Antipyretic rectal suppositories for children against fever: a review of medications and use for infants and older children. Suppositories for children Paracetamol: instructions for using an effective remedy against fever and pain
Analgesic-antipyretic
Active substance
Release form, composition and packaging
◊ Rectal suppositories for children from white to white with a creamy or white with a yellowish tint, torpedo-shaped.
Excipients: solid fat base to obtain a suppository weighing 1.25 g.
5 pieces. - contour cell packaging (2) - cardboard packs.
pharmachologic effect
Non-narcotic, blocks COX1 and COX2 mainly in the central nervous system, affecting the centers of pain and thermoregulation. In inflamed tissues, cellular peroxidases neutralize the effect of paracetamol on COX, which explains practically complete absence anti-inflammatory effect. No blocking effect on Pg synthesis in peripheral tissues causes him to lack negative influence on water-salt metabolism(retention of Na+ and water) and the mucous membrane of the gastrointestinal tract.
Pharmacokinetics
Absorption - high, TC max - 0.5-2 hours; C max - 5-20 µg/ml. Protein binding - 15%. Penetrates through the BBB. Less than 1% of the dose of paracetamol taken by a nursing mother penetrates into breast milk. Metabolized in the liver in three main ways: conjugation with glucuronides, conjugation with sulfates, oxidation by microsomal liver enzymes. In the latter case, toxic intermediate metabolites are formed, which are subsequently conjugated with glutathione, and then with cysteine and mercapturic acid. The main isoenzymes of cytochrome P450 for this metabolic pathway are the isoenzyme CYP2E1 (mainly), CYP1A2 and CYP3A4 (minor role). With glutathione deficiency, these metabolites can cause damage and necrosis of hepatocytes.
Additional metabolic pathways include hydroxylation to 3-hydroxyparacetamol and methoxylation to 3-methoxyparacetamol, which are subsequently conjugated to glucuronides or sulfates.
In adults, glucuronidation predominates, in newborns (including premature babies) and small children - sulfation. Conjugated metabolites of paracetamol (glucuronides, sulfates and conjugates with glutathione) have low pharmacological (including toxic) activity.
T1/2 - 1-4 hours. Excreted by the kidneys in the form of metabolites, mainly conjugates, only 3% unchanged.
Indications
Used in children from 3 months to 12 years as:
- antipyretic for acute respiratory diseases, influenza, childhood infections, post-vaccination reactions and other conditions accompanied by an increase in body temperature;
- an analgesic for pain of mild to moderate intensity, including: headaches and toothaches, muscle pain, neuralgia, pain from injuries and burns.
Contraindications
Hypersensitivity, neonatal period (up to 1 month).
Carefully. Renal and liver failure, benign hyperbilirubinemia (including Gilbert's syndrome), viral hepatitis, blood diseases (leukopenia, thrombocytopenia), early infancy(up to 3 months).
Dosage
Rectally.
The frequency of administration is 2-4 times a day; interval - at least 4 hours.
The dose depends on the age and body weight of the child. The average single dose is 10-12 mg/kg body weight. The maximum daily dose of paracetamol should not exceed 60 mg/kg body weight.
from 6 to 12 months – 0.5-1 suppository (50-100 mg);
from 1 year to 3 years - 1-1.5 suppositories (100-150 mg);
from 3 to 5 years – 1.5-2 suppositories (150-200 mg);
from 5 to 10 years – 2.5-3.5 suppositories (250-350 mg);
from 10 to 12 years – 3.5-5 suppositories (350-500 mg).
Do not take the drug for more than 3 days as an antipyretic and 5 days as an analgesic without a doctor’s prescription! In children under 3 months of age, it can be used at elevated temperatures caused by vaccination (vaccination). For all other indications, Paracetamol in children under 3 months of age is used only as prescribed by a doctor.
Side effects
Allergic reactions (incl. skin rash, itching, angioedema).
Rarely - hematopoietic disorders (anemia, thrombocytopenia, methemoglobinemia).
Overdose
Symptoms: within the first 24 hours after administration gastrointestinal disorders(diarrhea, loss of appetite, nausea, vomiting, cramps, stomach pain), Symptoms of liver dysfunction may appear 12-48 hours after an overdose (the severity of necrosis directly depends on the degree of overdose) - increased activity of “liver” transaminases, increased prothrombin time ; expanded clinical picture Liver damage appears after 1-6 days. In case of severe overdose - liver failure with progressive encephalopathy. Rarely, liver dysfunction develops at lightning speed and can be complicated by renal failure (tubular necrosis).
Treatment: administration of SH-group donors and precursors for the synthesis of glutathione-methionine within 8-9 hours after an overdose and N-acetylcysteine - up to 12 hours. The need for additional therapeutic measures (further management, intravenous administration of N-acetylcysteine) is determined depending on the concentration of paracetamol in the blood, as well as on the time elapsed after its administration.
Drug interactions
Stimulators of microsomal oxidation in the liver (phenytoin, ethanol, barbiturates, flumecinol, phenylbutazone, tricyclic antidepressants) increase the production of hydroxylated active metabolites, which makes it possible to develop hepatotoxic effects in small overdoses. Inhibitors of microsomal oxidation (including) reduce the risk of hepatotoxicity. When taken together with salicylates, nephro toxic effect paracetamol increases. Combination with chloramphenicol leads to an increase in the toxic properties of the latter. Enhances the effect
Paracetamol can be called one of the most popular antipyretic drugs if we're talking about about a decrease in the child’s temperature. Doctors call this medication safe for children and are often prescribed for both fever and pain. The smallest children are often prescribed candles.
