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paracetamol (paracetamol, EFVDAS)

✓ Approved

Elan · PTGS1 · Small Molecule

What is paracetamol?

paracetamol is a small molecule developed by Elan. It is approved for therapeutic indications via oral (po).

Drug Profile

Brand Namesparacetamol, EFVDAS
CompanyElan
Drug ClassSmall Molecule
Molecular TargetPTGS1, PTGS2
RouteOral (PO)
StatusApproved
Sources: ClinicalTrials.gov, Elan

Mechanism of Action

Molecular Targets

paracetamol acts on 2 molecular targets:

PTGS1prostaglandin-endoperoxide synthase 1 (COX3, PCOX1)
PTGS2prostaglandin-endoperoxide synthase 2 (GRIPGHS, hCox-2)
Want deeper analysis?Noah AI can explain complex mechanisms and compare to similar drugs.

Therapeutic Indications

paracetamol is developed for 1 unique indication across 1 therapeutic area.

Therapeutic AreaConditionPhase
Gastrointestinal disordersAbdominal pain✓ Approved

Related Research Articles

PubMedAnesthesiology research and practice2026-11-11

Intravenous Paracetamol for Perioperative Shivering Prophylaxis in Patients Undergoing Spinal Anesthesia: A Prospective, Randomized, Double-Blind Controlled Trial.

Ruenhunsa Thitinuch T, Nonphiaraj Saranyoo S, Srikajonkiat Donlaya D, Panichakul Kanya K et al.

Perioperative shivering (POS) is a common, distressing complication of spinal anesthesia (SA), but a standard prevention has not been identified. This study aimed to determine whether intravenous (IV) paracetamol prevents POS in patients undergoing surgery under SA. In this prospective, randomized, double-blind controlled trial, 92 patients scheduled for surgery under SA received IV paracetamol 15 mg/kg (n = 46) or an equal volume of saline (n = 46) over 15 min before SA. The primary outcome was the overall incidence of POS. The primary analysis was per-protocol (PP) (n = 86; paracetamol 42; control 44) after exclusion of 6 patients postrandomization. Post hoc best-case and worst-case sensitivity analyses including all 92 patients were also performed. Secondary outcomes included shivering score, shivering duration, rescue pethidine requirements, temperature changes, and adverse events. Baseline and intraoperative characteristics were comparable between groups. In the PP analysis, POS incidence was lower with paracetamol than control (26.2% vs. 50.0%; p = 0.023). This was not robust to missing-data assumptions: the best-case analysis remained significant (23.9% vs. 52.2%; p = 0.005), but the worst-case analysis did not (32.6% vs. 47.8%; p = 0.137), and the fragility index was 2. Intraoperative shivering occurred in 4.8% vs. 22.7% (p = 0.016). Paracetamol also demonstrated lower highest shivering score (p = 0.039), shorter duration of shivering (p = 0.031), and less rescue pethidine use (p = 0.019). There were no statistically significant differences in temperature changes, hypothermia, or nausea and vomiting between groups. In the PP analysis, prophylactic IV paracetamol was associated with a lower incidence, severity, and duration of POS and a lower need for rescue pethidine use. However, the primary finding was not robust under worst-case assumptions (fragility index 2); larger confirmatory trials are warranted. Trial Registration: Thai Clinical Trials Registry: TCTR20210209004.

PMID 43011396
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PubMedActa veterinaria Scandinavica2026-11-11

Analgesic and clinical side effects of paracetamol and meloxicam in female dogs after elective ovariectomy or ovariohysterectomy - randomized clinical trial.

Salla Kati K, Pekkola Vuokko V, Kallio-Kujala Ira I, Lepajoe Jaan J et al.

This prospective, randomized, blinded, controlled clinical trial aimed at comparing the analgesic and antihyperalgesic effect of paracetamol and meloxicam following elective ovariectomy or ovariohysterectomy in healthy female dogs. In addition, it aimed at evaluating gastrointestinal side effects up to 48 h after surgery. Standardised anaesthesia protocol was utilised in all dogs and, at the end of the surgery, either meloxicam (0.2 mg/kg, Group M, n = 15 dogs) or paracetamol (10 mg/kg, Group P, n = 15 dogs) was administered intravenously. Pain was evaluated at 1, 2, 3, 4 and 6 h after the administration of either paracetamol or meloxicam using short form of Glasgow composite pain scale (GCPS-SF). Rescue analgesia with intravenous methadone (0.2 mg/kg) was administered in case of ≥ 6 over 24 points. The success rate of each treatment was calculated based on the need of rescue analgesia within 6 h after surgery. Subsequently, the success rate was assessed for non-inferiority between treatments. The non-inferiority margin was set as -33%. Mechanical nociceptive thresholds and sensitivity to Von Frey filaments were tested at 2, 4 and 6 h after the administration either paracetamol or meloxicam. Once discharged, animals were remotely evaluated through a standardized questionnaire. Rescue analgesia was administered at the hospital during the 6-hour post-operative period in a total of 15 dogs without difference between groups (p = 0.358). The success rate for analgesia was (9/15) 60% and (6/15) 40% in group M and P, respectively. The lower limit of the 95% CI of the difference for success rate (-55%, 15.5%) was lower than the margin set for non-inferiority (-33%) and therefore the non-inferiority of the group P versus group M was not confirmed. Mechanical sensitivity increased in both group after surgery. Mild self-limiting gastrointestinal side effects were detected in both groups. Dogs receiving paracetamol needed more rescue analgesia than dogs receiving meloxicam in the post-operative period. The rate of success with both drugs was lower than expected. Frequent assessment of pain is mandatory to ensure efficient analgesia also beyond the first post-operative day and future studies are warranted to validate methods for out-of-hospital pain assessment.

