responsible for regulating the body’s temperature.
Its analgesic effect, in turn, occurs due to the direct action of the medication on the central nervous system, causing the perception of pain to be reduced throughout the body – this is because it is a centrally acting analgesic.
The effect of paracetamol starts between 15 to 30 minutes after oral administration and acts for 4 to 6 hours. Despite having a later peak in concentration when taken with meals, paracetamol does not have its absorption affected by food.
What is important to know, in the case of pregnant women, is that the medication can cross the placenta, reaching the baby.
Read the full package insert for paracetamol!
Dosage: how many paracetamol pills can you take per day?
It is difficult to say which is the maximum safe dosage, as each person has different reactions. But, according to what is established in the package leaflet, the maximum daily dose (for adults) should not exceed 4000mg, equivalent to 5 tablets of 750mg or 8 tablets of 500mg, taken in intercalated doses.
However, in addition to the need to consult a doctor to confirm the possibility of using the drug, guidance on dosage is also essential.
In the case of pregnant women, care must be redoubled. For them, the maximum allowed dose may be less than 4000mg, which happens according to medical evaluation.
To reach the safe dosage per day individually, the doctor also needs to assess other factors, such as the pregnant woman’s clinical condition, diseases and health, in general.
Is the use of paracetamol in pregnancy safe?
It depends . The use of this type of painkiller is only safe when taken properly, that is, by medical prescription and in doses considered safe.
Like any medication, paracetamol has some adverse reactions and, in the case of pregnant women, these reactions can also interfere with the baby’s health, since the substances are absorbed and pass through the placenta.
The most recommended is that pregnant women consider the drug as a last option, regardless of the gestational trimester.
To relieve symptoms such as pain and fever, they can opt for more natural options, such as home remedies. However, even in these cases, prior to ingesting any substance, medical consultation and guidance are also essential.
To understand how safe a drug is for pregnant women, it is important to know about the existing risk categories:
Pregnancy risk categories
According to the classification of medications in pregnancy, established by the Food and Drug Administration , in the USA, there are five risk categories that pregnant women should be aware of, being divided into A, B, C, D and X. Paracetamol is included in risk category B .
This classification is similar to what Anvisa determines in Brazil and, according to the national agency, pregnant women should not take paracetamol without medical advice.
The excerpt present in Anvisa’s technical regulation , in which it establishes the warning phrases about the active principles and other substances that must appear on labels and package inserts, says the following about the risk category of paracetamol:
- Risk category B: animal studies have not shown fetal risk, but there are also no controlled studies in pregnant women; or else, animal studies revealed risks, but they have not been confirmed in controlled studies in pregnant women.
This means that, even after being tested on animals, it is not possible to conclude through these studies whether there are the same risks for the pregnant woman and the baby when using the medication.
For the knowledge of pregnant women, it is interesting to know a little more about the other categories, according to what Anvisa says:
- Risk category A: in controlled studies in pregnant women, the drug showed no risk to the fetus in the first trimester of pregnancy. There is no evidence of risk in the subsequent quarters, the possibility of fetal damage being remote;
- Risk category C : no studies have been carried out on animals or pregnant women; or else, animal studies have shown risk, but there are no studies available in pregnant women;
- Risk category D (in high doses): the drug has demonstrated positive evidence of human fetal risk, however, the potential benefits for women may possibly justify the risk, such as, for example, in cases of serious or threatening diseases life, and for which there are no other safer drugs;
- Risk category X : in studies in animals and pregnant women, the drug caused fetal abnormalities, with clear evidence of risk to the fetus that is greater than any possible benefit for the patient.
Therefore, when consulting with the doctor or checking with the pharmacist, it is important to remember about these categories and question whether the prescribed medication is part of any of them. In addition, it is also worth remembering the importance of reading the package insert.
Read more: What is the meaning of the stripes of the medicines and their colors?
What are the risks for the baby?
You have probably heard the saying that the difference between the medicine and the poison is the dose. These popular sayings are not always true, but in this case we can say that they are.
Any medication, when taken improperly, can bring health risks. And paracetamol is no different.
Despite being considered among the other analgesic options the safest for pregnant women, it should not be taken without medical advice and in high doses, as there are some adverse reactions that can occur.
For people in general, although rare, the drug can cause severe allergic reaction (anaphylactic reaction), hypersensitivity and skin reactions such as hives, rashes and itching.