Release form and composition
Paracetamol suppositories are produced in different pharmaceutical companies– “Altfarm”, “Altaivitamins”, “Biochemist” and others. All of them as the main component providing candles healing effect, contain Paracetamolum. Depending on its quantity in one suppository, the following dosages are distinguished:
- 50 mg
- 100 mg
- 250 mg
- 500 mg
Apart from Paracetamolum, such a medicine has only one auxiliary ingredient, which is a fatty base. Thanks to this base, the candle has a torpedo-shaped shape, white-cream or white color, the drug easily enters the anus and dissolves quite quickly inside the intestines.
Operating principle
Paracetamol affects brain tissue (in particular, the centers of pain and temperature regulation) by blocking cyclooxygenase. By influencing the functioning of such an enzyme, the drug lowers body temperature and eliminates pain if it is of moderate or mild intensity. Suppositories do not have a pronounced anti-inflammatory effect.
Indications
Most often, “Paracetamol” in suppositories is used to bring down the temperature caused by ARVI, chicken pox, measles, flu, mumps, herpes or other viral infection. Medicine effectively fights fever that occurs during inflammatory processes caused by bacteria, such as tonsillitis, pyelonephritis or tonsillitis. In addition, this medication can also be used in case of a temperature reaction to vaccination. Since suppositories have I have analgesic effect, they can also be used for toothache, pain in the joints, throat, ear and other localizations.
At what age is it prescribed to children?
Paracetamol suppositories should not be used during the neonatal period. If the baby is already 1 month old, then the doctor may prescribe such a medication at a high temperature, but with some reservations. For such young patients, Paracetamol is indicated only when the temperature rises, which is a reaction to vaccination. In addition, the drug is used once.
If the baby is already 3 months old, you can use candles without fear. This form of Paracetamol can be used up to 12 years of age, choosing the right dosage for a specific child.
Although patients over 6 years old can already be given tablets, and children from 3 months to 12 years old are also allowed Paracetamol in suspension, the use of suppositories is sometimes preferable:
- Firstly, if the child has nausea, and any drugs taken by mouth provoke an attack of vomiting.
- Secondly, if the small patient cannot tolerate any chemical additives present in liquid or tablet form.
Contraindications
Suppositories are not used not only for hypersensitivity to Paracetamol, but the following situations may also be contraindications:
- The appearance of erosive or ulcerative changes in the wall of the digestive tract.
- Stomach or intestinal bleeding.
- Lack of glucose 6 phosphate dehydrogenase.
- Inflammation of the rectum.
Young patients with kidney disease require increased attention from the doctor when prescribing Paracetamol suppositories. bronchial asthma, blood pathologies, liver damage and some other diseases.
Side effects
When treated with Paracetamol, allergic reactions or other negative symptoms, for example, nausea or bronchospasm. In this case, the medicine is immediately discontinued, and the child should be shown to a doctor.
Instructions for use
The following procedure can be given when using Paracetamol suppositories:
- The child needs to be put down and hands washed. Having spread the buttocks and carefully inserted the candle, released from the packaging, into the anus, you need to push it inside with your finger.
- To prevent the use of a suppository from causing bowel movements, it is recommended to insert the drug either after an enema or after a natural bowel movement.
- If necessary, the candle can be cut into halves, but the resulting sharp edges should be rubbed with your fingers to smooth them out.
- Paracetamol in suppositories is used 2 to 4 times a day. The interval between medications should be at least 4 hours.
- To determine the dosage of the drug for a specific baby, you need to know his age and body weight. Doctors calculate a single dose by multiplying the patient’s body weight by 10-12 mg, while the child should not receive more than 60 mg/kg of Paracetamol per day.
- The average single dosage of Paracetamol in suppositories for babies up to one year is 50-100 mg. Children from 1 to 3 years old are given a suppository with a dosage of 100 mg or half a suppository of 250 mg. For children 3-5 years old, this medication is prescribed in a dose of 150-200 mg. A child 5-10 years old is prescribed suppositories of 250 mg of Paracetamol, and at 10-12 years of age the therapeutic effect will only be from using the medicine with the highest dosage (500 mg in one suppository).
- It is recommended to limit the duration of use of suppositories to 5 days if the medication is prescribed for pain, or 3 days if Paracetamol is used as an antipyretic. More long-term treatment must be agreed with a doctor
Thank you
Paracetamol is an antipyretic and analgesic drug for children and adults from the group of non-steroidal anti-inflammatory drugs (NSAIDs). Used as symptomatic remedy to relieve pain and reduce body temperature in the composition complex therapy various colds, as well as weak or moderate pain syndrome(for example, dental, headache, menstrual pain, migraine, neuralgia, muscle pain, etc.).Release forms, names and composition of Paracetamol
Currently, Paracetamol is available in the following dosage forms Oh:
- Tablets for oral administration;
- Capsules for oral administration;
- Syrup for oral administration;
- Oral suspension for children and adults;
- Rectal suppositories (candles) for children and adults.