PMID 43010011
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PubMedJournal of medicine and life2026-11-10

Knowledge and awareness of glucose-6-phosphate dehydrogenase deficiency in the Al-Baha region, Saudi Arabia: a cross-sectional study.

Alamr Fahad Ali FA, Alamri Raghad Ahmed RA, Alzahrani Alanoud Saleh AS, Algamdi Nada Saleh NS et al.

Glucose-6-phosphate dehydrogenase (G6PD) deficiency is a common inherited enzymopathy and a leading cause of hemolytic anemia, with a high prevalence in Saudi Arabia. Affected individuals are often asymptomatic until exposed to specific triggers, making public awareness essential for prevention. This study evaluated knowledge and awareness of G6PD deficiency among adults in the Al-Baha region. A cross-sectional survey was conducted between January and July 2025 among residents aged 18 years and older, using a structured online questionnaire covering general knowledge, symptom recognition, triggers, and management. Knowledge was scored across 33 items and grouped into three bands. We assessed associations with demographic variables using the chi-square test and multivariable logistic regression (P < 0.05). Of 487 participants, 298 (61.2%) were female and 472 (96.9%) Saudi nationals; 226 (46.4%) were aged 20-30 years. Although 311 (63.9%) had heard of the condition, the mean knowledge score was 6.22 ± 1.51 of 33, and 264 (54.2%) fell into the lowest band. Fava beans were correctly identified as a trigger by 450 respondents (92.4%), but awareness of infections (28.5%), aspirin (13.6%), and paracetamol (13.1%) was low. Knowledge level was associated with gender (P = 0.005) and age (P = 0.008); in the adjusted analysis, age was the only independent predictor, participants aged 31-40 years having lower odds of high knowledge than those aged 20-30 years (OR = 0.260; 95% CI, 0.114-0.591; P = 0.002). Public awareness of G6PD deficiency in Al-Baha is inadequate, particularly regarding non-dietary triggers, underscoring the need for targeted educational interventions.

PMID 43005638
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PubMedPediatric nephrology (Berlin, Germany)2026-11-10

Patent ductus arteriosus and neonatal acute kidney injury-a comparative analysis of treatment strategies.

Wildes Dermot D, Kuhar Maja M, Mullaly Rachel R, Riordan Michael M et al.

To evaluate the impact of ductal treatment timing, treatment modality and cumulative ductal exposure on the incidence of acute kidney injury (AKI) in very preterm infants with patent ductus arteriosus (PDA). Additionally, to determine whether high-risk PDA phenotype is independently associated with AKI after adjustment for confounding variables, and to assess whether the initial medical agent for ductal closure is associated with post-treatment AKI. We conducted a retrospective study of 184 infants born under 29 weeks' gestation admitted to a tertiary neonatal unit between 2020-2023. PDA severity was stratified using the El-Khuffash PDA score (high risk ≥5). AKI was defined using the modified neonatal KDIGO criteria. Time-anchored outcomes were used to address AKI temporality. Multivariable bias-reduced logistic regression was performed to control for gestational age, condition at birth, gender and small-for-gestational-age status. Median gestational age was 26.6 weeks with a median birth weight of 863 g. AKI occurred in 28/175 infants (16%) with 20/28 (71%) occurring by day of life fourteen. AKI incidence was 19.6% in the high-risk, refractory to medical treatment infants, 21.8% in the high-risk responsive to medical treatment infants and 8.7% in low-risk infants. Among high-risk treated infants, post-treatment AKI occurred in 17.1% with no discrepancy between paracetamol-first (14.7%) and ibuprofen-first (18.3%) strategies (adjusted OR 1.63, 0.49-5.48). In this cohort of premature infants with PDA, AKI was common in crude analyses. Among high-risk treated infants, ibuprofen-first treatment strategy was not associated with increased post-treatment AKI, though estimates were imprecise and confounding by indication remains likely.

