May 20, 2022

VERA FILES TECHNICAL SHEET: When and how to take paracetamol

In some parts of the country, people have reported a “temporary shortage” of brands of paracetamol and flu medications in local pharmacies following a sudden increase in the number of flu-like illnesses and infections. coronavirus disease 2019 (COVID-19) after Christmas and due to the spread of the Omicron variant.

The Department of Health (DOH), however, said there was “no ongoing shortage”. The Department of Trade and Industry (DTI) blamed the limited supply of these drugs on a holiday delivery problem and encouraged the public to buy generics instead.

On Monday January 10, the DTI’s consumer protection group said stocks had been replenished at local pharmacies and consumers can now expect a “more than adequate” supply of medicines. On the same day, the two agencies issued an order setting a purchase limit for paracetamol, products associated with paracetamol and drugs that relieve phlegm.

What is paracetamol used for and what products contain it? Here are three things you need to know:

1. What is paracetamol used for and when should it be taken?

Paracetamol is an over-the-counter pain reliever taken to “treat minor to moderate cases” of body aches and reduce fever. Paracetamol can also reduce symptoms of COVID-19, but health experts say the drug cannot cure the viral infection.

“It (paracetamol) has its limits in terms of the appropriate dosage because above certain doses, you can have liver damage, in particular,” said Dr Beaver Tamesis, president of the Pharmaceutical Association and of the health of the people. Philippines (PHAP).

Tamesis, who is also chief executive of multinational pharmaceutical company Merck Sharp & Dohme, pointed out that the maximum dose most clinicians prescribe for adults is three grams of paracetamol, or six 500 milligram (mg) tablets per day, taken in four hours. intervals.

“As soon as you start dosing it above three grams a day, we’re already getting into very, very dangerous territory,” said Tamesis, who cautioned that the dosage is different for children and should be consulted by a pediatrician. .

A global team of public health experts from the non-profit group Meedan explained:

“Although paracetamol is commonly used to relieve symptoms of COVID-19, it is important to strictly adhere to the prescribed dosage listed on the drug bottle. The dosage of paracetamol for adults is one to two 500-milligram tablets up to four times in 24 hours, with at least four hours between doses.Any higher amount may be dangerous and is not advised.

Source: Meedan Health Unit, Is paracetamol effective in treating or curing COVID-19?, August 5, 2020

2. How to take paracetamol?

Health experts and pharmacies warn that paracetamol should not be taken with any other medication that contains it to avoid overdose, drug-induced liver injury, and liver failure.

“You should not combine different brands that potentially contain paracetamol, such as Biofluwith paracetamol tablets because you might actually be approaching an overdose,” Tamesis said.

“That’s because, of course, you don’t always see the amount of paracetamol in a tablet. You’re lucky if you have the full package and can read and find the milligram content. [in the product information]. But if you buy retail in supermarkets, pharmacies or even in sari-sari stores, so sometimes you won’t know how many [paracetamol] is in them,” he explained. “So the easiest advice? Do not do that.”

Paracetamol is sometimes combined in specific doses with other compounds, such as nasal decongestants (phenylephrine hydrochloride) and antihistamines (chlorphenamine maleate).

Well-known brands, such as Bioflu exist since 2010 and Neozep since 2012, as well as generic products such as Cortal Flu and NoFlu, all contain 500 mg of paracetamol as indicated in their product sheet. Another generic form, Fludex contains 325 mg of paracetamol.

Patients are also warned against taking combination products with separate paracetamol tablets, as indicated in the information sheet for some of these medicines.

3. What are health experts saying about taking paracetamol and other drugs to reduce symptoms of COVID-19?

For mild to moderate cases, the DOH prescribes taking paracetamol for a fever above 37.5 degrees Celsius at four-hour intervals. In its COVID-19 home care guidelines, the DOH also advises these patients to take prescription medications for coughs and sore throats, if they have these symptoms.

“Right now if you can get tested and then positive Kayo, Merong specific therapy contrast covid[-19]said Tamesis, referring to molnupiravir, an experimental COVID-19 treatment pill that prevents the spread of the virus in the body and can help patients “at risk of severe cases.” (See VERA FILES FACTSHEET: Novel Coronavirus: Six Things You Need to Know)

(Right now, if you can get tested and test positive, there is specific therapy for COVID-19)

On December 22, 2021, the Philippine Food and Drug Administration granted emergency use authorization for Merck and Ridgeback’s molnupiravir. COVID-19 patients who qualify for the treatment can access it free of charge through Vice President Bayanihan’s office e-Konsulta, as prescribed by his volunteer doctors.

These drugs, however, do not apply to patients with severe COVID-19 who need to be referred to COVID-19 hospitals.

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Sources, Group: Some areas experiencing a “temporary shortage” of paracetamol brands, January 4, 2022

GMA News Online, Temporary shortage of paracetamol in certain regions – pharmaceutical group, January 4, 2022

One News, some regions are experiencing a shortage of paracetamol brands, January 5, 2022

Official Ministry of Health Facebook page, On the Alleged Shortage of Paracetamol and Other Drugs, January 4, 2022

Philippine Department of Commerce and Industry, READ | DTI OPINION: On the issue of paracetamol supply, January 5, 2022

ABS-CBN News, DTI: Paracetamol supply expected to ‘normalize’ as pharmacies replenish stocks, January 10, 2022

SunStar, DTI expects a restock of paracetamol in pharmacies the weekend of January 10, 2022

Philippine News Agency, Paracetamol, flu drug supply returns to normal this weekend: DTI, January 7, 2022

Department of Trade and Industry, JOINT MEMORANDUM CIRCULAR NO. 22-01, January 10, 2022

What is a paracetamol?

  • National Health Service Inform (Scotland), Paracetamol, October 11, 2021
  • UNILAB, Dos and don’ts of taking paracetamol, accessed 4 January 2022
  • Personal communication, Dr. Beaver Tamesis, January 7, 2022
  • Meedan Health Unit, Is paracetamol effective in treating or curing COVID-19?, August 5, 2020

How should we take it?

  • ProHealth Pharmacy Official Facebook Page, BAWAL NA BAWAL PAGSABAYIN!, September 30, 2020
  • Healthdirect Australia, Paracetamol., Aug 2020
  • National Health Service (UK), Paracetamol for adults, May 23, 2019
  • National Institutes of Health, Paracetamol-induced liver damage and challenges associated with intentional and unintentional use, April 27, 2020
  • National Center for Biotechnology Information (US National Library of Medicine), Phenylephrine hydrochloride, accessed January 11, 2022
  • National Center for Biotechnology Information (U.S. National Library of Medicine, Chlorphenamine Maleate, Accessed January 11, 2022
  • UNILAB, Bioflu, consulted on January 11, 2022
  • UNILAB, Neozep, consulted on January 11, 2022
  • ATC Healthcare International Corporation, Cortal Flu, accessed 11 January 2022
  • ATC Healthcare International Corporation, NoFlu, accessed 11 January 2022
  • The Generics Pharmacy, Fludex, Accessed January 11, 2022
  • UNILAB, Bioflu (Patient Information Leaflet), Accessed January 11, 2022
  • UNILAB, Neozep (Patient Information Leaflet), Accessed January 11, 2022

Symptoms of COVID-19 and paracetamol

  • Ministry of Health, COVID-19 Guide, accessed 11 January 2022]
  • Meedan Health Unit, How is Merck’s molnupiravir different from ivermectin?, October 5, 2021
  • Philippine Food and Drug Administration, emergency use authorization (EUA) for molnupiravir [MOLNARZ]December 22, 2021
  • Ministry of Health, FAQ COVID-19, May 2021