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Paracetamol was first synthesized in 1878 by Morse, and introduced for medical usage in 1883. However, due to misinterpretation of its safety profile, it enjoyed only limited use until the 1950s, when the chemically similar, and up until then preferred analgesic, phenacetin was withdrawn because of renal toxicity. Paracetamol is now probably the most commonly used drug worldwide, available over the counter, used in almost all ages, and forming Step 1 of the WHO analgesic ladder.

First-line treatment for pain and pyrexia, it plays an important role in multimodal analgesia, 1, 2 and is considered to possess a generally excellent safety profile except in significant overdose, with few drug interactions. Oral and rectal administration can produce analgesia within 40 min, with maximal effect at 1 h, but large variations in bioavailability (ranging from 63 to 89% for oral, and 24 to 98% for rectally administered preparations …