Dose Can Help to Achieve Effective Pain Relief for Acute Mild to Moderate Pain with Over-the-Counter Paracetamol

Abstract

Background: Paracetamol (acetaminophen) is one of the most widely used Over-The-Counter (OTC) analgesics for the self-treatment of mild to moderate acute pain. Different dosages are used in different countries and, in some of them, a large proportion of adults are using low doses (325 mg to 500 mg). Objectives: The objective of the study was to review information from published research studies to answer the question: is there a dose-dependent analgesic effect of paracetamol in the treatment of mild to moderate acute pain? Methods: A detailed assessment of available systematic reviews, meta-analyses and single randomised trials was undertaken based on an electronic literature search focusing on studies comparing higher and lower doses of paracetamol in the management of mild to moderate acute pain. Results: Reviews and comparative trials generally showed greater efficacy with higher dose paracetamol (1000 mg) than with lower doses (500 mg or 650 mg) in achieving clinically significant pain relief with comparable tolerability in different types of pain. Conclusions The nature and intensity of the pain are two key elements of the therapeutic choice. Higher dose immediate-release paracetamol (1000 mg), used for a short duration of time (4-5 days) and adhering to recommendations within the label for risk groups, delivers safe and more effective analgesia than lower doses for adults with mild to moderate acute pain.