The downside of paracetamol

If you have frequently been giving your child paracetamol (liquid or tablets) whenever he/she is down with fever, you might want to cut down on your go-to remedy. That’s because the harmless seeming paracetamol when given in excess could give rise to bigger health problems.

Health warning

Doctors in the UK have warned that parents are putting their children’s health at risk by giving them paracetamol too readily. Professor Alastair Sutcliffe, specialising in general paediatrics at University College London, said, “Parents are using paracetamol too permissively. They seem to fear fever as an illness per se, which it is not. There is evidence that the excess usage of paracetamol is associated with increased rates of asthma, increased rates of liver damage — but [also] less widely known, kidney and heart damage.”

Other experts pointed that children were being given more than the recommended dose by those taking care of them. who didn’t know how much they’d had earlier that day. Steve Tomlin, a pharmacist said, “Where we go wrong is when people carry on using it at high doses. Children often go from one care setting to another — with the grandparents, or school — and the chances of them getting extra doses might be quite high. You only need two or three days giving an extra dose or two above what is recommended and it... can start hitting the liver.”

Helen Sammons, a pediatrician said the medicine should not be used to treat a mild fever alone. ‘The temperature in itself is not bad,” she said. “You have a fever because your body is trying to fight an infection. Paracetamol is very good to treat the pain – you shouldn’t necessarily give it because a child has a temperature.”

In 2013, Spanish research found that children given paracetamol or similar medicines at least once a month were up to four times more likely to develop asthma. The academics suggested that paracetamol reduces the amount of a chemical called glutathione in the lungs and blood, which damages the lung tissue.

Parental guidance

Paracetamol is a useful medication for symptomatic pain relief in painful situations, such as reducing the discomfort that may be associated with fever. Dr Behram Pardiwala, consultant internal medicines, Wockhardt Hospitals, says that the first thing that parents need to know is whether and when it is safe to use paracetamol, including when they should seek medical advice for an unwell child. Understand whether it is necessary to give paracetamol to children when they have fevers, caused by common viral illnesses. Parents should know how to use paracetamol safely — including the dose, formulation and strength.

Ideal dosage

Paracetamol is used for both fever and pain, basically wherever inflammation is suspected. Dr Piyush Shah, consultant neonatologist, Cloudnine Hospital informs, “The ideal dosage is 10- 15mg/kg/dose three to four times a day, in pediatric population. No consultation is needed for giving paracetamol. But we need to know why the child is having fever before we treat fever. Fever is our friend. Its presence suggest an inflammation in body whose site needs to be investigated for.” Dr Soni, Pratik Kumar, consultant cardiologist, Wockhardt Hospital says that paracetamol is normally used in the doses of 500 or 850 or 100 mg. The doses for children is written on the bottle of paracetamol syrup and is based on the weight of the child. Each manufacturer specifies it.

Paracetamol taken in excess among children and adults too

“Nowadays paracetamol is given to the children in excess dosages to reduce the temperature at a faster rate. If the temperature is high, parents usually indulge in giving their children more than four doses in 24-hour period,” says Dr Pardiwala adding that paracetamol is in excess use among adults too.

The downside

So do our experts agree that excess paracetamol is linked to asthma and may also cause damage to the kidneys, liver and heart, as mentioned in the study Studies show that an excess usage of paracetamol is associated with an increased rate of asthma, liver damage and not so widely known heart damage. Parents are using paracetamol too excessively for their children. They seem to fear fever as illness per se. Paracetamol overdose can cause liver failure as well. An acetaminophen (the active ingredient contained in paracetamol) may cause unwanted side effects and requires immediate medical attention). Other harmful effects are diarrhea, loss of appetite, nausea or vomiting, stomach cramps or pain, swelling, pain, or tenderness in the upper abdomen or stomach area, warns Dr Pardiwala.

“Anything in excess, is harmful. In research and pharmacology, there is an association between paracetamol and likelyhood on causing asthma and kidney damage. But I have not come across any case in my practice,” says Dr Shah. Dr Soni says that paracetamol doesn’t do anything to/ heart. The other harmful effects of excess paracetamol in children includes kidney damage, bone problems and chronic liver inflammation.

Fever is a common symptom of many childhood illnesses and is part of the body’s normal response to fight infection. However, it doesn’t mean that you ignore the fever altogether. It’s important to watch for those additional signs and if it persists for a long time, see the doctor.

Source: http://www.dnaindia.com/health/report-the-downside-of-paracetamol-2173175