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Acetaminophen, also known by its common name paracetamol, is a widely utilized medication that serves as an effective analgesic, which means it alleviates pain, and an antipyretic, which refers to its ability to reduce fever. This compound is characterized by its chemical formula C8H9NO2. It is one of the most popular and frequently used over-the-counter drugs available on the market today, and it comes in a variety of formulations to suit different needs and preferences. These formulations can include tablets, capsules, syrups, and even suppositories, making it accessible and convenient for individuals seeking relief from minor aches and pains or the discomfort of fever.
Acetaminophen differs from the nonsteroidal anti-inflammatory agents described in that it is devoid of anti-inflammatory and antirheumatic properties. It was recently shown that acetaminophen, like aspirin, inhibits cyclooxygenase action in the brain and is even stronger than aspirin. On the other hand, the mechanism of analgesic action of acetaminophen is not fully clear, since it acts poorly on peripheral cyclooxygenase.
Acetaminophen is an analgesic and antipyretic compound. Unlike many NSAIDs, which inhibit both COX-1 and COX-2, early studies suggested that acetaminophen is a poor inhibitor of both isoforms. However, it does inhibit COX-2 by 83% and COX-1 by 56% in human bloodex vivo, albeit at a high 1,000 mg dose, with IC50values of 25.8 and 113.7 μM, respectively. Acetaminophen is enzymatically and non-enzymatically converted to several reactive metabolites that contribute to adverse or indirect effects, including liver injury. At toxic doses, the acetaminophen metabolite N-acetyl-4-benzoquinone imine (NAPQI; ) depletes glutathione reserves in the liver, leading to an accumulation of NAPQI and subsequent hepatocyte necrosis. Acetaminophen decreases glutathione levels and reduces glutathione peroxidase activity in mice when administered at a dose of 250 mg/kg and induces ferroptotic cell death in primary mouse hepatocytes, an effect that can be blocked by the ferroptosis inhibitor ferrostatin-1 . Acetaminophen has analgesic and antipyretic properties in animal models.
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Acetaminophen was first discovered by H. N. Morse in 1878. Although many studies on its use as an analgesic were performed, it wasn’t until 1950 that it was marketed under the name Triagesic. Today, its most common trade names are Tylenol and Panadol, but a large percentage of its sales are as a generic drug. It is the most commonly used medication for pain and fever in both the United States and Europe. It is on the World Health Organization's List of Essential Medicines.