The suspension is often called "children's Paracetamol", meaning the type of drug that contains active substances in dosages for children. Often the name "children's Paracetamol" is used to refer to any form of the drug (suspension or suppositories) containing active substance in children's doses. In this case, no specific form is meant.
Suppositories for rectal administration are almost always and universally called “Paracetamol suppositories”. In addition to the indicated names used in everyday life to designate various forms and varieties of Paracetamol, there is another group of names of medicines containing paracetamol as the active substance. In this case, manufacturers can give the drug any sonorous commercial name, for example, Panadol, Apap, Kalpol, Efferalgan and others, or use one simple trick. This technique consists in the fact that the name of the drug is made up of two parts, the first of which is the word “Paracetamol”, and the second is several letters or a word indicating the manufacturer of this particular medicine, for example, “Paracetamol-UBF”, “Paracetamol- LekT", "Paracetamol MS", "Paracetamol-Hemofarm", etc.
Since all these drugs contain the same active substance, that is, they are synonyms and are available in the same dosage forms, the common name “Paracetamol” is used for them. In the further text of the article we will provide information about all these varieties and options. medicines, united common name Paracetamol. At the same time, we will also use the general name Paracetamol for all varieties, without citing specific commercial names that manufacturers came up with to distinguish their drug from the general range.
As an active substance, all forms of Paracetamol include a component of the same name - paracetamol, in the following dosages:
- Tablets – 200, 500 and 325 mg;
- Capsules – 325 mg;
- Syrup – 120 mg per 5 ml and 125 mg per 5 ml;
- Suspension for adults – 120 mg per 5 ml;
- Suspension for children – 24 mg/ml;
- Suppositories for adults – 50 mg, 100 mg, 250 mg and 500 mg;
- Suppositories for children - 50 mg, 100 mg, 125 mg and 250 mg.
Effect of Paracetamol (what helps)
Paracetamol is a non-narcotic pain reliever and antipyretic drug from the group of non-steroidal anti-inflammatory drugs (NSAIDs). This means that the drug is blocking the work cyclooxygenase – a special enzyme that ensures the synthesis of biologically active substances that provoke the development of pain, inflammation and increased body temperature. That is, Paracetamol blocks the formation of substances responsible for the development of pain and fever, thereby relieving pain and normalizing body temperature.A distinctive feature of Paracetamol from other drugs NSAID groups is its ability to block cyclooxygenase in the central nervous system, which gives it the ability to perfectly reduce temperature, relieve moderate pain and have virtually no effect negative influence on the gastric mucosa. However, this same ability to inactivate cyclooxygenase in the central nervous system gives Paracetamol another property - the drug has virtually no anti-inflammatory effect. That is why Paracetamol is not used to relieve pain associated with severe inflammatory process, such as muscle and joint pain, traumatic injuries ligaments, tendons, bruises, etc.
That is, Paracetamol has a pronounced and one of the most powerful antipyretic effects among all NSAIDs and a moderate analgesic effect. Therefore, the drug is used to reduce elevated temperature body in children and adults and for the relief of pain of moderate or low intensity, not associated with the inflammatory process (for example, headache, toothache, menstrual pain, neuralgia, muscle aches, etc.).
Paracetamol in soluble forms (suspension, syrup, suppositories) works faster than tablets Therefore, if you need to get the effect in the shortest possible period of time, you should use these types of the drug.
Indications for use
All dosage forms of Paracetamol are completely same readings for use because they are intended to enter the bloodstream and provide a systemic effect. Accordingly, regardless of how Paracetamol enters the bloodstream (by ingestion or insertion into the rectum), it will have exactly the same effect. And different dosage forms allow you to choose the most convenient and optimal option for using Paracetamol in each specific case. For example, when severe vomiting it is necessary to use Paracetamol in the form rectal suppositories which are inserted into the rectum. If it is impossible to swallow a tablet, for example, with a sore throat or other disease associated with swelling of the throat or oropharynx, Paracetamol should be taken in the form of syrup or suspension, etc. That is, the differences in the indications for the use of different dosage forms of Paracetamol lie in their use in different clinical situations for the same symptoms.
It should be remembered that Paracetamol is intended only to relieve painful symptoms and not to treat the disease. Therefore, in combination with Paracetamol, it is imperative to use other medications that can cure the underlying disease.
Instructions for use
Let's consider the rules of use, dosage and duration of therapy with various forms of Paracetamol separately.Paracetamol tablets (200, 325 and 500), syrup and suspension - instructions for use
Tablets should be taken orally, swallowed whole or broken in half and washed down big amount water (minimum 100 ml). Shake the syrup and suspension well before use, then pour into a measuring spoon or small container and swallow, also with plenty of water. You can dissolve the required amount of syrup in prepared water and drink it completely. The suspension should not be diluted in water; it must be drunk whole and only then washed down with water. Tablets, syrup and suspension must be taken 1 - 2 hours after meals so that the effect of the drug develops as quickly as possible. In principle, Paracetamol in any form can be taken immediately after meals, but in this case its absorption into the bloodstream slows down and, accordingly, therapeutic effect takes longer to develop. If you take Paracetamol before meals, you can provoke the development of side effects from the digestive tract.
It should be remembered that the fastest therapeutic effect syrup and suspension provide relief, but the tablets will have to wait a little longer for their effect. Therefore, if you need to get an antipyretic or analgesic effect quickly, you should use a syrup or suspension for a person of any age. If it is quite possible to wait 15 - 30 minutes before the effect appears, then it is recommended to take Paracetamol tablets.
