western countries.

Close-up of tablets spilling out of an open bottle

What’s too bad about it? Why does it harm the liver then?

Paracetamol is metabolized and detoxified into the body, goes through the liver, and in the liver it can create substances like NAPQI after improper metabolism. What actually is this NAPQI? Well, it’s a very very toxic substance for the liver. The good thing is that like other toxic substances and the metabolites produced by the paracetamol, this NAPQI is also excreted out through the urine after combining with another molecule glutathione.

Normally, if we take the paracetamol in small amounts or not more than the prescribed amounts, the NAPQI thus produced could be nullified by glutathione. But, if you take it in excessive amounts, then you can create higher levels of NAPQI than what your body can actually detoxify. And if it builds up to extreme levels, you can even die! Initially, there might not be any symptoms at all, thus making it more difficult to detect and thus even more difficult to treat.

As a result of the dangerous effects caused by this drug, there was a federal drug administration advisory panel which said that they should ban all its prescription including its usage in any of the drugs. The prescription must be limited to less than 325 mg of paracetamol per pill per day.


Paracetamol is a metabolite of phenacetin and phenacetin which can cause cancer in higher amounts. People with gastric ulcer is usually treated with paracetamol rather than aspirin as it is less irritating to the stomach lining than aspirin even though the pain killing effect of both the drugs is about the same. Paracetamol is often added with a few more compounds to enhance its pain killing effect.

The maximum amount of paracetamol within the safe limits is about 4 grams a day if taken as the sum of all the doses throughout the day, while the maximum amount that can be taken at a time is 2 grams. Break the limits and it could be very dangerous or even lethal.

The only take home lesson here is to keep your drugs into the limits!

another muggle :|