Read more: Skin allergy: causes and how to identify symptoms
The risks that paracetamol may cause in the baby are associated with the possibility of the child developing conditions such as attention deficit disorder , autism , asthma and delayed language.
These complications for the baby are associated with the action that the drug causes in the brain receptors, more precisely in the central nervous system (CNS) – paracetamol works by reducing the perception of pain.
By crossing the placenta, this substance can also reach the baby’s brain, which can affect the same structures of the CNS, which are involved in the maturation and connections of the child’s neurons.
But although some studies indicate that there is an association between the use of paracetamol during pregnancy and some harm to the baby, these are still considered to be inconclusive.
Understand the complications and risks raised in the studies:
According to a study released by the International Journal of Epidemiology , there is a greater chance of the incidence of childhood asthma and other respiratory diseases in children in which the mother used paracetamol during pregnancy.
However, this risk, which can be 20% in babies up to 18 months of age and 50% in children aged 7 years, is associated with continuous use of the drug and not sporadic use (from time to time).
According to a study published by European Psychiatry , based on an interview with about 754 women between the 8th and 13th week of pregnancy, there are chances of using paracetamol during pregnancy to influence the development of problems such as language delay.
Comparing the frequency of use of paracetamol and carrying out a test to measure the development of children aged up to 30 months, the researchers established an average of 50 words to consider the child with language delay at that age.
The group was divided between pregnant women who took paracetamol more than 6 times since the beginning of pregnancy and those who never took it.
The result of children with some type of delay represented 10%, with children born to mothers who consumed in high doses 6 times more prone to this risk in development.
A study published in the International Journal of Epidemiology indicates that prenatal exposure to the substance is associated with a greater number of symptoms of autism, such as hyperactivity and impulsivity.
However, the research does not indicate the risk dose. The reported data are from mothers who used the medication at a frequency of never , sporadically and always , which cannot be considered conclusive.
Attention deficit and hyperactivity
A relationship between the use of paracetamol and Attention Deficit Hyperactivity Disorder ( ADHD ), according to a study by researchers at the University of California and the University of Aarhus (Denmark), occurs after the follow-up done with more than 64,000 children and mothers who used the medication during pregnancy.
In this analysis, it was observed that the chances of developing this type of disorder were 13% to 37% in pregnancies whose mothers used paracetamol.
What type of pain reliever can a pregnant woman take?
Paracetamol can be taken, as long as the doctor agrees and the daily dose does not exceed the limit of 4000mg, because, despite the risks, it is still considered the safest. Other common pain relievers, such as aspirin and ibuprofen , are not indicated.
The Tylenol , paracetamol-based drug product, often also be used by pregnant women to help reduce headaches.
However, it is the doctor who accompanies the pregnant woman and the most qualified professional to say which type of medication, whether analgesic or of another class, is safe for her condition.
It is worth mentioning that self-medication should not be practiced . When experiencing headache, body aches, sore throat, fever or any other symptom, a pregnant woman should see a doctor.
As an alternative to medications, pregnant women can opt for homemade recipes for natural painkillers.
There are some medicinal plants that can be taken in the form of tea or used as essential oils that help provide an analgesic effect on the body.
However, it is very important to be careful with the choice of plants, as most do not have scientific proof that they really work as an analgesic. In addition, there are a number of plants contraindicated by the risks they can cause to pregnant women, such as ginger and green tea, which should be avoided.
One option in these cases is turmeric tea, which is not among the contraindicated teas. However, it should also be consumed in moderate amounts, as high doses can cause uterine contractions.
In addition to this plant, omega 3 can also contribute to the relief of headaches and other symptoms.
However, these natural painkillers do not work as a medicine, in which the action and relief of pain is much faster.
They should be included in the diet or in the daily life of the pregnant woman to help with pain relief, however, as mentioned, they do not have the same action as the drugs and the need for use varies according to the condition of the pregnant woman.
In these cases, the guidance given to the medications is also valid. The doctor should advise on the risks of using these natural recipes and also on the safe amount.
Pregnancy is a special moment in a woman’s life, but it is also a period that requires a lot of care. It is common to have doubts about medication, about what is safe or not to take.
Therefore, we seek to clarify in this article about the risks present in paracetamol. If you are pregnant and suffer from symptoms that require the use of a painkiller, see a doctor so that he can guide you, and never self-medicate!
Now that you know about how acetaminophen works and its indications during pregnancy, how about sharing this information with your friends and family? Thanks for reading!