In some parts of the country, people reported a “temporary shortage” of paracetamol brands and flu medication in local pharmacies following a sudden surge in the number of flu-like illnesses and coronavirus disease 2019 (COVID-19) infections after Christmas and due to the spread of the Omicron variant.
The Department of Health (DOH), however, declared that there is “no ongoing shortage.” The Department of Trade and Industry (DTI) attributed the tight supply of these drugs to a delivery issue during the holidays and encouraged the public to buy generic products instead.
On Monday, Jan. 10, DTI’s Consumer Protection Group said that stocks had been replenished in local pharmacies, and that consumers can now expect “more than enough” supply of the medicines. That same day, the two agencies issued an order setting a purchase limit for paracetamol, products combined with paracetamol, and medicines that ease phlegm.
What is paracetamol for and what products contain it? Here are three things you need to know:
1. What is paracetamol for and when should one take it?
Paracetamol is an over-the-counter pain reliever taken to “address minor to moderate cases” of body aches and reduce fever. Paracetamol can also reduce COVID-19 symptoms, but health experts say the medicine cannot cure viral infection.
“It (paracetamol) has its limits in terms of proper dosing because above certain doses, one can have liver damage, in particular,” Dr. Beaver Tamesis, president of the Pharmaceutical and Healthcare Association of the Philippines (PHAP), said.
Tamesis, who is also managing director of multinational pharmaceutical company Merck Sharp & Dohme, emphasized that the maximum dose that most clinicians prescribe for adults is three grams of paracetamol, or six 500-milligram (mg) tablets per day, taken in four-hour intervals.
“The minute you start dosing it above three grams per day, we’re getting to very, very dangerous territory already,” said Tamesis, who warned that dosage is different for children and should be consulted with a pediatrician.
A global team of public health experts from the non-profit group Meedan explained:
“While paracetamol is routinely used to relieve COVID-19 symptoms, it is important to strictly respect the dosage prescribed as stated on the medication bottle. The dosage of paracetamol for adults is one to two 500-milligram tablets up to four times in 24 hours, with at least four hours in between doses. Any higher amount can be dangerous and is not advised.”
Source: Meedan’s Health Desk, Is paracetamol effective in treating or curing COVID-19?, Aug. 5, 2020
2. How should one take paracetamol?
Health experts and pharmacies warn that one should not take paracetamol with any other medicine that contains it to avoid overdose, drug induced liver injury, and liver failure.
“You should not be combining different brands that potentially contain paracetamol, such as Bioflu, with paracetamol tablets because you might be actually approaching overdose,” Tamesis said.
“This is because, of course, you don’t always see how much paracetamol is in a tablet. You’re lucky if you have the full packaging and you can read and find the milligram content [in the product information]. But if you buy in retail in supermarkets, drugstores, or even in sari-sari stores, then sometimes, you won’t know how much [paracetamol] is in them,” he explained. “So the simplest advice? Do not do it.”
Paracetamol is sometimes combined in specific doses with other compounds, such as nasal decongestants (phenylephrine hydrochloride) and antihistamines (chlorphenamine maleate).
Name brands, such as Bioflu have been around since 2010 and Neozep since 2012, as well as generic products such as Cortal Flu and NoFlu, all contain 500 mg of paracetamol as indicated in their product information. Another generic form, Fludex contains 325 mg of paracetamol.
Patients are also warned against taking combination products with separate paracetamol tablets, as indicated in the information sheet of some of these medicines.
3. What do health experts say about taking paracetamol and other medicines to reduce COVID-19 symptoms?
For mild to moderate cases, DOH prescribes taking paracetamol for fever above 37.5 degrees Celsius in four-hour intervals. In its COVID-19 at-home care guidelines, the DOH also advises these patients to take prescription medicines for cough and sore throat, if they experience these symptoms.
