Paracetamol

Sounds like 'pa-ra-SEE-ta-mol'

Key points about paracetamol for adults

  • When it's taken as directed, paracetamol works well. However, it's important that you read and follow the instructions provided on the packaging carefully.
  • Don't take more than the daily recommended dose. If you take too much, all at once or over a period of days, paracetamol can damage your liver.
  • Be aware that some pain relief and cold and flu medicines have paracetamol in them.
  • Find out how to take it safely and possible side effects.
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Paracetamol is used to treat different types of pain including headache, migraine, period pain and aches and pains associated with colds and flu. It's the most commonly used pain relief medicine in Aotearoa New Zealand. Read more about pain relief medication.

Paracetamol is also used to treat fever but mild fever doesn't need to be treated unless it's causing discomfort.

Paracetamol tablets are available in 2 strengths

In Aotearoa New Zealand, paracetamol tablets are available in 2 strengths  500 mg tablets and 665 mg tablets. Your dose of paracetamol will depend on the strength you are taking.

Examples of paracetamol brands in New Zealand
500 mg tablets and caplets
  • Panadol®
  • Ethics Paracetamol®
  • Paracare®
  • Pharmacare Paracetamol®
665 mg tablets
  • Apo-Osteo®
  • Panadol Back & Neck®
  • Panadol Osteo P®
  • Paracetamol Osteo-Tab®

Paracetamol is also in some other medicines such as cold and flu medicines and in pain-relief medication (see below for examples).

This is the most common strength available as tablets or caplets. They are immediate-release tablets, meaning they start working straight away. 

  • Dose: The usual dose for adults is 1 or 2 tablets every 4 to 6 hours when required for pain. Don't take more than 4 doses in 24 hours (8 tablets in 24 hours). Taking more than the recommended dose can harm your liver.
  • Timing: Depending on why you're taking paracetamol, your healthcare provider may advise that you take regular doses or take it only when you need it for pain relief. Wait at least 4 hours between doses. Keep track of the timing of your doses and check when it was last taken before taking it again.

The 665 mg tablets are used for osteoarthritis. These are modified-release tablets, where the dose is delivered over a longer time period. This means you can take fewer doses throughout the day.

  • Swallow the tablets whole. Don't crush or chew them.
  • Dose: The usual dose for adults is 2 tablets every 6 to 8 hours when required for pain. Don't take more than 6 tablets in 24 hours. Taking more than the recommended dose can harm your liver.
  • Timing: Depending on why you're are taking paracetamol, your healthcare provider may advise that you take regular doses or take it only when you need it for pain relief. Wait at least 6 hours between doses. Keep track of the timing of your doses and check when it was last taken before taking it again.

Some people may need lower doses of paracetamol

Some people should take less than the usual dose, eg, if you have liver problems, weigh less than 50 kg, drink a lot of alcohol or if you're dehydrated. If 1 or more of these apply to you, the usual adult dose may be harmful to your liver. Talk to your pharmacist or healthcare provider if you don't know what dose to take.

Taking paracetamol with other pain medicines

Paracetamol is also in many pain medicines you can buy from the pharmacy (eg, Maxigesic and Nuromol). An overdose can happen if you take more than 1 paracetamol-containing medicine.

If you do take other medicines that have paracetamol in them, be careful not to take more than the recommended dose of paracetamol each day (4 grams in 24 hours). If you are taking paracetamol 665 mg modified release tablets, don't take other products containing paracetamol.

It's safe to take paracetamol with other types of pain medicines that don't contain paracetamol (eg, ibuprofen) and opioid medicines (eg, codeine). They all work differently so the type of medicine you need to treat your pain depends on what type of pain you have.

Paracetamol is found in many cold and flu products

Check the ingredients of cold and flu medicines before you take them. Paracetamol is included in many cold and flu products, eg, Codral®, Coldrex® and Lemsip®. If you do take other medicines that have paracetamol in them, be careful not to take more than the recommended dose of paracetamol each day (4 grams in 24 hours). If you're taking paracetamol 665 mg modified release tablets, don't take other products containing paracetamol. Check with your pharmacist if you are not sure whether a product contains paracetamol.

Paracetamol is a very popular medicine and when taken correctly works well. However, too much paracetamol is very harmful to your liver.

If you realise you've had too much paracetamol (including from other products with paracetamol in them), call your doctor, nurse or the Poisons Centre  0800 POISON (0800 764 766) immediately.

DO NOT wait for signs of an overdose as these appear late when the damage to your liver is already done.

Late signs may include:

  • nausea (feeling sick) or vomiting (being sick)
  • diarrhoea (runny poo)
  • yellow skin or eyes
  • poor appetite
  • confusion or extreme sleepiness.

Older people are most at risk, so should take extra care. 

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Credits: Healthify He Puna Waiora Pharmacists. Healthify is brought to you by Health Navigator Charitable Trust.

Reviewed by: Angela Lambie, Pharmacist, Auckland

Last reviewed: