Paracetamol / Acetaminophen (Tylenol, Panadol)
A first-line option for pain and fever. Kinder to the stomach than NSAIDs, but its liver risk makes maximum dose a key consideration — especially with combination cold medicines.
What it's used for
Mild-to-moderate pain (headache, muscle aches, back pain) and fever. Often preferred when NSAIDs are contraindicated (stomach ulcers, kidney disease, certain cardiovascular conditions).
Typical dosing (adults)
- Standard: 500-1000mg every 4-6 hours.
- Max per 24 hours: 4000mg (some guidelines now recommend 3000mg max for safety).
- Many combination cold/flu products already contain acetaminophen — read labels to avoid double-dosing.
Key interactions
- Warfarin: moderate — regular use (≥2g/day for several days) can raise INR.
- Alcohol: moderate — regular heavy drinking increases risk of liver injury.
- Certain anticonvulsants (phenytoin, carbamazepine): may increase liver toxicity risk.
- Combination products: check all OTC cold and pain medicines for acetaminophen to avoid overdose.
Common side effects
Generally well tolerated at recommended doses. Rare but serious: allergic reactions, serious skin reactions (stop immediately). Liver damage at high doses — especially with alcohol or pre-existing liver disease.
Who should be cautious
- People with liver disease or regular alcohol use.
- Anyone taking multiple combination cold/flu products.
- Very low body weight — doses may need adjustment.
What to ask your pharmacist
- Does any other medicine I take contain acetaminophen?
- Is my maximum daily dose different because of my situation?
- Is acetaminophen or ibuprofen better for what I have?