Pregnancy, breastfeeding and fertility while taking paracetamol for adults Paracetamol is the first choice of painkiller if you’re pregnant. It is commonly taken during pregnancy and does not harm your baby.
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What paracetamol brand is safe for pregnant?
Suffering from a throbbing headache? When you’re pregnant, you can’t just pop any painkiller carelessly. After all, you’re carrying a baby in your belly, which means you have to think not just of your welfare, but your baby’s as well. Certain medicines have adverse effects during the different stages of your pregnancy.
- Some may cause miscarriages, while others may even delay and prolong your labor.
- But if headache and stress are wearing you down and you have tried all other home remedies to no avail, then it’s time for you to look at medicine that you can safely take without fear of harming yourself or your unborn child.
And while you always have to talk to your OB-GYN before taking any medication during pregnancy, here’s a description of three over-the-counter painkillers and their possible effects on you and your baby: 
Aspirin Many people use aspirin as a headache treatment. It is generally not recommended to be taken as a painkiller if you’re pregnant. Taking aspirin in your first trimester can have dire consequences. You’re risking yourself for pregnancy loss, as well as congenital disabilities for your child-to-be.
Prolonged use during pregnancy can also increase bleeding in the brain, especially for premature infants. However, some doctors allow you to take low doses of aspirin if you’re experiencing problems like recurring pregnancy loss, preeclampsia, and clotting disorders. Still, you should consult your obstetrician before taking aspirin for these problems.
Ibuprofen Ibuprofen is a nonsteroidal anti-inflammatory drug or NSAID traditionally used to manage pain, inflammation, and fever. If you’re pregnant though, taking ibuprofen for headache and stress is a risky move. It is classified as a C drug by the US Food and Drug Administration, which means that there isn’t enough research to determine the safety of the drug for pregnant women.
- For one, ibuprofen can cause premature closure of your baby’s ductus arteriosus, a blood vessel that transports blood into the lungs of the growing fetus.
- If this blood vessel closes early, your baby can develop high blood pressure in the womb.
- Plus, a 2011 study published in the Canadian Medical Association Journal found out that women who took ibuprofen and other NSAIDs early in their pregnancy are more at risk for miscarriage.
Ibuprofen gets even worse if you take it during your third trimester. There’s evidence that ibuprofen and other NSAIDs can cross the placental barrier and linger in the fetus, causing all kinds of adverse effects on fetal development. Ibuprofen can also reduce the quantity of amniotic fluid, resulting in delayed and extended labor. 
The only possible adverse effect happens when you combine paracetamol with caffeine, Taking in more than 200 mg of caffeine per day together with paracetamol can cause your baby to be born underweight. It might also lead to a miscarriage according to the UK’s National Health Service.
- Still, numerous studies have shown that paracetamol can safely relieve headache and stress while you’re pregnant.
- Make sure that you go for a trusted paracetamol brand like Paracetamol (Biogesic) that provides relief for headache and fever.
- And don’t forget to always consult your OB-GYN before taking any medicine during pregnancy.
Paracetamol is the generic name of Biogesic. IF SYMPTOMS PERSIST, CONSULT YOUR DOCTOR ASC Ref No: U030P061318B | U151P031920BS | U147P092220BS | U151P102820BS
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Can I take Panadol Extra in pregnancy?
Panadol Extra Advance 500mg/65mg Tablets (P) This information is intended for use by health professionals Panadol Extra Advance 500 mg/65 mg Tablets Each tablet contains Paracetamol 500 mg and Caffeine 65 mg. For full list of excipients, see section 6.1.
- Tablet. White to off-white, film coated, oval shaped tablets.
- XPx” (with the P inside in a circle) debossed on one side, “- -” on the other side.
- A mild analgesic and antipyretic formulated to give extra pain relief.
- The tablets are recommended for the treatment of most painful and febrile conditions, for example, headache, including migraine, backache, toothache, rheumatic pain and dysmenorrhoea, and the relief of the symptoms of colds, influenza and sore throat.
Oral use. Adults (including the elderly), and children aged 16 years and over: Two tablets up to four times daily. The dose should not be repeated more frequently than every 4 hours. Do not exceed 8 tablets in 24 hours. Children aged 12-15 years: One tablet up to four times daily.
