Is intravenous paracetamol safe?

Article written by Pharmacist Hoang Tra Linh - Vinmec Danang International General Hospital.

Paracetamol (acetaminophen) is an antipyretic and pain reliever used to treat symptoms such as fever or headache, muscle pain, joint pain, back pain, toothache, cold...

1. When is Paracetamol indicated intravenously?

With the characteristics of good absorption into the body through many drug delivery routes, now Paracetamol has many types of preparations with different concentrations and dosage forms:
Paracetamol 500mg tablets, 500mg Paracetamol effervescent tablets, 80mg oral powder, 150mg, 250mg, oral suspension syrup Paracetamol 160 mg/5 mL rectal tablets Paracetamol 80mg, 150mg, 250mg Intravenous solution Paracetamol 1g/100ml Efficacy of the drug through non-invasive drug routes such as oral, The rectal route is relatively high, so tablets or powder for oral administration are preferred. Intravenous lines should only be used for short-term treatment of fever or relief of mild to moderate pain (trauma, post-surgery...) in the following cases:

Acute pain or high fever requires a quick-acting drug immediately after use. Patients who cannot use the drug in other dosage forms: Patients who are comatose, have a lot of vomiting, cannot take oral form, or patients with diarrhea, anal ulcer cannot use the suppository form.

2. Is Paracetamol safe for intravenous use? What are the possible side effects?

Compared with other non-invasive drug routes, when using Paracetamol intravenously, the drug is delivered directly into the blood of the patient, so the onset of action is faster and the effect is better. However, because this is the route of drug delivery that can penetrate into the body's circulation, there are also risks when administering the drug:
Related to the infusion technique: swelling of the injection site, thrombosis, irritation of the infusion line, infections... Drug-related: The risk of unwanted reactions (including allergic reactions, anaphylaxis to drugs) can appear soon during and after the infusion.

Therefore, you should not arbitrarily use intravenous Paracetamol at home, intravenous Paracetamol should be prescribed by a doctor and performed at medical facilities.
Paracetamol is relatively safe when used at the recommended dose. Overdose can cause liver and kidney toxicity. In addition, rare reactions such as hypersensitivity, erythema or angioedema have been reported. If you experience the above symptoms, you should stop taking the drug and notify your doctor.

3.Notes for safe intravenous use of paracetamol?

Intravenous Paracetamol is given by direct intravenous infusion, infusion time must be at least 15 minutes. It is necessary to pay attention to the maximum dose of paracetamol, especially when using different dosage forms or drugs with the same ingredients at the same time. Paracetamol. In adults, the maximum dose is 1g/dose every 4-6 hours and 4g/day, in children the dose is calculated according to the age and weight of the child, intravenous Paracetamol needs to be done at medical facilities. During and after the infusion, patients should be closely monitored for possible adverse reactions Intravenous only when clearly needed, switch to oral dosage forms as soon as possible.

Paracetamol đường tĩnh mạch được truyền tĩnh mạch trực tiếp

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References source:
National Pharmacopoeia 2015: Monograph Paracetamol Paracetamol 10mg/ml Solution for Infusion, eMC What is the evidence supporting the use of intravenous paracetamol? Clinical Pharmacist, Vol. 3, p118 | URI: 11072095

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Bài viết này được viết cho người đọc tại Sài Gòn, Hà Nội, Hồ Chí Minh, Phú Quốc, Nha Trang, Hạ Long, Hải Phòng, Đà Nẵng.