During therapy, Paracetamol should be taken 2 to 3 times a day, keeping an interval of at least 4 hours between two consecutive doses. People suffering from kidney failure should maintain an interval of 8 hours between two consecutive doses of Paracetamol. It is recommended to always take the drug at approximately equal intervals, as this will avoid sharp jumps temperature and fluctuations in pain intensity.
The tablets are intended only for adults or adolescents over 15 years of age weighing at least 50 kg. Suspension and syrup with a dosage of 250 mg per 5 ml and 500 mg per 5 ml are also intended only for adults or adolescents over 12 years of age weighing at least 40 kg.
Adults are recommended to take 200–400 mg of Paracetamol at a time. Single dosage should not exceed 500 mg, daily – 3000 mg. For people suffering from renal failure, the maximum permissible single dosage of Paracetamol is 250 mg, and the daily dosage is 1500 mg.
To reduce fever, Paracetamol in any form should not be used for more than three days without consulting a doctor. For pain relief, without consulting a doctor, Paracetamol can be used for no longer than five days.
When taking Paracetamol tablets, syrup and suspension, you should remember that the drug can cause liver damage, which is especially likely in people suffering from alcoholism. In addition, Paracetamol changes the concentration of glucose and uric acid in the blood.
During the entire period of Paracetamol therapy, it is necessary to take a general blood test.
Paracetamol syrup contains sucrose, which must be taken into account by people suffering from diabetes.
Instructions for use of suppositories
Suppositories are inserted into the rectum one at a time. Therefore, you should select candles with the dosage required in this case for a particular person. To insert the suppository, you need to take a comfortable position, for example, squatting or kneeling, etc. Then moisten forefinger working hand (right for right-handers and left for left-handers) with water, with the other hand, carefully spread the buttocks, freeing the anus and push the candle into it. Then you need to pass the suppository past the anal sphincter so that it enters the rectum. To do this, the index finger is inserted into the anus approximately 4 cm, that is, to the end of the second phalanx. After inserting the suppository, you should wash your hands thoroughly with soap.
Suppositories are used as needed 1 to 4 times a day, maintaining an interval of at least 4 hours between successive administrations. The maximum permissible single dosage for adults is 1000 mg, and the daily dosage is 4000 mg.
Without consulting a doctor, you cannot use suppositories for more than 3 days to reduce body temperature, and for more than 5 days to relieve pain.
Candles can be used for children from three months.
Paracetamol suppositories can be used as desired or when oral forms are not available, e.g. small child who has difficulty swallowing medicine, vomiting, etc. It is necessary to know that the effect of using Paracetamol in suppositories occurs faster than from tablets, but at approximately the same speed as when taking syrup or suspension.
Paracetamol - dosage for adults
For adults and adolescents over 12 years of age with a body weight of more than 40 kg, the dosage of Paracetamol for a single dose is 200 - 500 mg. If necessary, you can increase the single dosage to a maximum of 1000 mg. Maximum permissible daily dosage for adults is 4000 mg. For fever and pain, Paracetamol is taken 3 to 4 times a day at approximately equal intervals. The minimum acceptable time interval between two consecutive doses of the drug is 4 hours.Paracetamol should not be taken for more than 5 to 7 days in a row. If longer-term pain relief is required, then it is necessary to select another drug from the NSAID group that is suitable for long-term use.
Paracetamol for children - instructions
Children's forms of Paracetamol include suspension and suppositories with a low content of active substance. The rules for using these forms in children are the same as in adults. That is, the suspension must be measured with a special spoon, lid or other device and given to the child to drink. After he swallows the suspension, you need to give him plain water to drink. The suspension should not be diluted in water, as this may reduce the dosage of the drug that the child will receive. After all, having diluted the suspension in water, it is necessary to force the child to drink the entire volume of liquid, and often this is impossible. Children's suspensions and suppositories contain small amounts of the active substance, but exactly the same dosages are available among adult drugs. Therefore, in the absence Children's Paracetamol you can use adult form, having the same dosage as for children.
Suppositories are administered into anus child, placing him on his stomach and slightly raising his buttocks. To insert a candle, the index finger of one hand is moistened with water, and with the other hand, the buttocks are spread to the sides, exposing and stretching the skin of the anus. Then, with a wet finger, gently insert the suppository into the rectum. If necessary, you can cut the candle into pieces, for example, in half or in a ratio of 1/3 to 2/3, etc.
Suspensions and suppositories are used for a child, if necessary, 3 to 4 times a day, trying to maintain equal intervals between doses. You can re-give the baby the suspension or administer the suppository after at least 4 hours. Maximum permissible duration The use of children's Paracetamol without consulting a doctor is 5 - 7 days.
Pediatricians recommend using suppositories and suspension in a certain order, depending on the temperature and the child’s reaction to the drug. So, when a child’s temperature rises to 38.0 o C, then first of all you should use rectal suppositories. If the temperature has returned to normal, then it is also recommended to further reduce the temperature with the help of candles. If the temperature does not return to normal, then the child is given a suspension. If the temperature rises above 38.0 o C, then the child is immediately given a suspension without trying to use suppositories. This tactic of action is conditional, so it does not need to be strictly adhered to. In each situation, it is necessary to choose the drug that is more convenient for the child and adults.