“Right now, if you can get tested and then positive kayo, merong specific therapy kontra COVID[-19],” Tamesis said, referring to molnupiravir, an experimental COVID-19 treatment pill that prevents the spread of the virus in the body and can help patients “at risk for severe cases.” (See VERA FILES FACT SHEET: Novel coronavirus: Six things you need to know)
(Right now, if you can get tested and you test positive, there’s a specific therapy against COVID-19)
On Dec. 22, 2021, the Philippine Food and Drug Administration gave Merck and Ridgeback’s molnupiravir emergency use authorization. COVID-19 patients who qualify for the treatment can access it for free through the Office of the Vice President’s Bayanihan e-Konsulta, as prescribed by its volunteer doctors.
These medications, however, don’t apply to severe COVID-19 patients who need to be referred to COVID-19 hospitals.
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Sources
Inquirer.net, Group: Some areas having ‘temporary shortage’ of paracetamol brands, Jan. 4, 2022
GMA News Online, Temporary paracetamol shortage experienced in some areas –pharma group, Jan. 4, 2022
One News, Some Areas See Shortage Of Paracetamol Brands, Jan. 5, 2022
Department of Health Official Facebook Page, On the Alleged Shortage of Paracetamol and Other Drugs, Jan. 4, 2022
Department of Trade and Industry Philippines, READ | DTI ADVISORY: On the Issue of Paracetamol Supply, Jan. 5, 2022
ABS-CBN News, DTI: Paracetamol supply expected to ‘normalize’ as drugstores replenish inventory, Jan. 10, 2022
SunStar, DTI expects replenishment of Paracetamol in drugstores on weekend, Jan. 10, 2022
Philippine News Agency, Paracetamol, flu meds supply back to normal this weekend: DTI, Jan. 7, 2022
Department of Trade and Industry, JOINT MEMORANDUM CIRCULAR NO. 22-01, Jan. 10, 2022
What is a paracetamol?
- National Health Service Inform (Scotland), Paracetamol, Oct. 11, 2021
- UNILAB, Do’s and Don’ts When Taking Paracetamol, Accessed Jan. 4, 2022
- Personal communication, Dr. Beaver Tamesis, Jan. 7, 2022
- Meedan’s Health Desk, Is paracetamol effective in treating or curing COVID-19?, Aug. 5, 2020
How should one take it?
- ProHealth Pharmacy Official Facebook Page, BAWAL NA BAWAL PAGSABAYIN!, Sept. 30, 2020
- Healthdirect Australia, Paracetamol., August 2020
- National Health Service (United Kingdom), Paracetamol for adults, May 23, 2019
- National Institutes of Health (U.S. National Library of Medicine), Liver injury induced by paracetamol and challenges associated with intentional and unintentional use, April 27, 2020
- National Center for Biotechnology Information (U.S. National Library of Medicine), Phenylephrine hydrochloride, Accessed Jan. 11, 2022
- National Center for Biotechnology Information (U.S. National Library of Medicine, chlorphenamine maleate, Accessed Jan. 11. 2022
- UNILAB, Bioflu, Accessed Jan. 11, 2022
- UNILAB, Neozep, Accessed Jan. 11, 2022
- ATC Healthcare International Corporation, Cortal Flu, Accessed Jan. 11, 2022
- ATC Healthcare International Corporation, NoFlu, Accessed Jan. 11, 2022
- The Generics Pharmacy, Fludex, Accessed Jan. 11, 2022
- UNILAB, Bioflu (Patient Information Leaflet), Accessed Jan. 11, 2022
- UNILAB, Neozep (Patient Information Leaflet), Accessed Jan. 11, 2022
COVID-19 symptoms and paracetamol
- Department of Health, COVID-19 Guide, Accessed Jan. 11, 2022]
- Meedan’s Health Desk, How does Merck’s Molnupiravir differ from Ivermectin?, Oct. 5, 2021
- Philippine Food and Drug Administration, Emergency Use Authorization (EUA) for Molnupiravir [MOLNARZ], Dec. 22, 2021
- Department of Health, COVID-19 FAQs, May 2021
(Guided by the code of principles of the International Fact-Checking Network at Poynter, VERA Files tracks the false claims, flip-flops, misleading statements of public officials and figures, and debunks them with factual evidence. Find out more about this initiative and our methodology.)
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