Para-AL
Para-AL Uses, Dosage, Side Effects, Food Interaction and all others data.
Para-AL exhibits analgesic action by peripheral blockage of pain impulse generation. It produces antipyresis by inhibiting the hypothalamic heat-regulating centre. Its weak anti-inflammatory activity is related to inhibition of prostaglandin synthesis in the CNS.
Para-AL (Acetaminophen) is thought to act primarily in the CNS, increasing the pain threshold by inhibiting both isoforms of cyclooxygenase, COX-1, COX-2, and COX-3 enzymes involved in prostaglandin (PG) synthesis. Unlike NSAIDs, acetaminophen does not inhibit cyclooxygenase in peripheral tissues and, thus, has no peripheral anti-inflammatory affects. While aspirin acts as an irreversible inhibitor of COX and directly blocks the enzyme's active site, studies have found that acetaminophen indirectly blocks COX, and that this blockade is ineffective in the presence of peroxides. This might explain why acetaminophen is effective in the central nervous system and in endothelial cells but not in platelets and immune cells which have high levels of peroxides. Studies also report data suggesting that acetaminophen selectively blocks a variant of the COX enzyme that is different from the known variants COX-1 and COX-2. This enzyme is now referred to as COX-3. Its exact mechanism of action is still poorly understood, but future research may provide further insight into how it works. The antipyretic properties of acetaminophen are likely due to direct effects on the heat-regulating centres of the hypothalamus resulting in peripheral vasodilation, sweating and hence heat dissipation.
| Trade Name | Para-AL |
| Generic | Paracetamol |
| Paracetamol Other Names | Acenol, Acetaminofén, Acetaminophen, Acétaminophène, APAP, Paracetamol, Paracétamol, Paracetamolum |
| Weight | 120mg/5ml |
| Type | Oral Suspension |
| Formula | C8H9NO2 |
| Weight | Average: 151.1626 Monoisotopic: 151.063328537 |
| Protein binding | The binding of acetaminophen to plasma proteins is low (ranging from 10% to 25%), when given at therapeutic doses. |
| Therapeutic Class | Non opioid analgesics |
| Manufacturer | Albion Pharmaceuticals Ltd |
| Available Country | Bangladesh |
| Last Updated: | September 19, 2023 at 7:00 am |
Uses
Para-AL IV is used for the management of mild to moderate pain, the management of moderate to severe pain with adjunctive opioid analgesics, the reduction of fever.
Para-AL is a non-salicylate antipyretic and non-opioid analgesic agent. Para-AL IV injection is a sterile, clear, colorless, non pyrogenic, isotonic formulation of Para-AL intended for intravenous infusion.
Para-AL is also used to associated treatment for these conditions: Acute Gouty Arthritis, Acute Musculoskeletal Pain, Allergies, Ankylosing Spondylitis (AS), Arthritis, Chills, Cold, Cold Symptoms, Common Cold, Common Cold/Flu, Cough, Cough caused by Common Cold, Coughing caused by Flu caused by Influenza, Dyskinesia of the Biliary Tract, Dyskinesia of the Urinary Tract, Febrile Convulsions, Febrile Illness Acute, Fever, Fibromyalgia Syndrome, Flu caused by Influenza, Headache, Joint dislocations, Menstrual Distress (Dysmenorrhea), Mild pain, Muscle Inflammation, Muscle Injuries, Muscle Spasms, Musculoskeletal Pain, Nasal Congestion, Neuralgia, Osteoarthritis (OA), Pain, Pollen Allergy, Postoperative pain, Premenstrual cramps, Rheumatoid Arthritis, Rhinopharyngitis, Rhinorrhoea, Severe Pain, Sinusitis, Soreness, Muscle, Spasms, Spastic Pain of the Gastrointestinal Tract, Sprains, Tension Headache, Toothache, Upper Respiratory Tract Infection, Whiplash Syndrome, Acute Torticollis, Mild to moderate pain, Minor aches and pains, Minor pain, Moderate Pain, Airway secretion clearance therapy, Antispasmodic, Bronchodilation
Dosage
Para-AL dosage
Adults and adolescents weighing 50 kg and over: the recommended dosage of Para-AL IV is 1000 mg every 6 hours or 650 mg every 4 hours, with a maximum single dose of Para-AL IV of 1000 mg, a minimum dosing interval of 4 hours, and a maximum daily dose of Para-AL of 4000 mg per day.