Paracetamol - dosage for children
The dosage of suspension and suppositories in children is determined by age and body weight. Moreover, the child’s body weight plays a decisive role. That is, if body weight is less age norm, then you should give the child the amount of Paracetamol intended for the previous age group. For example, if a child is 1.1 years old, but his body weight is low, then he should be given Paracetamol in a dosage for children from 3 to 12 months. It is also necessary to remember that for children under 12 years of age the drug should be used only in the form of a suspension or rectal suppositories.Single dosages of Paracetamol for children of various ages and body weights are shown in the table.
| Paracetamol form | Child's age | Dosage in mg |
| Suspension | 3 – 12 months | 60 – 120 mg (2.5 – 5 ml) 2 – 3 times a day |
| 16 years | 120 – 240 mg (5 – 10 ml) 4 times a day | |
| 6 – 12 years | 240 – 480 mg (10 – 20 ml) 4 times a day | |
| Over 12 years old | 200 – 500 mg (8 – 21 ml) 3 – 4 times a day | |
| Suppositories | 3 – 6 months | 80 mg (2/3 100 mg suppositories) 2 times a day |
| 6 – 12 months | 80 mg (2/3 100 mg suppositories) 2 – 3 times a day | |
| 1 – 2 years | 80 mg (2/3 100 mg suppositories) 3 – 4 times a day | |
| 24 years | 125 – 150 mg 2 – 3 times a day | |
| 4 – 6 years | 125 – 150 mg 3 – 4 times a day | |
| 6 – 8 years | 250 – 300 mg 2 – 3 times a day | |
| 8 – 12 years | 250 – 300 mg 3 times a day | |
| 12 – 15 years | 250 – 400 mg 3 – 4 times a day |
The table shows single dosages of Paracetamol for children of different ages. In addition, you need to know the following maximum permissible daily dosages of Paracetamol for children of different ages:
- Children under 6 months weighing no more than 7 kg – 350 mg per day;
- Children 6 – 12 months weighing no more than 10 kg – 500 mg per day;
- Children 1 – 3 years old weighing no more than 15 kg – 750 mg per day;
- Children 3 – 6 years old weighing no more than 22 kg – 1000 mg per day;
- Children 6 – 9 years old weighing no more than 30 kg – 1500 mg per day;
- Children 9 – 12 years old weighing no more than 40 kg – 2000 mg.
Impact on the ability to operate machinery
Paracetamol does not affect the ability to control mechanisms, therefore, while using the drug, you can engage in any type of activity related to the need to have high speed reactions and concentration.Overdose
Overdose is possible when using Paracetamol in any form, even rectal suppositories. On the first day after an overdose, a person experiences the following symptoms: - Pale skin;
- Vomit;
- Impaired glucose absorption;
- Liver dysfunction.
If poisoning occurred less than 4 hours ago, then first of all the person’s stomach is washed and sorbents are given (for example, activated carbon, Polysorb, Polyphepan, etc.). Further treatment overdose is intravenous administration antidote, which can be used as any substance that is a donor of SH groups, for example, unithiol. Together with the antidote, glutathione precursors – methionine and acetylcysteine – are administered over 8–9 hours. In the future, depending on the person’s condition, the administration of unithiol, methionine and acetylcysteine can be repeated.
Interaction with other drugs
Paracetamol reduces the effectiveness of drugs that remove uric acid from the body (Probenecid and others), but enhances the effects of anticoagulants (Warfarin, Thrombostop, etc.). The use of barbiturates reduces the effectiveness of Paracetamol.Drugs that are inducers of liver enzymes (Phenytoin, Rifampicin, Phenylbutazone, barbiturates, tricyclic antidepressants, etc.) and Diflusanil increase the toxic effect of Paracetamol on the liver, which makes the likelihood of severe intoxication even with a minimal overdose. Drugs that are inhibitors of liver enzymes (cimetidine, etc.), on the contrary, reduce the toxic effect of Paracetamol on liver function.
Alcoholic drinks increase the risk of developing pancreatitis while taking Paracetamol. Combined use with Aspirin for a long period of time increases the risk of developing kidney cancer or Bladder. Taking Paracetamol with other NSAIDs increases the risk of developing kidney pathology, including renal failure.
Paracetamol for children (can it be given)
Paracetamol can be given to children from three months of age in standard dosages. In principle, the drug can be given to children from birth, but in this case, for babies under 3 months, the dosage is prescribed by the doctor on an individual basis.Paracetamol is the safest antipyretic and analgesic drug for use in childhood under 12 years old. However, this does not mean that it is completely safe and can be given in excess of dosage, without observing the intervals between doses, etc. Paracetamol should be used only in recommended doses, without increasing them at your own discretion and without giving the baby the drug more than once every 4 hours.
Currently, there are two safest "children's" types of drugs for reducing fever, relieving pain and inflammation - these are drugs containing paracetamol or ibuprofen as an active substance. However, ibuprofen is more likely to cause severe side effects, so paracetamol is still safer. That is why pediatricians recommend first of all using Paracetamol to relieve pain and reduce fever, but if it does not work, then use Ibuprofen.
