Paracetamol Injectable: Dosing and Precautions

Therapeutic action

Analgesic, antipyretic.

Indications

• Very high fever, only when oral administration is not possible.
• Mild pain, only when oral administration is not possible.

Forms and strengths, route of administration

Do not exceed indicated doses, especially in children and older patients. Paracetamol intoxications are severe, with hepatic cytolysis.

• 500 mg (10 mg/ml, 50 ml) and 1 g (10 mg/ml, 100 ml) vials for infusion.

Dose

• Neonate: 7.5 mg/kg (0.75 ml/kg) every 6 hours, administered over 15 minutes, maximum 30 mg/kg daily.
• Child 1 month and over and under 10 kg: 10 mg/kg (1 ml/kg) every 6 hours, administered over 15 minutes, maximum 30 mg/kg daily.
• Patient 10 kg and over and under 50 kg: 15 mg/kg (1.5 ml/kg) every 6 hours, administered over 15 minutes, maximum 60 mg/kg daily.
• Patient 50 kg and over: 1 g (100 ml) every 6 hours, administered over 15 minutes, maximum 4 g daily.

Duration

According to clinical response. Change to oral route as soon as possible.

Contra-indications, adverse effects, precautions

• Do not administer to patients with severe hepatic impairment.
• Administer with caution to patients with moderate hepatic impairment, severe renal impairment, chronic alcoholism, malnutrition, or dehydration.
• May cause malaise, hypotension, and rash, very rarely.
• Pregnancy and breast-feeding: no contra-indication.
• As the efficacy of IV paracetamol is not superior to oral paracetamol, the IV route is restricted to situations where oral administration is not possible.
• For mild pain, IV paracetamol is used alone or in combination with a parenteral NSAID.
• For moderate pain, IV paracetamol is used in combination with a parenteral NSAID and tramadol.
• For severe pain, IV paracetamol is used in combination with a parenteral NSAID and morphine.
• Paracetamol has no anti-inflammatory properties.
• Do not mix with other drugs in the same infusion bottle.