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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

PubMedFrontiers in pain research (Lausanne, Switzerland)2026-10-15

Comparative evaluation of the antipyretic and analgesic efficacy and safety of a fast-release paracetamol 650 mg formulation vs. conventional paracetamol formulations in adults with acute febrile or febrile-pain conditions: a multicenter randomized controlled trial.

Mondal Susobhan S, Ikbal S K Ashik SKA, Agrawal Sumit S, Raykantiwar Amar A et al.

Paracetamol is widely used for management of fever/pain. With increasing emphasis on rapid symptom relief, this study compared the response following a single 650 mg oral dose of four commercially available tablets in acute febrile and febrile-pain conditions. This multicenter, open-label trial (CTRI/2025/12/098995) included adults (18-60 years) with oral temperature ≥38 °C (with/without pain) and symptom onset within ≤72 h. Consenting participants were randomized (1:1:1:1) to receive a single dose of the test fast release test paracetamol (A) and conventional paracetamol (B, C, D) drug. Oral body temperature(digital thermometer) and pain (numerical rating scale (NRS) were assessed at predefined intervals till 90 ± 2 min. Outcomes included magnitude and onset of antipyretic and analgesic effects, adverse events (AEs), and patient satisfaction. Among 220 febrile participants (55% women; mean temperature 38.51 °C), 169 reported pain (mean NRS score 7.31). At 90 ± 2 min, fast release paracetamol demonstrated significantly greater reduction in temperature (1.54 °C), along with the fastest rate of decline (1.03 °C/hr), and the shortest restricted mean time to defervescence (84.27 min), resulting in majority of participants (60.0%) experiencing defervescence (temperature ≤37 °C). Pain reduction was also significantly greater with fast release test paracetamol (5.2 units; 3.4 units/hr), with onset of analgesia (≥30% reduction in NRS score) after a comparatively shorter median time (30 min; conventional, 60-90 min). By 90 ± 2 min, pain resolved (NRS score = 0) in 23.2% (A), 22.5% (B), 11.9% (C), and 6.8% (D) participants, with restricted mean times to resolution being 90.00, 89.25, 89.29, and 90.00 min, respectively. Overall, 82.2% participants reported treatment satisfaction, with likelihood highest for fast-release test paracetamol (A). Four participants reported unrelated, mild/moderate AEs. All evaluated paracetamol 650 mg formulations demonstrated antipyretic and analgesic activity within 90 min, while the fast-release formulation showed earlier and, for several assessed outcomes, greater reductions in temperature and pain. These findings may support consideration of formulation choice when rapid early symptomatic relief is desired. CTRI/2025/12/098995.

PMID 42876821
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PubMedNanoImpact2026-10-14

Mechanistic insights into the biological effects of environmentally relevant pharmaceutical-loaded real-life polypropylene microplastics in Drosophila melanogaster.

Alaraby Mohamed M, Balsamo Marta M, Abass Doaa D, Elkady Elham Farghal EF et al.

Although the adsorption of pharmaceuticals by microplastics (MPLs) may reduce environmental contaminant concentrations, their effects on bioavailability and biological toxicity following ingestion remain poorly studied. To mimic environmentally relevant exposure, environmentally relevant polypropylene microplastics (PP-MPLs) derived from post-consumer plastic products (real-life) were used as carriers for the pharmaceuticals paracetamol (PCM) and ciprofloxacin (CFX), using Drosophila larvae in vivo model. Free PCM and CFX were tested at concentrations equivalent to their respective adsorption loadings on PP-MPLs (0.03% and 0.02% w/w, respectively), enabling direct comparison under environmentally realistic conditions. PP-MPLs, with or without adsorbed pharmaceuticals, retained their irregular morphology and heterogeneous size distribution, representing an environmentally relevant mixture of micro- and nanoscale particles. Following oral exposure, PP-MPLs, either alone or carrying adsorbed pharmaceuticals, sequentially traversed the intestinal barrier penetrating the peritrophic membrane, accumulating within enterocytes, and ultimately reaching hemolymph. Particle exposure induced extensive enterocyte vacuolation, significantly increased intracellular reactive oxygen species (ROS), and triggered targeted gene-expression changes involving antioxidant, immune, detoxification, and stress-response pathways, while genes associated with digestive function were consistently deregulated. Despite elevated oxidative stress, PP-MPLs did not alter mitochondrial membrane potential. In contrast, free PCM induced significant mitochondrial depolarization without increasing ROS, whereas this effect was abolished following adsorption onto PP-MPLs, potentially due to reduced bioavailability. Moreover, pharmaceutical-loaded PP-MPLs did not elicit additive molecular toxicity compared with PP-MPLs alone.