Paracetamol during pregnancy
In experimental studies on animals, no negative effects of Paracetamol on the fetus (teratogenic, embryotoxic or mutagenic) were established. However, for obvious ethical reasons, such studies have not been conducted on pregnant women, and therefore Paracetamol is considered only conditionally safe during pregnancy. This means that the drug should only be taken after consulting a doctor and carefully assessing the possible risks. However, such dry prohibitive language official instructions do not fully reflect the real state of affairs. Naturally, from the standpoint of evidence-based medicine, Paracetamol really cannot be considered a completely safe drug during pregnancy, since there is no data from special studies conducted with the participation of pregnant volunteers. But besides the position evidence-based medicine Doctors around the world are guided by long-term observational data that accumulates when using the drug.
Such observations of the use of Paracetamol by pregnant women over several decades show that the drug does not cause any negative impact on the fetus and the course of pregnancy. Therefore, it can be considered completely safe for pregnant women. Accordingly, if necessary, Paracetamol can be used during pregnancy in recommended dosages.
Use during breastfeeding
Paracetamol passes into breast milk in small quantities - from 0.04 to 1% of the dose taken. Considering such a small amount and the permissibility of using Paracetamol in newborns and infants, practicing pediatricians allow taking the drug when breastfeeding. However, doctors warn that Paracetamol during breastfeeding can only be taken short course no longer than a week. If the drug needs to be taken for a longer period of time, then you should stop breastfeeding and transfer the child to artificial formula.The instructions for use indicate that Paracetamol during breastfeeding can only be taken as prescribed by a doctor and in cases where the expected benefit exceeds all possible risks. You should not be afraid of this phrase, since manufacturers must write this in the instructions if there is no research data on female volunteers. Data from long-term observations of the condition of women taking the drug, according to the rules for preparing accompanying instructions for drugs, are not taken into account. But in practice, doctors all over the world always take into account not only the results of experiments, but also observational data. And based on observations, Paracetamol is quite safe during breastfeeding.
Paracetamol and Analgin
A fairly well-known and widespread combination of Analgin + Paracetamol, used for the purpose of quick and effective reduction temperature is very dangerous. Analgin can provoke severe complications in children and adults, such as anaphylactic shock, a critical decrease in the number of leukocytes in the blood, collapse and a persistent decrease in body temperature below normal. Due to the relative frequency of these complications, Analgin was banned for use as an antipyretic in Europe and the USA back in the 60s and 70s of the 20th century. WHO, in its 1991 statement, also strongly recommends against the use of Analgin as an antipyretic.Therefore, due to possible very severe complications Paracetamol with Analgin should not be used to reduce temperature. If Paracetamol is not effective enough, then it is recommended to use any drug containing ibuprofen (for example, Nurofen, Ibuprofen, etc.) or nimesulide (Nimesil, Nise, Nimulid, etc.).
Paracetamol or Aspirin?
The choice between Paracetamol and Aspirin must be made taking into account a number of factors. Thus, Aspirin is more effective in reducing fever, but it cannot be used in children under 15 years of age with viral infections, since in this case there is a high risk of developing Reye's syndrome (liver failure + encephalopathy). That is, if we are talking about a child under 15 years old, then you should always choose Paracetamol rather than Aspirin.An adult can choose any drug, provided that he does not suffer from intolerance to any one of them. Moreover, it is recommended to choose Paracetamol to reduce the temperature, and Aspirin to relieve pain. Doctors advise that if you have a body temperature, you should always use Paracetamol first, and only if it is ineffective, use Aspirin. Aspirin should not be used as a first-line drug.
So, absolute contraindications The following conditions and diseases are applicable:
- Individual sensitivity or intolerance to Paracetamol or components of the drug;
- Neonatal period up to 1 month;
- Glucose-6-phosphate dehydrogenase deficiency;
- Diseases of the blood system.
- Kidney or liver failure;
- Benign hyperbilirubinemia (increased concentration of bilirubin in the blood);
- Viral hepatitis;
- Alcohol damage liver;
- Alcoholism;
- Diabetes mellitus (for syrup only);
- Pregnancy and breastfeeding period;
- Elderly age over 65 years;
- Age less than 3 months.
Paracetamol: therapeutic properties, dosage, contraindications - video
What to do if paracetamol does not help reduce your child’s temperature - video
Paracetamol analogs and synonyms
On pharmaceutical market There are drugs synonymous and analogues of Paracetamol. Synonyms are medicines, which also contain paracetamol as an active substance. Analogs include any other drugs from the NSAID group (Aspirin, Ibuprofen, Nimesulide, etc.). Below we provide only a list of synonymous drugs, since the number of analogues is excessively large. The following drugs are synonyms for Paracetamol:
- Apap tablets;
- Daleron suspension and tablets;
- Children's Panadol syrup and rectal suppositories;
- Ifimol syrup and solution for injection;
- Calpol suspension;
- Xumapar granules;
- Lupocet syrup;
- Mexalen tablets, syrup and rectal suppositories;
- Pamol tablets, effervescent tablets, solution and rectal suppositories;
- Panadol tablets and syrup;
- Perfalgan solution for injection;
- Prohodol tablets and suspension for children;
- Sanidol tablets;
- Strimol tablets;
- Tylenol tablets;
- Tylenol children's drops, syrup and chewable tablets;
- Flutabs effervescent tablets;
- Cefekon D rectal suppositories for children;
- Efferalgan tablets, rectal suppositories and children's syrup.