Adults and adolescents weighing under 50 kg: the recommended dosage of Para-AL IV is 15 mg/kg every 6 hours or 12.5 mg/kg every 4 hours, with a maximum single dose of Para-AL IV of 15 mg/kg, a minimum dosing interval of 4 hours, and a maximum daily dose of Para-AL of 75 mg/kg per day.
Children >2 to 12 years of age: the recommended dosage of Para-AL IV is 15 mg/kg every 6 hours or 12.5 mg/kg every 4 hours, with a maximum single dose of Para-AL IV of 15 mg/kg, a minimum dosing interval of 4 hours, and a maximum daily dose of Para-AL of 75 mg/kg per day.
Side Effects
As all paracetamol products, adverse drug reactions are rare (>1/10000, <1/1000) or very rare (<1/10000). Frequent adverse reactions at injection site have been reported during clinical trials (pain and burning sensation). Very rare cases of hypersensitivity reactions ranging from simple skin rash or urticaria to anaphylactic shock have been reported and require discontinuation of treatment. Cases of erythema, flushing, pruritus and tachycardia have been reported.
Precaution
Administration of Para-AL in doses higher than recommended may result in hepatic injury, including the risk of severe hepatotoxicity and death. Do not exceed the maximum recommended daily dose of Para-AL. Use caution when administering Para-AL in patients with the following conditions: hepatic impairment or active hepatic disease, alcoholism, chronic malnutrition, severe hypovolemia (e.g., due to dehydration or blood loss), or severe renal impairment (creatinine clearance < 30 ml/min). There were infrequent reports of life-threatening anaphylaxis requiring emergent medical attention. Discontinue Para-AL IV immediately if symptoms associated with allergy or hypersensitivity occurs. Do not use Para-AL IV in patients with Para-AL allergy.
Food Interaction
- Avoid alcohol. Alcohol may increase the risk of hepatotoxicity.
Volume of Distribution
Volume of distribution is about 0.9L/kg. 10 to 20% of the drug is bound to red blood cells. Acetaminophen appears to be widely distributed throughout most body tissues except in fat.
Half Life
The half-life for adults is 2.5 h after an intravenous dose of 15 mg/kg. After an overdose, the half-life can range from 4 to 8 hours depending on the severity of injury to the liver, as it heavily metabolizes acetaminophen.
Clearance
Adults: 0.27 L/h/kg following a 15 mg/kg intravenous (IV) dose. Children: 0.34 L/h/kg following a 15 mg/kg intravenous (IV dose).
Pregnancy & Breastfeeding use
Pregnancy Category C. There are no studies of intravenous Para-AL in pregnant women; however, epidemiological data on oral Para-AL use in pregnant women show no increased risk of major congenital malformations. Animal reproduction studies have not been conducted with IV Para-AL and it is not known whether Para-AL IV can cause fetal harm when administered to a pregnant woman. Para-AL IV should be given to a pregnant woman only if clearly needed. There are no adequate and well-controlled studies with Para-AL IV during labor and delivery; therefore, it should be used in such settings only after a careful benefit-risk assessment. While studies with Para-AL IV have not been conducted, Para-AL is secreted in human milk in small quantities after oral administration.
Contraindication
Para-AL is contraindicated in patients with known hypersensitivity to its active ingredient or to any of the excipients in the intravenous formulation. Also contraindicated in patients with severe hepatic impairment or severe active liver disease
Special Warning
Pediatric Use: The safety and effectiveness of Para-AL IV for the treatment of acute pain and fever in pediatric patients ages 2 years and older is supported by evidence from adequate and well-controlled studies of Para-AL IV in adults.
Geriatric use: No overall differences in safety or effectiveness were observed between these subjects and younger subjects, and other reported clinical experience has not identified differences in responses between the elderly and younger patients.
Patients with Hepatic Impairment: Para-AL is contraindicated in patients with severe hepatic impairment or severe active liver disease and should be used with caution in patients with hepatic impairment or active liver disease. A reduced total daily dose of Para-AL may be warranted.
Patients with Renal Impairment: In cases of severe renal impairment (creatinine clearance < 30 ml/min), longer dosing intervals and a reduced total daily dose of Para-AL may be warranted.
