Indications

Ace Power is indicated for:

• Relief of fever, common cold, and influenza symptoms

• Management of pain: headache, toothache, earache, bodyache, myalgia, neuralgia, dysmenorrhoea, sprains, colic, back pain, post-operative pain, postpartum pain, inflammatory pain, and post-vaccination pain in children

• Treatment of rheumatic and osteoarthritic pain with joint stiffness
  (Use only under registered physician's guidance)

Pharmacology

• Mechanism: Paracetamol (acetaminophen) primarily acts centrally by inhibiting cyclooxygenase (COX) isoforms (COX-1, COX-2, COX-3), reducing prostaglandin synthesis in the CNS. This elevates pain thresholds and inhibits the hypothalamic heat-regulating center.

• Key Properties:

  • Analgesic: Blocks peripheral pain impulse generation

  • Antipyretic: Induces peripheral vasodilation and sweating

  • Weak Anti-inflammatory: Lacks significant peripheral anti-inflammatory effects (unlike NSAIDs) due to minimal COX inhibition in peripheral tissues.
    *Note: The exact mechanism remains incompletely understood, with ongoing research into COX-3 selectivity.*

Dosage & Administration

Standard Tablet

• Adults: 1–2 tablets every 4–6 hours (max 4 g/day)

• Children (6–12 years): ½–1 tablet 3–4× daily (max 2.6 g/day)

Extended-Release Tablet

• Adults/Children >12 years: 2 tablets every 6–8 hours (max 6 tablets/24hr). Do not crush.

Syrup/Suspension

Suppository

Paediatric Drops

Actizorb™ Tablet (Fast-Dissolving)

• Adults/Children ≥12 years: 1–2 tablets every 4–6 hours (max 8 tablets/24hr)

• Children 7–11 years: ½–1 tablet every 4–6 hours (max 4 tablets/24hr)
  Not recommended for children <7 years

IV Infusion

Interactions

• Alcohol: ↑ Risk of hepatotoxicity (avoid chronic use)

• Barbiturates/Tricyclic Antidepressants: ↓ Paracetamol metabolism

• Anticonvulsants/Oral Contraceptives: Induce liver enzymes, ↓ therapeutic efficacy

• Disulfiram: May prolong paracetamol half-life

Contraindications

• Hypersensitivity to paracetamol or any component

Side Effects

Generally mild; may include:

• Hematological: Thrombocytopenia, neutropenia, agranulocytosis

• Allergic: Skin rashes, anaphylaxis (rare)

• GI: Nausea, pancreatitis (occasional)

Pregnancy & Lactation

• Pregnancy: Safe at recommended doses; use under medical supervision.

• Lactation: Excreted minimally in breast milk—compatible with breastfeeding.

Precautions & Warnings

• Hepatic Impairment: Contraindicated in severe liver disease. Use caution in hepatic impairment/alcoholism—reduce dose.

• Renal Impairment: Adjust dose if CrCl <30 mL/min.

• Overdose Risk: Do not exceed 4 g/day (adults). Higher doses cause hepatotoxicity.

• Special Populations:

  • Geriatric: No dose adjustment needed.

  • Malnourished/Dehydrated Patients: ↑ Overdose risk.

• Anaphylaxis: Discontinue immediately if hypersensitivity occurs.

Overdose Management

• Toxic Dose: >10 g (adults); >5 g in high-risk patients (alcoholism, enzyme inducers).

• Symptoms:

  • 0–24 hr: Nausea, vomiting, pallor

  • 24–72 hr: Hepatic failure (jaundice, coagulopathy), renal injury, metabolic acidosis

• Treatment:

  1. Activated charcoal (if ingestion <1 hr)

  2. N-acetylcysteine IV (gold standard within 8 hr) or oral methionine

  3. Monitor liver/renal function; consult toxicology specialist

Therapeutic Class

Non-opioid Analgesic