The most widely used painkiller in the UK, and the one most often taken twice by accident.
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Paracetamol is a simple analgesic and antipyretic — it relieves pain and reduces fever.
It is not an anti-inflammatory. That distinction matters more than most people realise: for a swollen, inflamed joint an NSAID often works better, while for headache or fever paracetamol is usually the sensible first choice.
Its mechanism is still not fully established, more than a century after it entered use. It appears to act centrally, within the brain and spinal cord, rather than at the site of injury.
It is the safer painkiller in pregnancy, in kidney disease, in heart disease and in people taking anticoagulants — which is why it remains so widely recommended despite being modest in effect.
Adults: one or two 500mg tablets, up to four times in 24 hours. Never more than 4g (eight 500mg tablets) in any 24-hour period. Leave at least four hours between doses.
Check every other medicine you are taking for paracetamol. It is present in a large number of cold and flu remedies, night-time preparations and combination painkillers such as co-codamol and co-dydramol.
Taking a branded cold remedy alongside paracetamol tablets is the commonest route to accidental overdose in the UK. The active ingredients are listed on every box.
Adults under 50kg need a reduced dose, and so do people with liver disease, chronic alcohol use, or significant malnutrition. Children are dosed by weight and age — the Calpol packaging sets this out clearly.
Taken regularly and to time for a few days, paracetamol works considerably better than taken sporadically when pain peaks. Combining it with ibuprofen, where ibuprofen is safe for you, gives better relief than a higher dose of either.
At correct doses paracetamol is remarkably well tolerated — which is precisely why its overdose risk is underestimated. Most people experience nothing at all.
Paracetamol overdose is dangerous, and the most dangerous feature is that people feel well for the first 24 hours. Liver damage develops over the following days, by which time treatment is far less effective.
Treatment works extremely well when given early. That is the whole reason to act immediately rather than wait to see how you feel.
If you have taken more than the maximum dose, whether deliberately or by accident, go to A&E or call 111 straight away, even if you feel completely fine. Do not wait for symptoms.
Paracetamol is considered the painkiller of choice in pregnancy, at the lowest effective dose for the shortest time.
No routine monitoring is needed for occasional use.
Long-term daily use at full dose is worth reviewing rather than continuing indefinitely, and liver function may be checked.
Paracetamol is available without a prescription and costs very little, so there is rarely any reason to pay for one.
A supermarket pack of sixteen 500mg tablets costs well under a pound. Paying a consultation fee to be prescribed paracetamol is not good value and we will say so.
Where it does come up usefully is in a wider conversation — what the pain actually is, whether it is being treated with the right thing at all, and whether an anti-inflammatory can safely be added.
Paracetamol is among the cheapest medicines available anywhere. Supermarket own-brand tablets cost pennies; branded versions of the identical drug cost several times more and work no better.
Buying the branded version is paying for the box. The active ingredient and the dose are the same.
Pharmacies limit sales to two packs at a time, which is a deliberate overdose-prevention measure introduced in the UK and shown to have reduced deaths.
Paracetamol can be stopped at any time without tapering.
Taking painkillers for headache on more than about 15 days a month can itself cause a daily headache — medication overuse headache. It is common, frequently missed, and resolves only by stopping the painkiller, which temporarily makes things worse before it makes them better.
If you are reaching for paracetamol most days for headache, that is worth a conversation rather than a bigger box.
Adding an NSAID, if safe for you, is usually more effective than increasing paracetamol — and the maximum dose should never be exceeded, whatever the pain. Pain not controlled by the correct dose needs assessing rather than escalating.
Yes, if ibuprofen is safe for you. They work by different mechanisms, so combining them gives better relief than doubling either. They can be taken together or staggered.
Ibuprofen is not safe for everyone — stomach ulcers, kidney disease, heart failure and later pregnancy all count against it.
It is the recommended painkiller in pregnancy, used at the lowest effective dose for the shortest necessary time. That advice reflects decades of use.
Often because it is taken too late and too irregularly. Taken to time for two or three days it performs considerably better.
It is also genuinely modest for inflammatory and nerve pain, which need a different approach rather than a higher dose.
If you have exceeded the maximum daily dose, contact 111 or A&E now rather than waiting. Feeling well means nothing in the first 24 hours, and treatment works far better early.
No. For a hot, swollen joint an anti-inflammatory generally works better — but paracetamol is safer for many people, which is the trade-off.
Clinically reviewed by Dr Mohammad Zubair Khan, GMC 7563469
Last reviewed
August 30, 2026
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