Intravenous paracetamol as an antipyretic and analgesic medication: the significance of drug metabolism

J Pharmacol Sci. 2014;124(2):144-52. doi: 10.1254/jphs.13133fp. Epub 2014 Jan 30.

Abstract

One prospective, open-label, non-randomized study was conducted in 100 patients to define the antipyretic and analgesic effect of a new intravenous formulation of 1 g of paracetamol; 71 received paracetamol for the management of fever and 29 received paracetamol for pain relief after abdominal surgery or for neoplastic pain. Serial follow-up measurements of core temperature and of pain intensity were done for 6 h. Additional rescue medications were recorded for 5 days. Blood was sampled for the measurement of free paracetamol (APAP) and of glucuronide-APAP and N-sulfate-APAP by an HPLC assay. Defervescence, defined as core temperature below or equal to 37.1°C, was achieved in 52 patients (73.2%) within a median time of 3 h. Patients failing to become afebrile with the first dose of paracetamol became afebrile when administered other agents as rescue medications. Analgesia was achieved in 25 patients (86.4%) within a median time of 2 h. Serum levels of glucuronide-APAP were greater among non-responders to paracetamol. The presented results suggest that the intravenous formulation of paracetamol is clinically effective depending on drug metabolism.

Publication types

  • Clinical Trial, Phase IV
  • Multicenter Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Abdominal Pain / drug therapy*
  • Acetaminophen / administration & dosage*
  • Acetaminophen / blood
  • Acetaminophen / metabolism*
  • Acetaminophen / pharmacokinetics
  • Adolescent
  • Adult
  • Aged
  • Female
  • Fever / drug therapy*
  • Fever / etiology
  • Humans
  • Infections / complications
  • Infusions, Intravenous
  • Interleukin-6 / blood
  • Male
  • Middle Aged
  • Pain, Intractable / drug therapy*
  • Pain, Postoperative / drug therapy*
  • Prospective Studies
  • Treatment Outcome
  • Young Adult

Substances

  • Interleukin-6
  • Acetaminophen