Guide to Paracetamol For Fever and Body Pain
Confused about paracetamol? Our expert guide covers correct dosage for adults & children, how it works for fever and body pain, safety tips, and when to see a doctor.
Written by Dr. J T Hema Pratima
Reviewed by Dr. D Bhanu Prakash MBBS, AFIH, Advanced certificate in critical care medicine, Fellowship in critical care medicine
Last updated on 4th Sep, 2025
Introduction
When a throbbing headache, aching muscles from the flu, or a sudden fever strikes, paracetamol is often the first medicine we reach for. Known as acetaminophen in the United States and by brand names like Panadol, Tylenol, and Calpol globally, it's one of the world's most trusted and widely used pain relievers (analgesics) and fever reducers (antipyretics). But how much do we really know about this common household staple? Its accessibility can sometimes lead to misuse, which carries significant risks. This comprehensive guide will walk you through everything you need to know about using paracetamol safely and effectively to manage fever and body pain. We'll explore how it works, nail down the correct dosages for all ages, highlight critical safety warnings, and help you understand when it's time to seek more than just over-the-counter relief.
What Exactly is Paracetamol?
Paracetamol, also called acetaminophen, is a medication primarily used to treat mild to moderate pain and fever. It is not a steroid (corticosteroid) or a traditional Non-Steroidal Anti-Inflammatory Drug (NSAID) like ibuprofen or aspirin. This distinction is crucial because it means it doesn't reduce inflammation significantly and has a different side effect profile, making it suitable for people who cannot tolerate NSAIDs.
You'll find it sold under a plethora of brand names worldwide, including:
Tylenol (US, Canada)
Panadol (UK, Europe, Asia, Australia)
Calpol (UK, commonly for children)
Ofirmev (intravenous form used in hospitals)
It's also a key component in many combination cold and flu remedies (e.g., Theraflu, Sudafed SE) and prescription pain medications like Percocet and Vicodin.
Consult a General Physician for the best advice
How It Works in the Body
The precise mechanism of action of paracetamol has been a topic of scientific debate, but it is now widely believed to work primarily in the central nervous system (the brain and spinal cord). It is thought to inhibit an enzyme called cyclooxygenase (COX), which is involved in the production of prostaglandins, chemicals that promote pain, inflammation, and fever. Unlike NSAIDs, which work throughout the body, paracetamol's action is concentrated in the brain, explaining its potent effect on reducing fever and pain with minimal anti-inflammatory impact.
Paracetamol for Fever: A Trusted Antipyretic
One of the most commonly used medicines, paracetamol is well-known for its effectiveness in reducing fever and providing quick relief.
Why We Get Fevers and How Paracetamol Helps
A fever is not an illness itself but a symptom, a defence mechanism where your body's thermostat (hypothalamus) is reset to a higher temperature to help fight off infection. Paracetamol helps by acting on the hypothalamus, effectively persuading it to lower the body's temperature set point. This leads to sweating and vasodilation (widening of blood vessels), which allows heat to escape from the body, thereby reducing fever.
Correct Dosage for Fever by Age Group
Dosage is weight-based for children and standard for adults. Always use the measuring device that comes with the medicine and consult a doctor before using it.
Adults and Children (12+ years and over 50 kg): 500mg to 1000mg every 4-6 hours as needed. Do not exceed 4000mg (4 grams) in 24 hours.
Children (6-12 years): Typically 250mg to 500mg every 4-6 hours. Always check the packaging for weight/age-specific guidelines.
Infants & Young Children (3 months - 5 years): Use a liquid formulation (e.g., suspension) and dose strictly according to weight. The usual dose is 10-15mg per kilogram of body weight, given every 4-6 hours.
Unique Insight: While effective, remember that a mild fever can be beneficial. You don't always need to treat a fever if the person is comfortable. The goal is comfort, not necessarily achieving a "normal" temperature.
Using Paracetamol for Body Pain and Aches
Paracetamol is a reliable option to ease mild to moderate pain, helping you feel more comfortable in daily activities.
Types of Pain It Can Address
Paracetamol is effective for a variety of common body pains, including:
Headaches and migraines
Muscle aches and sprains
Backache
Toothache
Arthritis pain (though it doesn't reduce joint swelling)
Period pain (dysmenorrhoea)
General pain and discomfort associated with colds and flu
How It Compares to NSAIDs like Ibuprofen
This is a common point of confusion. The choice often depends on the type of pain and individual health.
Paracetamol: Best for pain and fever. Gentler on the stomach; does not increase bleeding risk. Safe for most people, including pregnant women (after consulting a doctor).
Ibuprofen (NSAID): Better for inflammatory pain (e.g., sprains, swollen joints), menstrual cramps, and dental pain. Can irritate the stomach lining and carries risks for those with kidney, heart, or bleeding issues.
