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Paracetamol, or acetaminophen, is an analgesic and antipyretic agent used to treat fever and mild to moderate pain. It is a widely available over-the-counter drug sold generically or under various brand names, including Tylenol and Panadol.
Paracetamol relieves pain in acute mild migraine and episodic tension headache. At a standard dose, paracetamol slightly reduces fever, though it is inferior to ibuprofen in that respect and the benefits of its use for fever are unclear, particularly in the context of fever of viral origins. Paracetamol is effective for pain after wisdom tooth extraction, but it is less effective than ibuprofen. The combination of paracetamol and ibuprofen provides greater analgesic efficacy than either drug alone. The pain relief paracetamol provides in osteoarthritis is small and clinically insignificant. Evidence supporting its use in low back pain, cancer pain, and neuropathic pain is insufficient. Paracetamol is the first-line treatment for pain and fever in pregnancy; no causal association with neurodevelopmental disorders has been established, while untreated pain and fever can harm the mother and fetus.
When used as directed, at a recommended maximum daily dose for an adult of three to four grams, paracetamol is safe and effective in the short term, with uncommon adverse effects similar to those of ibuprofen. It is often used in patients who cannot tolerate nonsteroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen. Chronic consumption of paracetamol is in many cases not of benefit, and may result in abnormal liver function tests, and higher doses may lead to toxicity, including liver failure. Paracetamol poisoning is one of the leading causes of poisoning in high-income countries, and the foremost cause of acute liver failure in many countries.
Paracetamol was first made in 1878 by Harmon Northrop Morse or possibly in 1852 by Charles Frédéric Gerhardt. It is the most commonly used medication for pain and fever in both the United States and Europe. It is on the World Health Organization's List of Essential Medicines. Paracetamol is available as a generic medication, with brand names including Tylenol and Panadol, among others. In 2023, it was the 112th most commonly prescribed medication in the United States, with more than 5 million prescriptions.
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