PMID 43007428
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PubMedJournal of orthopaedic case reports2026-11-08

Optimizing Post-operative Analgesia for Early Rehabilitation after Orthopedic Knee Surgery: A Randomized Comparison of Adductor Canal, Infiltration between the Popliteal Artery and Capsule of the Posterior Knee and Genicular Nerve Blocks.

Rath Abhilash A, Himabindu Mannasamudram M, Painkra Anjali A, Kakodia Pradyumna Singh PS et al.

Orthopedic knee surgery, including anterior cruciate ligament tear repair, patellar fracture fixation, and surgery for knee osteoarthritis, is often followed by moderate to severe pain that delays early mobilization, quadriceps activation, and physiotherapy. Motor-sparing, opioid-sparing analgesia is therefore preferred. Ultrasound-guided adductor canal block (ACB), infiltration between the popliteal artery and capsule of the posterior knee (IPACK) block, and genicular nerve block (GNB) are three such options, but direct comparisons in orthopedic knee surgery are limited. To compare the post-operative analgesic efficacy of ultrasound-guided ACB, IPACK block, and GNB in patients undergoing knee surgeries under subarachnoid block. This prospective, randomized, single-blind comparative study was conducted in the Department of Anaesthesiology, N.S.C.B. Medical College and Hospital, Jabalpur, over 18 months after institutional ethics committee approval (IEC/2023/7335-1). Ninety-nine ASA physical status I-II patients aged 18-60 years scheduled for elective knee surgery were randomized equally into three groups (n = 33 each). Group A received ultrasound-guided ACB, Group I received ultrasound-guided IPACK block, and Group G received ultrasound-guided GNB. Each block was performed with 20 mL of 0.375% ropivacaine, followed by standardized spinal anesthesia. Post-operative pain was assessed using a Visual Analog Scale (VAS) over 24 h. Time to rescue intravenous paracetamol, tramadol requirement, and block-related complications were recorded. Baseline demographic characteristics were comparable among groups. Group G had lower mean VAS scores at most post-operative time points, including 16, 20 and 24 h. The time to first rescue paracetamol was longest in Group G (5.87 ± 0.43 h), followed by Group A (5.62 ± 0.48 h) and Group I (5.42 ± 0.49 h). The second paracetamol dose was also delayed the longest in Group G (11.79 ± 0.83 h). Tramadol was required in 6.06% of patients in Group G, compared with 21.21% in Group A and 30.30% in Group I. In patients undergoing orthopedic knee surgery, all three ultrasound-guided motor-sparing blocks provided clinically useful post-operative analgesia. GNB was associated with lower pain scores at most intervals, delayed rescue analgesic requirement, and reduced tramadol use compared with ACB and IPACK block, making it a promising option to support early rehabilitation. Larger adequately powered trials with procedure-specific subgroup analysis and functional outcomes, such as quadriceps strength and range of motion, are warranted.

PMID 42997111
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PubMedCureus2026-11-08

Sparing the Brain, Saving the Breast: Thoracic Segmental Spinal Anesthesia in Frail Geriatric Patients.

Scimia Paolo P, D'Agostino Massimiliano Luca ML, Starnari Roberto R, Gentili Luca L et al.

Thoracic segmental spinal anesthesia (TSSA) provides a selective neuraxial block while preserving spontaneous ventilation and may therefore be useful in frail older patients in whom general anesthesia carries increased cardiorespiratory and neurocognitive risk. We describe three women aged 81, 91, and 99 years (American Society of Anesthesiologists (ASA) physical status III, IV, and III, respectively) who underwent breast quadrantectomy, with sentinel lymph node biopsy in two cases, under TSSA as the sole anesthetic technique. After informed discussion of the individual risks and benefits, spinal anesthesia was performed at the T7-T8 interspace using a 25-gauge Whitacre needle (Becton, Dickinson and Company (BD), Franklin Lakes, New Jersey, USA). Hypobaric ropivacaine was administered at a low dose (7.5 mg in two patients and 6 mg in one), without intrathecal adjuvants or intraoperative sedation. All procedures were completed without conversion to general anesthesia or additional anesthetic supplementation. Spontaneous ventilation was maintained throughout, and no clinically relevant hemodynamic, respiratory, or neurological complications were observed. Lower-limb motor function was preserved at the end of surgery, and scheduled intravenous paracetamol alone provided postoperative analgesia during the first 24 hours. Scores on the Italian-validated Quality of Recovery-15 (QoR-15I) questionnaire remained high at 24 and 48 hours. These cases suggest that low-dose TSSA may be a feasible anesthetic option for selected frail elderly patients undergoing breast surgery. Larger prospective studies are required to better establish its safety, indications, and reproducibility.

PMID 42997418
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