The paracetamol suppository

introduction

Paracetamol is a pain reliever from the group of non-opioid analgesics. It relieves pain and reduces fever.

The name of the active ingredient is derived from the chemical name of the substance, i.e. from paraacetylaminophenol. Paracetamol belongs to the group of the most important pain relievers because it is usually very well tolerated. In Germany, paracetamol is available from pharmacies without a prescription. In general, it can be given at any age if the dosage is adjusted.There are adapted forms of administration for the various patient groups.

In addition to the commonly used tablets, paracetamol is also available as suppositories. The suppository is recommended in an adjusted dosage, especially for children and toddlers, as they often have difficulty taking normal tablets and can choke on the tablet. Paracetamol is mainly used in pain and febrile colds. Here it alleviates the symptoms. Normally, paracetamol is therefore taken for a short time, but longer-term medications are also possible in certain cases.
It can be given as a single drug (Monotherapy) or with other pain relievers (for example ASA = acetylsalicylic acid, active ingredient in Aspirin®).

Mode of action

The exact mechanism of action of paracetamol is not yet fully known. As a non-acidic non-opioid analgesic, it works differently than the acidic non-opioid analgesics (ASA, ibuprofen).

Paracetamol accumulates in the central nervous system (brain and spinal cord). There it inhibits a subtype of a certain enzyme (COX-3). In an uninhibited state, COX-3 (= cyclo-oxygenase 3) produces prostaglandins, i.e. messenger substances that play an important role in the mediation of pain and the development of inflammation and fever.

Paracetamol has only a very weak anti-inflammatory effect (anti-inflammatory), but effectively lowers the fever (antipyretic effect= fever-lowering effect). In addition to this mode of action, other effects of paracetamol are currently being discussed.

You might also be interested in: Fever suppositories for babies and children

Paracetamol suppositories for migraines

Paracetamol suppositories are an effective drug for migraines. The effectiveness in treating migraine attacks has been scientifically proven. For paracetamol suppositories, a suppository with 1000 milligrams of active ingredient is recommended. No more than 4 suppositories (4000 milligrams in total) should be taken per day.

Paracetamol suppositories for toothache

Paracetamol suppositories are only partially suitable for toothache. The active ingredient paracetamol has a pain-relieving effect, but above all it lowers fever. Paracetamol is very suitable for headaches. Toothache is often associated with an inflammatory component, so pain relievers that also have anti-inflammatory effects, such as ibuprofen or Aspirin®, are somewhat more suitable for toothache.

Read more on the subject at: Paracetamol for toothache

Duration of action

The duration of action of the paracetamol suppositories depends on the dose of the suppository. On average, the suppositories work 6 to 8 hours, slightly longer in infants and slightly shorter in adults. That is why babies younger than three months and weighing three to four kilograms need two suppositories a day with a dose of 75 milligrams of paracetamol. Adults may take 1000 milligrams of paracetamol four times a day, which corresponds to a duration of action of up to 6 hours.

application

The paracetamol suppositories already described are particularly suitable for Use in children, toddlers and babies. For that are low dose suppositories available adapted to the lower body weight of children.

In contrast to paracetamol tablets, suppositories are made applied rectally. To do this, the anus (Sphincter) in the Rectum introduced. There the suppositories dissolve and the active ingredient, i.e. that Paracetamol is absorbed.
Due to the quick absorption suppositories work faster than tablets, this is another advantage besides the ease of use. When using paracetamol suppositories longer than 72 hours a doctor must be contacted.

Can you share paracetamol suppositories?

Paracetamol suppositories are generally not intended for division. If it has to be exceptional, the uvula should be divided lengthways. The reason for the longitudinal division lies in the production of the suppositories, in which the active ingredient sinks and is more concentrated in the suppository tip. With the longitudinal division you avoid this problem and get two equal halves. It is advisable to divide the suppository with a heated knife, if necessary. The other half should be used shortly or discarded.

Are there paracetamol suppositories available in pharmacies without a prescription?

Paracetamol suppositories are available over the counter in the pharmacy in various dosages and pack sizes.