Paracetamol - price
Currently, the cost of various forms of Paracetamol in pharmacies in Russian cities varies within the following limits:- Tablets 200 mg, 10 pieces – 3 – 21 rubles;
- Paracetamol 500 mg, 20 pieces – 4 – 7 rubles;
- Tablets 500 mg, 20 pieces – 14 – 20 rubles;
- Suspension 120 mg per 5 ml, 100 ml – 61 – 77 rubles;
- Suspension 120 mg per 5 ml, 200 ml – 118 – 154 rubles;
- Suppositories 100 mg, 10 pieces – 31 – 42 rubles;
- Suppositories 500 mg, 10 pieces – 37 – 45 rubles;
- Suppositories 250 mg, 10 pieces – 48 – 60 rubles.
A high temperature accompanies almost any illness in a child, be it a cold or teething. And often it becomes an even greater cause for concern than the baby’s initial illness. On the one hand, the presence of temperature indicates that the body is actively fighting the disease. On the other hand, a significant increase in body temperature can lead to irreversible consequences.
Especially dangerous temperature is for infants and children in the first years of life, as it can cause the development of febrile seizures. This can be avoided if you constantly monitor your body temperature during illness and, if necessary, lower it special drugs. For children, candles are a convenient form of such means. After all, they put less strain on the liver and can be used even when the child is sleeping. Suppositories (or suppositories) Paracetamol is a popular antipyretic drug that is suitable for babies after three months of life.
Paracetamol suppositories for children have the shape of a cylinder with a pointed end and are packaged in film cell packaging, which is placed in cardboard box, which also includes instructions for use. The number of pieces in the package and the amount of paracetamol in one suppository depend on the manufacturer. This could be, for example, 6 or 10 suppositories, each of which will contain from 50 to 500 mg active substance. The color of the suppository varies from white to white-yellow.
Compound
The main active ingredient of suppositories is identical to their name - Paracetamol. One suppository may contain 80 mg, 150 mg, 170 mg, 330 mg or 500 mg of paracetamol. The auxiliary component is solid fat.
Operating principle
Paracetamol acts on the temperature and pain regulation centers in the body. It inhibits the production of prostaglandins (compounds that affect the rise in temperature and pain sensitivity). The drug begins to act in approximately 50-60 minutes and continues its effect for 6-8 hours.
Important! It should be remembered that Paracetamol in the form of suppositories begins to act later than syrup, but has a longer lasting effect. Therefore, when it is necessary to shoot down high temperature as fast as possible - liquid form will be more effective. Paracetamol suppositories should be used in advance, for example, before bedtime.
Indications (why prescribed to children)
Paracetamol is one of the safest medications for the baby's body. It is prescribed as an antipyretic and analgesic for:
- colds, flu, infectious diseases(chickenpox, rubella, whooping cough, measles, scarlet fever, mumps);
- increased temperature in children after vaccination;
- pain syndrome associated with teething, ear pain and sore throat.
Paracetamol in the form of suppositories is a convenient drug for children in the first six months of life, because:
- the absence of additional ingredients (sweeteners, flavorings, flavoring additives) reduces the likelihood of allergic reaction The child has;
- eliminates the possibility of choking on the drug or spitting it out in children who have problems taking medications by mouth (nausea, vomiting, regurgitation, whims);
- has fewer side effects and puts less strain on the body, since through the intestines medicinal substance immediately absorbed into the blood, bypassing the liver and digestive tract;
- can even be used in a child's sleep, if such a need arises.
At what age is it allowed to take
Manufacturers of Paracetamol in the form of suppositories recommend its use for children starting from three months, and for babies weighing more than 4 kg.
If necessary, suppositories can be used from birth, if possible benefit from the drug exceeds the potential risk from its use, and always after consultation with a doctor.
Contraindications and side effects
- dysfunction of the liver and kidneys;
- inflammatory diseases of the rectal mucosa;
- deficiency of the enzyme glucose-6-phosphate dehydrogenase;
- blood diseases;
- dysfunction of the anus and diarrhea.
Paracetamol should be prescribed with caution to pregnant women and during lactation.
Possible side effects from using Paracetamol:
- allergic reactions;
- increased bleeding, inhibition of hematopoiesis;
- bronchospasm;
- nausea, liver dysfunction;
- irritation of the rectum and anus.
Instructions for use and dosage
Suppositories must be used rectally, that is, inserted into the child’s anus, placing the baby on his side or back.
- You must wash your hands thoroughly with soap or use medical gloves. The candle should be at room temperature.
- The suppository should be administered to the child with the pointed end after bowel movements.
- The baby's buttocks must be kept pressed for several minutes so that the child does not reflexively push the suppository back.
The single dose depends on the age and weight of the child. The optimal single dose is 10-15 mg per 1 kg of child weight.
- babies from birth to three months are allowed to use the drug only as prescribed by a doctor;
- for children from three months to a year (weighing from 4 to 10 kg) a single dose of one suppository of 0.08 g is recommended;
- for children from one to six years old (weighing from 10 to 20 kg) a single dose of one suppository of 0.17 g is recommended;
- For children from 7 to 12 years old, a single dose of one suppository of 0.33 g is recommended;
- For children over 12 years of age, a single dose of 1-2 suppositories of 0.33 g is recommended.
