Paracetamol

CLINICAL USE

Analgesia and antipyretic

DOSE IN NORMAL RENAL FUNCTION

500 mg – 1 g every 4–6 hours(IV: if <50 kg, dose is 15 mg/kg)

PHARMACOKINETICS

Molecular weight :151.2

%Protein binding :20–30

%Excreted unchanged in urine : <5

Volume of distribution (L/kg) :1–2

half-life – normal/ESRD (hrs) :1–4/Unchanged

DOSE IN RENAL IMPAIRMENT

GFR (mL/MIN)

20 to 50 : Dose as in normal renal function

10 to 20 : Dose as in normal renal function

<10 : 500 mg – 1 g every 6–8 hours

DOSE IN PATIENTS UNDERGOING RENAL REPLACEMENT THERAPIES

CAPD :Not dialysed. Dose as in GFR <10 mL/min

HD :Dialysed. Dose as in GFR

<10 : mL/min

HDF/high flux :Dialysed. Dose as in GFR

<10 : mL/min

CAV/VVHD :Unknown dialysability. Dose as in normal renal function

IMPORTANT DRUG INTERACTIONS

Potentially hazardous interactions with other drugs

None known

ADMINISTRATION

Reconstition

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Route

Oral, rectal, IV

Rate of Administration

15 minutes

Comments

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OTHER INFORMATION

Beware sodium content of soluble tablets (1 tablet ≡ 18.6 mmol sodium)Nephrotoxic in overdose due to a reactive alkylating metaboliteMetabolites may accumulate in CKD 5; normal doses are used in CKD 5IV preparation starts working within 5 to 10 minutes with peak activity after 60 minutes.

See how to identify renal failure stages according to GFR calculation

See how to diagnose irreversible renal disease

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