PMID 42874708
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PubMedCurrent pharmaceutical design2026-10-14

Rational Use of Analgesic Agents in Elderly Patients: Implications of the Beers Criteria and STOPP/START Algorithms.

Kukul Güven Fatma Mutlu FM, Ucar Asli Bahar AB, Inci Ozlem O, Unaldi Mehmet M et al.

Pain affects approximately 30% of community-dwelling older adults and more than half of nursing-home residents but remains undertreated because age-related pharmacokinetic and pharmacodynamic changes render standard analgesic dosing hazardous. This review synthesises the evidence on rational analgesic prescribing in older adults, comparing the American Geriatrics Society 2023 Beers Criteria with STOPP/START version 3. In this structured narrative review, PubMed/MEDLINE, Embase and the Cochrane Library were searched (January 2000-May 2026), combining analgesic-class terms with the Beers Criteria, STOPP/START, potentially inappropriate medications, deprescribing and older age. Systematic reviews, meta-analyses, randomised trials, large observational studies and guidelines in English were eligible; studies confined to patients younger than 65 years were excluded. Analgesics are principal drivers of inappropriate prescribing: STOPP/START version 3 identified at least one potentially inappropriate medication in 73% of geriatric outpatients versus 56% under version 2, NSAIDs and aspirin being the most prevalent new criteria. The Beers Criteria designate meperidine, non-selective oral NSAIDs, anticholinergic tricyclic antidepressants, and opioid-benzodiazepine or opioidgabapentinoid combinations as highest risk; meperidine is most strongly associated with unplanned hospitalisation (OR 2.37). The instruments are complementary, not interchangeable: the Beers Criteria offer broader drug-disease coverage but are aligned with the United States formulary, whereas STOPP/START is bidirectional and more prescriptive on dose and renal thresholds. Neither has been shown to reduce falls, hospitalisation or mortality in adequately powered trials. Stepwise multimodal analgesia beginning with paracetamol and topical agents, initiated at low doses and titrated slowly, with comprehensive geriatric assessment and regular medication review, remains the evidence-based standard of care.

PMID 42872451
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PubMedPaediatric drugs2026-10-14

Efficacy of Ibuprofen Versus Acetaminophen for Acute Fever Management in Febrile Children: A Systematic Review and Meta-analysis of Randomized Controlled Trials.

Marseglia Gian Luigi GL, Marchisio Paola Giovanna PG, Milani Gregorio Paolo GP, Miraglia Del Giudice Michele M et al.

Ibuprofen and acetaminophen are the most widely used antipyretic agents in pediatric practice. Despite their common use, comparative evidence on their relative efficacy in febrile children remains heterogeneous, and clinical recommendations vary across guidelines and countries. We aimed to evaluate the comparative antipyretic efficacy of ibuprofen versus acetaminophen in febrile children through a systematic review and meta-analysis restricted to randomized controlled trials. A systematic search was conducted in Scopus, PubMed, and Web of Science using a predefined strategy combining terms for ibuprofen, paracetamol/acetaminophen, fever/febrile/pyrexia, and pediatric populations. The primary outcome was the proportion of children afebrile at 4 h. Continuous outcomes included temperature reduction at 4 h, time without fever during the first 4 h, and time-weighted summary temperature differences over 0-8 h. The study protocol was registered in PROSPERO (CRD420261353471). A total of 479 records were identified; after duplicate removal and screening, seven studies were included in the quantitative synthesis. For the primary outcome of afebrile status at 4 h, the pooled risk ratio was 1.26 (95% confidence interval [CI] 0.88-1.80; p = 0.106). Temperature reduction at 4 h was significantly greater with ibuprofen (mean difference 0.31 °C, p = 0.024). The time-weighted summary temperature outcome over 0-8 h numerically favored ibuprofen but did not reach statistical significance (mean difference - 3.52, 95% CI - 21.24 to 14.21; p = 0.240; I2 = 57.6%). An exploratory standardized mean difference analysis across heterogeneous continuous outcomes (seven comparisons) yielded a near-null pooled effect (Hedges' g - 0.08, 95% CI - 0.40 to 0.25; p = 0.645; I2 = 84.0%). The primary outcome-the proportion of children achieving afebrile status at 4 h-did not differ significantly between ibuprofen and acetaminophen (risk ratio 1.26, 95% CI 0.88-1.80; p = 0.106). Ibuprofen produced a statistically greater reduction in temperature at 4 h compared with acetaminophen (mean difference 0.31 °C), although this difference is unlikely to be clinically meaningful. These findings suggest a marginal quantitative advantage of ibuprofen to decrease body temperature, without a clinically significant difference between the two agents.