- The dose should not be repeated more frequently than every 4 hours.
- Do not exceed 4 tablets in 24 hours.
- Not recommended for children under 12 years.
- Hypersensitivity to paracetamol, caffeine or any of the other constituents.
- Do not exceed stated dose.
- Contains paracetamol.
- Do not use with any other paracetamol containing products.
The concomitant use with other products containing paracetamol may lead to an overdose. Paracetamol overdose may cause liver failure, which may require liver transplant or lead to death. Care is advised in the administration of paracetamol to patients with renal or hepatic impairment.
- If symptoms persist, medical advice must be sought.
- Keep out of the sight and reach of children.
- Pack Label:
Talk to a doctor at once if you take too much of this medicine, even if you feel well. Do not take anything else containing paracetamol while taking this medicine. Patient Information Leaflet: Talk to a doctor at once if you take too much of this medicine even if you feel well.
This is because too much paracetamol can cause delayed, serious liver damage. The speed of absorption of paracetamol may be increased by metoclopramide or domperidone and absorption reduced by colestyramine. The anticoagulant effect of warfarin and other coumarins may be enhanced by prolonged regular daily use of paracetamol with increased risk of bleeding; occasional doses have no significant effect.
Caffeine may increase clearance of lithium. Concomitant use is therefore not recommended.
- Paracetamol-caffeine is not recommended for use during pregnancy due to the possible increased risk of lower birth weight and spontaneous abortion associated with caffeine consumption.
- Caffeine in breast milk may potentially have a stimulating effect on breast fed infants.
- Due to the caffeine content of this product it should not be used if you are pregnant or breast feeding.
Adverse events from historical clinical trial data are both infrequent and from small patient exposure. Accordingly, events reported from extensive post-marketing experience at therapeutic/labelled dose and considered attributable are tabulated below by MedDRA System Organ Class. Adverse reactions identified during post-marketing use are reported voluntarily from a population of uncertain size, the frequency of these reactions is unknown but likely to be very rare (<1/10,000).
- Post marketing data
- PARACETAMOL
| Body System | Undesirable effect |
| Blood and lymphatic system disorders | Thrombocytopenia Agranulocytosis |
| Immune system disorders |
|
| Respiratory, thoracic and mediastinal disorders | Bronchospasm – more likely in patients sensitive to aspirin and other NSAIDs |
| Hepatobiliary disorders | Hepatic dysfunction |
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| Body System | Undesirable effect |
| Central nervous system | Dizziness Headache |
| Cardiac disorders | Palpitation |
| Psychiatric disorders |
|
| Gastrointestinal disorders | Gastrointestinal disturbances |
Reporting of suspected adverse reactions Reporting suspected adverse reactions after authorisation of the medicinal product is important. It allows continued monitoring of the benefit/risk balance of the medicinal product. Healthcare professionals are asked to report any suspected adverse reactions via the Yellow Card Scheme at www.mhra.gov.uk/yellowcard or search for MHRA Yellow Card in the Google Play or Apple App store.
- Risk factors
- If the patient
- a) Is on long term treatment with carbamazepine, phenobarbitone, phenytoin, primidone, rifampicin, St John’s Wort or other drugs that induce liver enzymes.
- Or
- b) Regularly consumes ethanol in excess of recommended amounts.
- Or
c) Is likely to be glutathione deplete e.g. eating disorders, cystic fibrosis, HIV infection, starvation, cachexia. Symptoms Symptoms of paracetamol overdosage in the first 24 hours are pallor, nausea, vomiting, anorexia and abdominal pain. Liver damage may become apparent 12 to 48 hours after ingestion.
- Abnormalities of glucose metabolism and metabolic acidosis may occur.
- In severe poisoning, hepatic failure may progress to encephalopathy, haemorrhage, hypoglycaemia, cerebral oedema, and death.
- Acute renal failure with acute tubular necrosis, strongly suggested by loin pain, haematuria and proteinuria, may develop even in the absence of severe liver damage.