Storage Condition
Store in a cool & dry place & away from children. For single use only. The product should be used within 6 hours after opening. Do not refrigerate or freeze.
Innovators Monograph
You find simplified version here Para-AL
FAQ
What is Para-AL?
Para-AL is a common painkiller used to treat aches and pain. It can also be used to reduce a high temperature. It's available combined with other painkillers and anti-sickness medicines. It's also an ingredient in a wide range of cold and flu remedies.
What are side effects of Para-AL?
- Skin rash that may include itchy, red, swollen, blistered or peeling skin.
- Wheezing.
- Tightness in the chest or throat.
- Trouble breathing or talking.
- Mouth, face, lips, tongue or throat start swelling.
How safe is Para-AL?
Para-AL is known to cause liver failure in overdose, but it also causes liver failure in people taking standard doses for pain relief. The risk is only about one in a million, but it is a risk. All these different risks stack up.
What are the types of Para-AL?
Types of Para-AL
- tablets or caplets.
- capsules.
- liquid – usually for children.
- soluble tablets (tablets that dissolve in water to make a drink)
- suppositories (capsules inserted into the back passage)
- an injection given into a vein – normally only used in hospital.
What happens if I take Para-AL without any reason?
Even taking one or two more tablets than recommended can cause serious liver damage and possibly death. Para-AL overdose is one of the leading causes of liver failure.
Why is Para-AL bad for our liver?
Para-AL itself is not toxic, but in large amounts it overwhelms the body's ability to process it safely. This can lead to build up of a toxic metabolite (or break-down product), which binds to liver cells, causing these cells to die.
What are the indications of Para-AL?
This Para-AL is used to treat mild to moderate pain (from headaches, menstrual periods, toothaches, backaches, osteoarthritis, or cold/flu aches and pains) and to reduce fever.
What happens if I take Para-AL on an empty stomach?
Ibuprofen, aspirin and other NSAIDs (non-steroidal anti-inflammatory drugs) can irritate the stomach lining, so it is best to take them with food, or a glass of milk. Para-AL doesn't irritate the stomach lining so it won't matter if you haven't eaten.
Can Para-AL help I sleep?
A successful result is one where the pain is reduced by half or more, or where they have no or only mild pain. That result delivers not just on pain, but also improves sleep, depression, quality of life, work, and the ability to get on with life.
How is Para-AL eliminated from the body?
Para-AL is readily absorbed from the gastrointestinal tract with peak plasma concentrations occurring about 30 minutes to 2 hours after ingestion. It is metabolised in the liver (90-95%) and excreted in the urine mainly as the glucuronide and sulphate conjugates. Less than 5% is excreted as unchanged Para-AL.
Is Para-AL is safe during pregnancy?
Para-AL is the first choice of painkiller if you're pregnant. Para-AL been taken by many pregnant women with no harmful effects in the mother or baby.
Is Para-AL safe during breastfeeding?
Para-AL is the first choice of painkiller if you're breastfeeding women. It's been taken by many breastfeeding women with no harmful effects in the mother or baby.
How does Para-AL work?
Para-AL seems to work by blocking chemical messengers in the brain that tell us we have pain. It also reduces fever by affecting the chemical messengers in an area of the brain that regulates body temperature.
When will I feel better after taking Para-AL?
Para-AL takes up to an hour to work. It keeps on working for about 5 hours.
Can I take Para-AL for a long time?
It's safe to take Para-AL regularly for many years as long as you don't take more than the recommended dosage.
Will Para-AL affect my fertility?
There's no firm evidence to suggest that taking Para-AL will reduce fertility in either men or women.
Will Para-AL affect my contraception?
Para-AL doesn't affect any type of contraception including the contraceptive pill or emergency contraception.
Can I drink alcohol with Para-AL?
Drinking a small amount of alcohol while taking Para-AL is usually safe. Try to keep to the recommended guidelines of no more than 14 units of alcohol a week. A standard glass of wine (175ml) is 2 units. A pint of lager or beer is usually 2 to 3 units of alcohol.
Is there any food or drink I need to avoid when taking Para-AL?
You can eat and drink normally while taking Para-AL. You can safely take Para-AL (but not ibuprofen) on an empty stomach.
