First-linePanadol, Calpol
Paracetamol
Central COX inhibitor / analgesic
First-line analgesic in all trimesters and lactation.
OralIVPR
First-line for
- Mild–moderate pain in pregnancy
- Pyrexia
- Post-partum analgesia
Mechanism
Central COX-2 / TRPA1 modulation; minimal peripheral effect.
Pregnancy analgesia ladder
- 1 — Paracetamol
- 2 — + Codeine (short course)
- 3 — + Morphine (avoid late T3)
Dosing
- Oral
- 1 g QDS, max 4 g/day
- IV
- 1 g over 15 min QDS
- ≤50 kg
- 15 mg/kg QDS, max 60 mg/kg/day
Contraindications
- CautionSevere hepatic impairment / chronic alcohol
Side effects
- Hepatotoxicity in overdose
- Rash (rare)
Fetal & maternal notes
- • Not teratogenic.
- • Safe in breastfeeding.
Key interactions
Warfarin
CautionProlonged use ↑ INR
Clinical pearls
- 💡 First-line analgesic in pregnancy and lactation.
- 💡 Overdose: NAC by weight + nomogram.
Content last reviewed: REPLACE_ME (e.g. 2026-07)
Spotted something out of date? See our disclaimer or use Report an Error above.