Cardiac arrhythmias and pancreatitis have been reported. Management Immediate treatment is essential in the management of paracetamol overdose. Despite a lack of significant early symptoms, patients should be referred to hospital urgently for immediate medical attention.
Symptoms may be limited to nausea or vomiting and may not reflect the severity of overdose or the risk of organ damage. Management should be in accordance with established treatment guidelines, see BNF overdose section. Treatment with activated charcoal should be considered if the overdose has been taken within 1 hour.
Plasma paracetamol concentration should be measured at 4 hours or later after ingestion (earlier concentrations are unreliable). Treatment with N-acetylcysteine may be used up to 24 hours after ingestion of paracetamol, however, the maximum protective effect is obtained up to 8 hours post-ingestion.
- Caffeine
- Symptoms
- Overdose of caffeine may result in epigastric pain, vomitting, diuresis, tachycardia or cardia arrhythmia, CNS stimulation (insomnia, restlessness, excitement, agitation, jitteriness, tremors and convulsions).
- It must be noted that for clinically significant symptoms of caffeine overdose to occur with this product, the amount ingested would be associated with serious paracetamol-related toxicity.
- Management
Patients should receive general supportive care (e.g. hydration and maintenance of vital signs). The administration of activated charcoal may be beneficial when performed within one hour of the overdose, but can be considered for up to four hours after the overdose.
- The CNS effects of overdose may be treated with intravenous sedatives.
- Summary Treatment of overdose requires assessment of plasma paracetamol levels for antidote treatment, with signs and symptoms of caffeine toxicity being managed symptomatically.
- ATC code: N02B E51 The combination of paracetamol and caffeine is a well established analgesic combination.
Paracetamol is rapidly and almost completely absorbed from the gastro-intestinal tract. It is relatively uniformly distributed throughout most body fluids and exhibits variable protein binding. Excretion is almost exclusively renal, in the form of conjugated metabolites.
- Panadol Extra Advance 500 mg/65 mg Tablets contain a disintegrant system which accelerates tablet dissolution compared to standard parcetamol and caffeine tablets.
- Human pharmacokinetic data demonstrate that the time taken to reach plasma paracetamol threshold (4-7 mcg/ml) is at least 44% faster with Panadol Extra Advance 500 mg/65 mg Tablets compared with standard paracetamol and caffeine tablets.
- Total extent of absorption of paracetamol and caffeine from Panadol Extra Advance 500 mg/65 mg Tablets is equivalent to that from standard paracetamol and caffeine tablets.
There are no pre-clinical data of relevance to the prescriber which are additional to that already included in other sections of the SPC.
- Tablet core:
- Starch pregelatinised,
- Povidone k-25,
- Calcium carbonate,
- Crospovidone,
- Alginic acid,
- Magnesium stearate,
- Microcrystalline cellulose.
- Film coat and polish:
- Titanium dioxide (E 171),
- Hypromellose,
- Macrogol,
- Polysorbate 80,
- Carnauba wax
- Tablets are in:
- • PVC 250 µm or 300 µm aluminium foil 30 µm blister packs in an outer cardboard carton.
- • Child resistant PVC / aluminium foil / polyethylene terephthalate blister packs in an outer cardboard carton.
- These are available in packs of 24, 30 or 32 tablets.
- GlaxoSmithKline Consumer Healthcare (UK) Trading Limited
- 980 Great West Road
- Brentford
- Middlesex
- TW8 9GS
- United Kingdom
| First Authorisation: Last Renewal: | 26/02/2010 09/04/2009 |
Panadol Extra Advance 500mg/65mg Tablets (P)
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Can I take 1 or 2 paracetamol when pregnant?
Full Text To the Editor : Recent epidemiological studies report paracetamol use in 65% of pregnant women.1 Although it is known that paracetamol can cross the human placenta, there is no evidence of it producing foetal complications in animal models, and it is considered a safe drug during pregnancy.2 For this reason, paracetamol is the first-line analgesic drug used in pregnant women.
