Intravenous
paracetamol (rINN)/intravenous
acetaminophen (USAN) is an
analgesic and
antipyretic agent, recommended worldwide as a first-line agent for the treatment of
pain and
fever in adults and children. In double-blind clinical trials, single or multiple doses of intravenous
paracetamol 1 g generally provided significantly better
analgesic efficacy than placebo treatment (as determined by primary efficacy endpoints) in adult patients who had undergone dental, orthopaedic or gynaecological surgery. Furthermore, where evaluated, intravenous
paracetamol 1 g generally showed similar
analgesic efficacy to a bioequivalent dose of
propacetamol, and a reduced need for
opioid rescue medication. In paediatric surgical patients, recommended doses of intravenous
paracetamol 15 mg/kg were not significantly different from
propacetamol 30 mg/kg for the treatment of
pain, and showed equivocal
analgesic efficacy compared with intramuscular
pethidine 1 mg/kg in several randomized, active comparator-controlled studies. In a randomized, noninferiority study in paediatric patients with an
infection-induced
fever, intravenous
paracetamol 15 mg/kg treatment was shown to be no less effective than
propacetamol 30 mg/kg in terms of
antipyretic efficacy. Intravenous
paracetamol was well tolerated in clinical trials, having a tolerability profile similar to placebo. Additionally, adverse reactions emerging from the use of the intravenous formulation of
paracetamol are extremely rare (<1/10 000). [table: see text].