The proper use of paracetamol is crucial to optimizing its effectiveness and achieving pain relief. Patients may conclude that paracetamol is ineffective after taking only one or two tablets a day for short periods of time and subsequently terminate treatment. This is an inadequate trial period for chronic pain conditions, which require up to 4g/day in divided doses for at least a week.95 The oral route is preferable with suspensions and dispersible preparations being available. Rectal and parenteral preparations are also available (in some countries). Paracetamol is available in combination with several opioids such as codeine, dihydrocodeine, dextropropoxyphene, and tra-madol, as well as other compounds such as caffeine and NSAIDs. The rationale behind such combinations is the theoretical enhancement of efficacy by combining two analgesics with different modes of action. Extended release paracetamol preparations are also available.
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