However, some authors have reported finding an association between paracetamol use in pregnant women and the development of attention-deficit hyperactivity disorder and autism spectrum disorder, 3 asthma, 4 criptorquidism 5 and foetal ductus arteriosus closure.6 In reference to neonatal complications, there have been reports of newborns with heart failure and pulmonary hypertension with a known history of intrauterine exposure to paracetamol and ductus arteriosus closure.
Allegaert et al. reviewed a case series in October 2018 and concluded that a causal relationship is highly probable, 6 as paracetamol has been proven to be effective for therapeutic closure of patent ductus arteriosus in preterm infants. The aim of our study was to describe the use of paracetamol by pregnant women in our area and assess their knowledge of the potential side effects of the drug on the foetus.
A secondary objective was to analyse which health care professional provided this information. We designed a prospective study with collection of data through a questionnaire administered to women admitted to the maternity ward of our hospital over a period of 3 months. We received 900 completed questionnaires (93% of mothers in the maternity ward during the period under study).
A majority of respondents had a university degree (55.5%). Of the total, 67.4% reported having used paracetamol during pregnancy, a proportion that was slightly larger compared to the previous literature. Most respondents (99%) consumed the therapeutic dose ( Figure 1,
The maximum daily dose of 4 or more grams per day was prescribed for management of headache (50% of cases), cold symptoms (33.3%) or toothache (16.7%). The distribution of paracetamol was similar in every trimester of pregnancy; 12.5% of respondents used it over 2 trimesters and 21.5% throughout the pregnancy.
The prescription was made most frequently by the primary care doctor (39%) or the gynaecologist (37%) ( Fig.2 ). When it came to knowledge about the drug, 26% of pregnant women believed that paracetamol had no effects on the foetus. In addition, 51.9% of pregnant women had received information from a health care professional about the effects of paracetamol.
Of the group that had received information, 74% reported being told that consumption of paracetamol carried no risks to the foetus. Our study reflects the current situation in the use of paracetamol by pregnant women and in the education given by health care providers in a metropolitan area with a population characterised by a medium-to-high educational attainment.
When it comes to the limitations of this study, given the high educational attainment of the survey respondents, most of who had a university degree, our findings may not be generalised to the general population. On the other hand, given the high response rate, our sample is representative of the population under study.
Another limitation is that the items explore retrospective information, so there is a risk of recall bias. The questionnaire did not investigate how long participants consumed the maximum dose of paracetamol. Analysing neonatal outcomes was not an objective of our study. However, it would be relevant to carry out another study with an appropriate design to assess the safety of prescribing paracetamol during pregnancy, as the current evidence on the subject is scarce.
In conclusion, use of paracetamol in pregnant women in our area was greater than reported in the literature, and the information that they received on the potential adverse effects or the dosage that is considered safe was inadequate. Until the quality of the evidence improves, public health education strategies should be implemented to guarantee delivery of sufficient information and to facilitate the search for alternatives encouraging rational use of this drug in order to control consumption during pregnancy.
References G. Bandoli, K. Palmsten, C. Chambers. Acetaminophen use in pregnancy: Examining prevalence, timing and indication of use in a prospective birth cohort. Paediatr Perinat Epidemiol., 00 (2019), pp.1-10 SMFM publications committee. Prenatal acetaminophen use and outcomes in children. Am J Obstet Gynecol., 216 (2017), pp.
B14-B15 R. Masarwa, H. Levine, E. Gorelik, S. Reif, A. Perlman, I. Matok. Prenatal exposure to acetaminophen and risk for attention deficit hyperactivity disorder and autistic spectrum disorder: a systematic review, meta-analysis, and meta-regression analysis of cohort studies.
- Am J Epidemiol., 187 (2019), pp.1817-1827 M.
- Cheelo, C.J.
- Lodge, S.C.
- Dharmage, et al,
- Paracetamol exposure in pregnancy and early childhood and development of childhood asthma: a systematic review and meta-analysis.
- Arch Dis Child., 100 (2015), pp.81-89 H.T.
- Sørensen, P. Bonde, B.
- Henriksen, J. Olsen.
- Maternal use of acetaminophen, ibuprofen, and acetylsalicylic acid during pregnancy and risk of cryptorchidism.