Dosage in the baby

Paracetamol suppositories are dosed depending on body weight and age. As a rule, a single dose is about 10 to 15 milligrams per kilogram of body weight. 60 milligrams per kilogram of body weight correspond to the maximum total daily dose. You should rest at least 6 hours between the suppositories.
Babies younger than 3 months and weighing around 3 to 4 kilograms should have paracetamol suppositories inserted at a dose of 75 milligrams if necessary. The suppositories may be given every 8-12 hours, i.e. a maximum of two suppositories with 75 milligrams of paracetamol per day. Babies who weigh 4 to 5 kilograms can also be given a suppository containing a 75 milligram dose, but 6 to 8 hours apart. This means that 3 suppositories (225 milligrams paracetamol in total) can be given on day. Babies older than three months and weighing around 5 to 6 kilograms are allowed to have a suppository containing 75 milligrams of paracetamol every 6 hours. This means that these babies can receive four suppositories a day, a maximum of four suppositories (300 milligrams paracetamol) a day.
For babies from 7 to 9 kilograms, i.e. babies around 6 to 9 months old, there are suppositories with 125 milligrams of paracetamol. A maximum of 3 suppositories of this dose may be given per day. Babies and toddlers from 9 to 12 kilograms of body weight, i.e. from around 9 months to 2 years, may also receive a single dose of 125 milligrams of paracetamol, but not more than four suppositories (500 milligrams in total) per day.

Dosage in the child

Paracetamol suppositories with 250 milligrams are available for children from one to three years of age with a body weight of around 10 to 15 kilograms. The toddlers are allowed to receive a single suppository and a maximum of three suppositories per day. Children from the age of up to six years and weighing up to 22 kilograms may receive a 250 milligram suppository as a single dose and a maximum of four suppositories per day.
Paracetamol suppositories with 500 milligrams of active ingredient are available for children between the ages of six and nine and about 22 to 30 kilograms. The children are allowed to receive one suppository as a single dose and a maximum of two suppositories per day. Children up to 12 years of age and weighing 30 to 40 kilograms receive one suppository and a maximum of three per day. Children who are over 12 years old and weigh more than 40 kilograms are given one or two suppositories of 500 milligrams each and a maximum of eight per day (4000 milligrams paracetamol).
For older children over 14 years of age, suppositories with 1000 milligrams of paracetamol are suitable, of which a maximum of four may be given daily.

Dosage in adults

Adolescents from 14 years of age and adults can get paracetamol suppositories with a dose of 1000 milligrams. A maximum of four suppositories, corresponding to a total dose of 4000 milligrams of paracetamol, may be inserted per day.

Are paracetamol suppositories allowed during pregnancy?

Paracetamol should only be used during pregnancy after careful consideration of the risk-benefit ratio. The suppositories should not be used for long periods of time, in high doses or in combination with other medications during pregnancy. Before using it, it can be helpful to ask your doctor for advice.

Read more on the subject at: Paracetamol in pregnancy

Are paracetamol suppositories allowed during breastfeeding?

Paracetamol passes into breast milk. There are no known adverse effects on the infant so interruption of breastfeeding is usually not required. Therefore, paracetamol suppositories should also be taken during breastfeeding after carefully weighing the risk-benefit ratio.

Read more on the subject at: Paracetamol while breastfeeding

Side effects

Generally show up when taking acetaminophen according to the recommendations rarely (? 0.01% to <0.1) until very rarely (? 0.01% with isolated cases) Side effects.

  • It can be used for Increase in certain liver enzymes such as the transaminases (rarely).
  • Very rarely can a Bronchospasm occur, but mostly with known ones Asthmatics (Analgesic asthma)
  • Also very rare serious changes in the composition of the blood, it then comes to a Thrombocytopenia (the number of platelets is too low) or one Agranulocytosis.
  • It can also occur in very rare cases Hypersensitivity reactions come this can be as simple Reddening of the skin appear more severe symptoms like urticaria and a anaphylactic shock however, they are also possible. In this case the immediate discontinuation of therapy is mandatory.

Besides the systemic side effects Specific side effects may also occur when using paracetamol suppositories. At the Insertion of the suppository can it to Injuries to the sensitive mucous membrane of the rectum. To avoid this one should use the suppository insert carefully. So that the suppository can be inserted easily and so that the aforementioned injuries do not occur, the suppository must be inserted with the side provided for it forward.

It can also occur when using paracetamol in suppository form Interactions come with other medication. You should therefore find out more from your doctor or pharmacist before taking different medications in combination. Interactions are possible when combining Paracetamol with Medicines to treat gout, With Sleeping pills (phenobarbital), With Drugs for epilepsy (Phenytoin, Carbamazepine), Anti-tuberculosis agents (Rifampicin) and many other drugs. In particular potentially hepatotoxic drugs can interact with paracetamol. Hence the medical consultation essential in advance.