Do you know what is “acetaminophen” and do you buy medicines OTC ?

You encounter them daily in your life. In every street, now a days you find more than 2 shops – yes the Druggists.  Quite often the so called educated middle class and the lower class seemingly trust the Chemist more.  Not many seem to understand that a Qualified Physician would always treat the ailing person by studying the symptoms and the medication taken on perceived symptoms might cause incalculable harm.  Vast majority of people think that they are afflicted by fever or something else and a Crocin or Dolo or Calpol would bring the needed relief.  Some even tend to think that if Dolo does not work, Calpol will.  Many have the habit of telling the Chemist try to describe their ailment to the Chemist and get a tablet or two thinking that relief would come overnight.

There is the popular joke of persons asking for medicine for loose motion and the attending person in the neighbouring Chemist would not even care to ask whether it for stoppage or easing.  Pyrexia commonly known as Fever is a common medical ailment revealed by increase in body temperature.  Most tend to associate it with cold without realizing that it can be caused by many different conditions from ordinary cold to some potentially dangerous things.   Fever is treated with antipyretics (literal meaning – against fire).  Understand that these drugs cause the Hypothalamus, a portion of the brain to override and then body would work to lower the temperature resulting in reduction in fever.  Most antipyretics are also are anti-inflammatory and analgesic – relieving pain also.  

Do you what this is going by its chemical data which would read :

Formula  -  C8H9NO2

Mol. Mass  -  151.17 g/mol

Physical data

Density - 1.263 g/cm³

Melt. Point - 168 °C (334 °F) and is soluble in water.

Solubility in water : 12.78 [1] mg/mL (20 °C)

It is the one that most of us with some little knowledge consider as a panacea for all illness. In fact, in India there was a common brand called ‘Fepanil’ – which my Medical representative friend told to mean as ‘fever pain nil’   -  it is the Paracetamol – most commonly bought over the counter drug used by adults and children as best seller.   Paracetamol is also known as acetaminophen.  

Paracetamol has been in use as an analgesic for home medication for over 30 years and is accepted as a very effective treatment for the relief of pain and fever in adults and children. Paracetamol is available in a tablet, capsule, liquid suspension, suppository, intravenous, and intramuscular forms. The common adult dose is 500 mg to 1000 mg. The recommended maximum daily dose, for adults, is 4000 mg. In recommended doses, paracetamol generally is safe for children and infants also. The common starch is one of the most widely used excipient in manufacture of solid dosage form and botanical starch is used as binder and disintegrant in tablet formulations – common example being sweet potato.    Read of IP, BP & USP.   There exists disintegration test requirement for hard gelatin capsules, soft gelatin capsules, modified release capsures and more.  Going by the formulation, the tests of Indian Pharmacopoeia 1996  is IP, British Pharmacopoei 2009  is BP and United States Pharmacopoeia is USP.    The tablets are designed to dissolve or disintegrate rapidly upon contact with saliva to eliminate trouble of digesting – this is ODT (orally disintegrating tablet) property.  Some have the habit of swallowing without taking water which is not advisable. 

Paracetamol is chemically 4-hydroxyacetanilide, is a centrally and peripherally acting non-opioid analgesic and antipyretic.   Though some tend to supplement one with another, the following are some of the brand names of the same drug, manufactured and marketed by different companies in India.  They are :

Calpol, Crocin,  Cetanil, Cemol, Disprin, Dolo, Febrex,  Lotemp, Thermol, Taurpol, Ultragin, Paxol,  Pacimol, Metacin  and much more…….  There are many bulk manufacturers and other product makers.  Globally, Panadol is the, GlaxoSmithKline trade name for the pharmaceutical paracetamol.  In many countries, it is marketed under various trade names which include : Crocin, Dolex, Panado, Tylenol, Acamol.

The onset of analgesia is approximately 11 minutes after oral administration of paracetamol.   Acute overdoses of paracetamol can cause potentially fatal liver damage,  the risk is heightened by alcohol consumption.  It is classified as a nonsteroidal anti-inflammatory drug (NSAID].  The analegesic properties Acetanilide was  reportedly first found serendipitously  and was later  introduced into medical practice.  Centuries earlier paracetamol was tried on patients.   Phenacetin was more popular for ages, later researches proved that paracetamol is a better tolerated alalgesic.   Research studies claim that in  recommended doses, paracetamol does not irritate the lining of the stomach, affect blood coagulation as much as NSAIDs, or affect function of the kidneys.  However, some studies  state  that high dose-usage (greater than 2,000 mg per day) does increase the risk of upper gastrointestinal complications such as stomach bleeding.

The purpose of this post is not claim any scholastic medicinal knowledge but to convey that ‘medicines are safe only when prescribed and self-medication is often dangerous’.  Always believe your Physician who is better qualified to diagnose and treat human health through study.  Leave the job to the specialists is what they say…………

Regards – S. Sampathkumar.