Paracetamol misuse could lead to liver damage in children

Emdad Rahman: Only a quarter (27%) of parents actually know which of the medicinal products for children that they are aware of contain paracetamol, reveals new research by the Royal Pharmaceutical Society (RPS). With many of these products being used to treat ailments on which they have no proven effect, there is a danger that some children could be exposed to liver damage through accidental paracetamol misuse.

According to the results of the survey conducted by YouGov on behalf of the Royal Pharmaceutical Society, one in six  (17%) surveyed parents of children aged twelve or under did not know that Calpol, one of the most popular products used in children’s treatment, contains paracetamol. Parents’ knowledge of other popular medicines was even more worrying. More than two thirds are unaware that commonly used products such as Disprol (68%), Medised (79%) and Medinol (76%) contain paracetamol.

Steve Tomlin, RPS spokesperson and consultant pharmacist, said: “The decision to use paracetamol in a child is often undertaken by parents and carers without discussion or contact with a healthcare professional. This, combined with the lack of awareness on which products contain paracetamol, may have serious effects on children’s health, such as exposure to long term liver damage. Whilst taking paracetamol at the recommended dose and frequency is safe, evidence shows that only small increases of just an extra dose a day over the course of three days can potentially cause liver damage.”

“The risk of accidental overdose is even higher if children have multiple carers, as monitoring of the medicine administration is much more difficult”.

Considering the fact that carers often carry on treatment for several days without seeking professional advice (over a third of those surveyed (34%) said they have used paracetamol or Calpol for three or more days to treat their child, before seeking professional advice), it is not surprising that problems can happen.

Survey results also reveal confusion among parents over which ailments paracetamol is actually an effective treatment for. Although they would mostly consider using paracetamol (e.g., Calpol, Disprol, Medinol, etc.) correctly for a number of conditions in young children aged twelve or under – including teething pains (70%), fever (80%) and stomach pains (36%) – the findings also show that some parents would consider using the same products to treat ailments on which paracetamol has no proven effect, with 20% using it for coughs and 6% for sleep.

As many as 38% of parents perceive paracetamol to be a relatively “safe drug” because it is sold over the counter, with over half (52%) saying the same about Calpol.

Steve Tomlin adds: “Paracetamol is safe as long as it’s administered at the recommended dose. There are 95 products containing paracetamol currently available from pharmacists in the UK. With this widespread availability of paracetamol containing products, it is feasible that a parent could inadvertently administer more than the recommended dose of paracetamol.”

According to the survey, almost a quarter (24%) of parents in Britain admit to giving their child two or more over-the-counter products containing paracetamol at some point during the course of their illness.

The recommended doses of paracetamol have been changed in order to ensure that children get the most effective dose of paracetamol. New dosing instructions and advice were introduced in November 2011. Companies which produce paracetamol for sale in the UK are required to put information regarding the new doses in the patient information leaflet.