PMID 42870135
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PubMedJournal of science and medicine in sport2026-10-13

Cryotherapy added to PEACE & LOVE rehabilitation for acute lateral ankle sprain in physically active adults: A randomized controlled trial in sports rehabilitation.

Halder Polok P, Hossain Md Zahid MZ, Akash Md Asfan Afroz MAA, Saha Joy J et al.

To evaluate whether adding cryotherapy during the first 72 h to a standardized PEACE & LOVE rehabilitation program improves early recovery after acute lateral ankle sprain compared with a room-temperature gel-pack control. Randomized, parallel-group controlled trial. Sixty physically active adults with Grade I-II acute lateral ankle sprain within 48 h of injury were randomized 1:1 to PEACE & LOVE rehabilitation plus either active cryotherapy or room-temperature gel-pack control. Cryotherapy was delivered using a 0-4 °C gel pack for 20 min, three times daily for 72 h. Both groups received identical progressive rehabilitation for four weeks. The primary outcome was average ankle pain during the previous 24 h measured using the Numeric Pain Rating Scale at Day 7. Secondary outcomes were swelling, Lower Extremity Functional Scale score, Weight-Bearing Lunge Test, paracetamol use, and re-injury. Outcomes were analyzed using linear mixed-effects models. All randomized participants completed follow-up. Pain decreased in both groups, with a statistically greater Day 7 reduction in cryotherapy than control (adjusted difference -1.10, 95% confidence interval -1.85 to -0.35; p = 0.004). However, this did not reach the pre-specified 2-point minimal clinically important difference. Swelling also decreased more with cryotherapy (-1.78 cm, 95% confidence interval -3.26 to -0.30; p = 0.019). Functional recovery, dorsiflexion, paracetamol use, and re-injury were comparable. Responder analysis produced a number needed to treat estimate with confidence intervals crossing infinity. Cryotherapy provided statistically greater short-term pain and swelling reductions, but its added clinical value beyond progressive rehabilitation remains uncertain within four weeks.

PMID 42869718
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PubMedJournal of multidisciplinary healthcare2026-10-13

Work-Related Musculoskeletal Pain and Analgesic Use Among Undergraduate Dental Students in Iraq: A Multi-Institutional Cross-Sectional Study.

Al-Hasani Noor R NR, Ibrahim Ali I AI, Al Haidar Aseel Haidar M J AHMJ, Hussein Ayat M AM et al.

This study aimed to evaluate the prevalence of work-related musculoskeletal pain (WMSP), analgesic use practices, pharmacological knowledge, attitudes toward unsupervised analgesic use, and ergonomic/non-pharmacological behaviors in this cohort. An online questionnaire was sent to third- to fifth-year Iraqi dental students using WhatsApp, Facebook, and Telegram platforms. The link was shared three times weekly during March-May 2026. The survey collected sociodemographic data, musculoskeletal pain experience, analgesic use patterns (especially non-steroidal anti-inflammatory drugs (NSAIDs) and paracetamol), pharmacological knowledge, attitudes toward unsupervised analgesic use, and ergonomic/non-pharmacological behaviors. Skip logic was applied to direct pain-related and analgesic-use items to eligible participants only. Out of 1081 collected responses, 791 dental students reported WMSP (73.2%; 95% CI: 70.5-75.8). A significantly higher prevalence of WMSP was recorded among female students than among male students (75.3% vs 68.7%; p = 0.020), and WMSP prevalence differed significantly across academic years, ranging from 66.3% among 3rd-year to 77.5% among 5th-year respondents (p = 0.001). The most commonly reported affected areas were neck, lower back, and shoulders, with prevalences of 58.4%, 53.9%, and 42.2%, respectively. About half of students with WMSP used analgesics, mainly paracetamol (46.9%) and ibuprofen (33.6%). Analgesic users demonstrated lower knowledge and safer-attitude scores than non-users (both p ≤ 0.002). The multivariable analysis revealed that higher analgesic-related pharmacological knowledge was independently associated with lower odds of analgesic use (OR = 0.828, 95% CI: 0.793-0.864; p < 0.001). A high prevalence of WMSP was reported among Iraqi dental undergraduates, with nearly half of affected students reporting analgesic use. Higher analgesic-related pharmacological knowledge was independently associated with lower odds of reported analgesic consumption. A combined approach utilizing ergonomic and pharmacological education may promote better pain-management behaviors and safer analgesic use; however, longitudinal or interventional studies are needed to evaluate its effectiveness.

PMID 42866211
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