Epidemiology, 21 (2010), pp.779-785 K. Allegaert, P. Mian, A. Lapillonne, J.N. van den Anker. Maternal paracetamol intake and fetal ductus arteriosus constriction or closure: a case series analysis. Br J Clin Pharmacol, (2018), Please cite this article as: Castillo Barrio B, Bravo Laguna MC, de la Calle Fernández M, Pellicer Martinez A.
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Can a pregnant woman take paracetamol for headache?
Coping with headaches in pregnancy – Paracetamol is the first choice of painkiller if you’re pregnant. However, for safety, if you take paracetamol in pregnancy, take it for the shortest possible time. You can get advice from your pharmacist, midwife or GP about how much paracetamol you can take and for how long.
drink plenty of fluids to prevent dehydrationget enough sleep – read tiredness and sleep in pregnancy to find out more about thisrest and relax – you could try a pregnancy yoga class, for example
Can you take 2 500mg paracetamol when pregnant?
Pregnancy and breastfeeding If necessary, Paracetamol 500mg Tables can be used during pregnancy. You should use the lowest possible dose that reduces your pain and/or fever and use it for the shortest time possible.
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What is difference between Panadol and Panadol Extra?
Q: There are so many different types of panadol! Which one should I be taking? | Take Control Active Rehab Panadol – The GlaxoSmithKline brand name for 500g of Paracetamol, This 500g of Paracetamol is common among all of the panadol range and acts as an analgesic (pain relief) and anti-pyretic (decreases temperature). It contains no anti-inflammatory substances.
- The usual adult dose is 1000mg, which equates to 2 tablets per every 4 hours.
- The active ingredient paracetamol is absorbed within the gastrointestinal tract with the highest concentration of paracetamol usually occurring 30-60 minutes after administration.
- Because a reasonable amount of paracetamol remains in the system for 24 hours there is a maximum daily dosage of 4000mg (4 x 2 tablet doses).
Panadeine – Contains the same 500mg of Paracetamol that is in panadol but with an additional 8mg of codeine phosphate. Codeine is from the opiate/narcotic family, with the strength of approximately 17% of morphine. In fact, a small amount of codeine actually converts into morphine when metabolised within the body.
The codeine acts centrally, blocking not only the sensation of pain but also the emotional response to pain within the central nervous system. It does have a mild sedative effect with some people experiencing dizziness and drowsiness and prolonged high doses of codeine can result in addictive behaviours.
Panadeine Extra – Basically is the stronger version of Panadeine. It still has the same 500mg of paracetamol but also has 15mg of codeine added to each tablet. It is an S3 medication which means that although it can be purchased without a prescription it will only be found behind the counter and the pharmacy assistant needs to get clearance from the pharmacist before selling it to you.
Codeine side-note: Opiates such as codeine and morphine have long been known for not only their pain relieving effects but also their smooth muscle relaxation effects. Historically they were often used to treat diarrhoea as they slow the peristaltic movement of faeces through the intestine, increasing the water re-absorption time and thereby resulting in firmer stools.
However this also means that in a person with normal bowel motions, the taking of a pain reliever such as Panadeine or Panadeine Extra can result in constipation. Panadol Extra – Contains 500mg of Paracetamol per caplet with an added 65mg of Caffeine.
The Caffeine is absorbed easily in the body after oral administration. It has been shown to reach its highest concentration levels within 1 hour. The standard dose of two caplets results in a total consumption of 1000mg of Paracetamol and 130mg of caffeine, which has been suggested to be equivalent to approximately 2 cups of instant coffee.
Every 1 Panadol Extra caplet provides the equivalent caffeine of 1 cup of coffee. The usual dose of two tablets is therefore equivalent to approximately 2 cups of coffee. Caffeine has long been known to be a pain reliever. The question is whether it provides additional benefit to paracetamol alone.
Some of the concerns with caffeine is that even in small doses of 50mg caffeine can cause tachycardia (increased pulse rate) and anxiety in some people. Pregnant women are also advised not to consume more than 200mg of caffeine per day. Unlike Panadeine Extra, Panadol Extra is an S2 medication. This means that whilst it is sold in a pharmacy it does not require input from a pharmacist and can be found of a standard shelf not behind the counter.