Important! Repeated administration of the suppository should be no earlier than after 4-6 hours, and no more than 4-5 times a day. In any case, it is necessary to focus, first of all, on the WEIGHT of the child. The daily dose of paracetamol should not exceed 60 mg/kg! Maximum permitted duration of use:
- children under 6 years old – 3 days;
- children over 6 years old – 5 days.
Overdose
To avoid overdose, it is necessary to clearly calculate the one-time and daily dose taking the drug. If the amount of Paracetamol taken is many times higher than the maximum recommended dose, digestive disorders (nausea, vomiting, diarrhea, lack of appetite, abdominal pain), increased sweating, heart failure and respiratory system. Negative Impact Paracetamol on the liver may be accompanied by drowsiness, pallor of the skin and mucous membranes, and dizziness.
Most symptoms appear on the first day after an overdose.
Interaction with other drugs
Paracetamol should not be taken with other medications that contain it, to avoid overdose. To do this, it is necessary to study in detail the composition of antipyretic drugs and alternate paracetamol-containing drugs with medications where the active substance is.
Paracetamol enhances the effect acetylsalicylic acid, caffeine, codeine. The combination of Paracetamol with alcohol leads to the fact that the toxicity of the drug increases significantly. Preparations containing Acetylcysteine are an antidote for Paracetamol poisoning.
Analogs
For Paracetamol, two groups of analogues can be distinguished.
- Preparations that also contain Paracetamol as an active substance, but have a different tradename. This is Panadol, in the form of suppositories. The effect of such drugs will be identical to the action of Paracetamol.
- Antipyretic drugs based on another active ingredient. This can be homeopathic suppositories - Viburkol - which are allowed even for newborns. Or drugs based on ibuprofen (, Arofen, Ibunorm Baby). It is they that need to be alternated with Paracetamol if it alone is not enough to reduce the temperature, or the required interval between uses has not expired.
Paracetamol in suppositories is a drug intended to relieve symptoms of the disease. According to statistics, the medicine is one of the most common drugs in the world. Paracetamol suppositories for children (instructions are below) are sold in every pharmacy and are available without a prescription.
Indications for use of suppositories
Paracetamol belongs to the following pharmacological groups: anilides, antipyretics, analgesics. Children's suppositories are often used for feverish conditions caused by,. Paracetamol brings down the temperature, elevated to subfebrile and febrile values. The medicine interferes with the production of a protein - interferon, which effectively neutralizes viruses.
According to the instructions, suppositories are prescribed only to relieve symptoms. The medication is effective for dental, burn, traumatic, neurogenic and headache pain. The medicine is prescribed for arthralgia, chicken pox, algodismenorrhea.
From what age can you use candles? Paracetamol suppositories are allowed for use from 3 months.
Dosage regimen
The medicine is administered rectally. Single dosage is 15 mg/kg, daily dosage should not exceed 60 mg/kg. Instructions for use do not allow the use of suppositories for longer than three days.
The table will help you quickly determine the dosage for children by age.
If during the three-day treatment period the symptoms are still bothersome, you should visit the clinic about the possibility of further use of the medication.
Note to parents! Before using suppositories, carefully read the instructions and interactions with other medications to avoid an overdose. Follow the prescribed dosage and read the storage conditions of Paracetamol.
Correct use of candles
The correct use of suppositories plays a big role in their effect on the body. Let's look at how to use and when you can use Paracetamol suppositories. Before using candles small child they give an enema, the adult just needs to go to the toilet.
Before inserting the suppository, wash your hands with soap, place the child on his side, tuck his legs toward his tummy. Taking Paracetamol out of the capsule, spread the baby's buttocks and insert the suppository into the anus. After administration, you should squeeze the child’s buttocks, hold them for a while and ask him to lie down for about half an hour.
Important! If you are afraid of injuring yourself with a candle delicate skin child, before using the suppository, lubricate the anus with Vaseline or baby cream.
The second method of introducing a suppository. Place the baby on his back, lubricate the anal entrance. Now take the baby by the legs and lift him up. Begin inserting the suppository. When passing through the sphincter, a slight resistance is felt, continue to insert the suppository. The medicine is injected 3 centimeters. After completing the procedure, squeeze the baby’s buttocks and hold for a couple of minutes so that the medicine passes further and a bowel movement does not occur.
If one injection is prescribed, it is better to do it at night. When the body rests, it absorbs the substance better. By the way, when the suppository is completely dissolved, it may leak a little from the anus. There is nothing wrong with this, the main thing is to put on panties or a diaper for your baby to protect the sofa from stains.
When does the action start?
“How long does it take for Paracetamol suppositories to work?” - a question that interests many parents. After prescribing medications, be sure to check with your doctor how quickly this or that works. You can ask for a stronger antipyretic if your child’s body temperature rises quickly.
In addition, the advantage of suppositories over oral antipyretics is that they do not have a negative effect on the liver, kidneys and stomach.
But in each individual case the action may begin differently. For some children, Paracetamol in suppositories does not help at all, so check with the doctor several times what he has prescribed for you, so as not to return to the hospital for a new prescription sheet.
Contraindications for use
Rectal suppositories should not be used if the rectal mucosa is damaged. They should not be administered if the child has increased sensitivity to the medicine. Also, Paracetamol suppositories are contraindicated for use as an antipyretic and analgesic in the presence of blood diseases and Gilbert's syndrome (constitutional hyperbilirubinemia).