For some types of pain, like a severe toothache, a healthcare professional might advise alternating paracetamol and ibuprofen for more comprehensive relief.
The Serious Risks: Paracetamol Overdose and Liver Damage
While paracetamol is generally safe when taken as directed, overdosing can pose severe health risks, especially to the liver.
How Overdose Happens
Paracetamol overdose is dangerously easy because the drug is in so many products. An overdose can occur from:
Taking more than the recommended dose within 24 hours.
Taking multiple medicines that all contain paracetamol (e.g., taking Tylenol for a headache while also using a multi-symptom cold medicine).
Taking doses too close together.
The Role of the Liver and Toxicity
The liver is responsible for metabolizing paracetamol. In correct doses, it safely processes it into non-toxic substances. However, in an overdose, the liver's metabolic pathways become overwhelmed. This leads to the production of a toxic byproduct (NAPQI) that damages liver cells, potentially causing acute liver failure, which can be fatal.
Early symptoms of an overdose are often mild (nausea, vomiting, lethargy) and can be mistaken for the original illness, which is why it's so dangerous.
Key Safety Precautions and Who Should Avoid It
Knowing when and how to use paracetamol safely is essential to prevent complications and protect your overall health.
Important Drug Interactions
Paracetamol can interact with other medications:
Alcohol: Regular heavy alcohol use increases the risk of liver damage. Avoid alcohol while taking paracetamol.
Warfarin: High, regular paracetamol use may increase the anticoagulant effect of warfarin, raising bleeding risk.
Other Liver-Metabolized Drugs: Can interact with epilepsy medications and certain antibiotics.
Populations That Need Extra Caution
Consult a doctor before use if you:
Have pre-existing liver disease or kidney impairment.
Are malnourished or have a history of alcoholism.
Are pregnant or breastfeeding (while generally considered safe, a doctor's advice is essential).
Weigh less than 50 kg (110 lbs); you may need a lower adult dose.
Paracetamol vs. Other Common Pain Relievers
Comparing paracetamol with other pain relief options can help you choose the safest and most effective treatment for your needs.
| Feature | Paracetamol (Acetaminophen) | Ibuprofen (Advil, Motrin) | Aspirin |
| Best For | Fever, headache, non-inflammatory pain | Inflammatory pain, cramps, swelling | Pain, fever (adults), anti-clotting |
| Anti-Inflammatory? | No | Yes | Yes |
| Stomach Upset Risk | Low | High | High |
| Bleeding Risk | No | Slight increase | Significant increase |
| Key Safety Concern | Liver damage | Stomach ulcers, kidney issues | Reye's syndrome in children |
When to See a Doctor: Beyond Self-Care
Paracetamol is for temporary relief. It's crucial to recognize when your symptoms indicate a more serious condition. Seek medical attention if:
The fever persists for more than 3 days or is very high (over 103°F or 39.4°C in adults).
The pain continues for more than 5 days (for adults) or 3 days (for children).
You experience signs of an allergic reaction (rash, itching, swelling).
Symptoms worsen or new symptoms appear.
You have underlying health conditions like liver or kidney disease and are unsure about taking it.
Conclusion
Paracetamol is an incredibly effective and safe medication when used correctly. Its ability to reliably reduce fever and alleviate common body pains like headaches and muscle aches makes it an indispensable part of any home medicine cabinet. However, its simplicity and accessibility belie the serious dangers of misuse. By respecting the dosage limits, being vigilant about hidden sources in other medications, and understanding the unique risks to your liver, you can harness the benefits of paracetamol without falling victim to its pitfalls. Always remember that it is a tool for managing symptoms, not a cure for underlying illness. Listen to your body; if your symptoms are severe or persistent, your best and safest choice is to seek advice from a doctor or pharmacist.
Consult a General Physician for the best advice
Consult a General Physician for the best advice
Dr. Mohamed Azeem
General Physician/ Internal Medicine Specialist
2 Years • MBBS,MD(Internal Medicine) CCEBDM
Karaikudi
Apollo Hospitals Karaikudi, Karaikudi
Dr. Sandhya Chandel
General Physician/ Internal Medicine Specialist
16 Years • MBBS, MD (Int. Med.), IDCCM
Bilaspur
Apollo Hospitals Seepat Road, Bilaspur
(125+ Patients)
Dr Syed Mateen Pasha
General Physician
2 Years • MBBS
Bengaluru
PRESTIGE SHANTHINIKETAN - SOCIETY CLINIC, Bengaluru
Dr Aakash Andgi
General Physician/ Internal Medicine Specialist
9 Years • MBBS MD
Bengaluru
Apollo Clinic, JP nagar, Bengaluru
Dr. Anand Ravi
General Physician
2 Years • MBBS
Bengaluru
PRESTIGE SHANTHINIKETAN - SOCIETY CLINIC, Bengaluru