A person can pick it up and take it to the cashier at the register without anyone questioning or advising what is in it. Panadol Osteo – Contains 665mg of Paracetamol and is a unique bi-layer tablet incorporating an immediate release and a sustained release dose of paracetamol.
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What can I take for a headache while pregnant?
What can I do about headaches during pregnancy? I’d rather not take medication. – Answer From Yvonne Butler Tobah, M.D. To prevent or relieve mild headaches during pregnancy without taking medication, try the following:
- Avoid headache triggers. If certain foods or odors have triggered a headache in the past, avoid them. A headache diary might help you identify triggers.
- Include physical activity in your daily routine. Try a daily walk or other moderate aerobic exercise.
- Manage stress. Find healthy ways to cope with stressors.
- Practice relaxation techniques. Try deep breathing, yoga, massage and visualization.
- Eat regularly. Eating regularly scheduled meals and maintaining a healthy diet might help prevent headaches. Also, drink plenty of fluids.
- Follow a regular sleep schedule. Sleep deprivation might contribute to headaches during pregnancy.
- Consider biofeedback. With this mind-body technique, you learn to control certain bodily functions — such as muscle tension, heart rate and blood pressure — to prevent headaches or reduce headache pain. If you’d like to try biofeedback to treat headaches during pregnancy, ask your health care provider for a referral to a biofeedback therapist.
Most pregnant women can safely take acetaminophen (Tylenol, others) to treat occasional headaches. Your health care provider might recommend other medications as well. Make sure you have the OK from your health care provider before taking any medication, including herbal treatments.
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What painkillers can I take during pregnancy?
What if I have already used a painkiller during pregnancy? – Paracetamol is the painkiller of choice for use in pregnancy and its use does not require medical supervision. It is not uncommon for women to have used other types of painkiller early in pregnancy before finding out they are pregnant.
In general, this type of use is not expected to harm the baby. It is important that women who take an NSAID long-term who become pregnant consult their doctor as, if possible, their medicine will need to be altered before week 30 of pregnancy. Pregnant women with long-term pain and/or specific pain conditions should speak to their doctor about appropriate pain relief options.
Women taking opiates/opioids and painkillers for neuropathic pain around the time of delivery may be advised to have their baby at a hospital with facilities for treating the baby after birth for any withdrawal symptoms.
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Is paracetamol and Panadol the same thing?
Paracetamol for adults Brand names: Disprol, Hedex, Medinol, Panadol.
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Which is better Panadol Extra or paracetamol?
Panadol Extra Advance contains a combination of active ingredients – paracetamol and caffeine. The combination of ingredients in Panadol Extra Advance is clinically proven to provide more effective pain relief than standard paracetamol tablets.
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Can I take 2 Panadols at once?
How to take paracetamol – Make sure you take paracetamol as directed on the label or leaflet, or as instructed by a health professional. How much you can take depends on your age, your weight, the type of paracetamol you’re taking and how strong it is. For example:
Adults can usually take 1 or 2 tablets (500mg) every 4-6 hours, but shouldn’t take more than 4g (8 x 500mg tablets) in the space of 24 hours. Children under 16 need to take a lower dose, depending on their age or weight – check the packet or leaflet, or ask a pharmacist or doctor for advice. For very young children, paracetamol liquid is given using a measuring spoon or an oral syringe.
Paracetamol should start to work within an hour and the effect usually lasts several hours. Don’t take more than the recommended dose if it isn’t relieving your symptoms. Adults can take ibuprofen at the same time if necessary, but this isn’t usually recommended for children.
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When should you not take Panadol Extra?
Who should not take Panadol Extra? –
- Children under 12 years of age.
- Panadol extra soluble tablets contain sorbitol and are not suitable for people with a rare hereditary intolerance to fructose.
- Panadol extra soluble tablets contain sodium (854mg sodium per two tablet dose). As such, they are not suitable for people on a low sodium diet. Ask your doctor or pharmacist for advice if this applies to you.
Panadol extra should not be used if you are allergic to any of its ingredients. If you feel you have experienced an allergic reaction, stop using Panadol extra and inform your doctor or pharmacist immediately.
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