Ask Dr KK: What is the maximum dose of paracetamol (acetaminophen) which can be combined in another drug?

In January, the US FDA mandated drug makers to include not more than 325 mg of Paracetamol in each tablet or capsule of combination medicines. 

About the author: Dr K K Aggarwal is Padmashri and Dr B C Roy National Awardee, President Heart Care Foundation of India, Dean Board of Medical Education Moolchand Medcity, Sr. Physician & Cardiologist, Visiting professor Clinical Research DIPSAR, Past President Delhi Medical Association, Past Academic and Research Wing Head IMA, Chairman Ethics Committee Delhi Medical Council.  

Ask Dr KK: At what dose Paracetamol (acetaminophen) and cause acute liver failure?

Practically all patients who take paracetamol (acetaminophen) in excess of 350 mg/kg develop severe liver toxicity unless appropriately treated. Clinically they present with SGOT or SGPT levels (AST or ALT) > 1000 IU/L.

About the author: Dr K K Aggarwal is Padmashri and Dr B C Roy National Awardee, President Heart Care Foundation of India, Dean Board of Medical Education Moolchand Medcity, Sr. Physician & Cardiologist, Visiting professor Clinical Research DIPSAR, Past President Delhi Medical Association, Past Academic and Research Wing Head IMA, Chairman Ethics Committee Delhi Medical Council.  

Ask Dr KK: What is the toxic dose of Paracetamol (acetaminophen)?

Toxicity is unlikely to result from a single dose of less than 150mg/kg in children or 7.5-10 gm in adults. Toxicity is likely to occur with a single ingestion greater than 250 mg/kg or those greater than 12 gm over a 24 hours period.   

About the author: Dr K K Aggarwal is Padmashri and Dr B C Roy National Awardee, President Heart Care Foundation of India, Dean Board of Medical Education Moolchand Medcity, Sr. Physician & Cardiologist, Visiting professor Clinical Research DIPSAR, Past President Delhi Medical Association, Past Academic and Research Wing Head IMA, Chairman Ethics Committee Delhi Medical Council.  

Ask Dr KK: What is the therapeutic dose of Paracetamol (acetaminophen)?

The therapeutic dose is 10-25 mg/kg per dose in children and 325-1000 ml per dose in adults given every 4-6 hours with maximum recommended daily dose of 80mg/kg for children and 3 gm in adults.

3g is the recent change from an early recommendation of 4gm in adults.

About the author: Dr K K Aggarwal is Padmashri and Dr B C Roy National Awardee, President Heart Care Foundation of India, Dean Board of Medical Education Moolchand Medcity, Sr. Physician & Cardiologist, Visiting professor Clinical Research DIPSAR, Past President Delhi Medical Association, Past Academic and Research Wing Head IMA, Chairman Ethics Committee Delhi Medical Council.  

Ask Dr KK: How common is paracetamol (acetaminophen) poisoning?

Acetaminophen (Paracetamol) is widely available and lay people commonly underestimate its toxicity. Acetaminophen accounts for more over doses and overdose death each year in the United States than any other drug. Acetaminophen induced acute liver failure is common, 50% of them being intentional or suicidal and other 50% unintentional or cardiac poisoning.


About the author: Dr K K Aggarwal is Padmashri and Dr B C Roy National Awardee, President Heart Care Foundation of India, Dean Board of Medical Education Moolchand Medcity, Sr. Physician & Cardiologist, Visiting professor Clinical Research DIPSAR, Past President Delhi Medical Association, Past Academic and Research Wing Head IMA, Chairman Ethics Committee Delhi Medical Council.  

Ask Dr KK:What is the difference between Paracetamol and acetaminophen?

They are same. In India it is called Paracetamol and in America it is known as acetaminophen.

About the author: Dr K K Aggarwal is Padmashri and Dr B C Roy National Awardee, President Heart Care Foundation of India, Dean Board of Medical Education Moolchand Medcity, Sr. Physician & Cardiologist, Visiting professor Clinical Research DIPSAR, Past President Delhi Medical Association, Past Academic and Research Wing Head IMA, Chairman Ethics Committee Delhi Medical Council.  

Ask Dr KK: Can paracetamol increase blood pressure?

Some studies have shown an increase in blood pressure with paracetamol. acetaminophen.

In one two-week randomized crossover trial, paracetamol 1 g three times daily increased systolic and diastolic blood pressure from 122 to 125 mmHg systolic and from 73 to 75 mmHg diastolic. [Circulation 2010; 122:1789]. But most other studies have not confirmed the same.

In therapeutic doses its safe for hypertensive patients to take paracetamol.