Calpol - how often is too often?

[SamboM]

There was a letter in the Guardian on Saturday saying that parents use Calpol too much and that the long-term effects of paracetomal use are bad. That is literally all it said, and it got me thinking about how much is too much.

I try to only give Calpol to my dd when absolutely necessary, recently she had a terrible cold and cough for a couple of weeks and as soon as that cleared up she was teething really badly. Giving her calpol in both cases eased her discomfort considerably. So i guess she had 1 or 2 doses a day for 2 weeks +

Other times she goes weeks without any.

Should I be concerned? And what are these long term ill effects? Liver damage maybe?

SamboM, I didn't see the article but your posting has me a bit concerned too. My ds2 has had a number of illnesses one after the other quite recently (fully recovered now) and I was giving Calpol for probably longer than you. Hopefully someone out there will know more.

SamboM, was the letter from a health professional, do you know, or a parent? I think as long as you stick to the dosage guidelines on the bottle, which err very strongly on the side of caution, you have no need to be too worried. Paracetamol used to recommended dosage levels is a very safe and effective drug indeed as far as I have heard. Liver damage from paracetamol is a real threat to anyone only if dosage guidelines are not followed, surely?
If there is a children's medication I consciously try and use as little as possible it is Ibuprofen, simply because its safety record for children is not as long established. Even so, it has its place and I would not hesitate to give either to a child if they were miserable with a stinking cold or teething. If alternative remedies such as Olbas oil in the bath, sponging or chamomile for teething are not doing the trick, I will happily break out the Calpol.
Hope she is feeling better.

Ask Jimjams. She is really good on these sorts of questions. Seems like scaremongering to me though. I agree with Marina that the doseage guidelines err on the side of caution and I am assuming it is meant over a long period of time. I don't see 2+ weeks as a long period of time in comparison to the childs life. If you were using it each evening to help the child sleep or something then that may be an issue but to help relieve pain for periods of illness, teething etc I would not think as being excessive.

Ds was on it for about 4 weeks due to the shocking cold he got and the fact his teeth were really hurting him at the same time. It took me 4 weeks before the doctor would finally prescribe antibiotics. I wasn't happy giving it for this long and eventually had to be very forceful to get the antibiotics which cleared up his cold/flu in a few days.

I don't know who it was from, it was in response to an article the previous week about adults being hooked on painkillers.

Hopefully Jimjams or another Mumsnetter with a science background will chip in SamboM but paracetamol is not an opiate and therefore I don't think it's addictive...

The letter is here: www.guardian.co.uk/weekend/story/0,3605,947227,00.html

and it says "William Leith omits to mention the growing market in kiddie painkillers (Confessions Of A Ten-A-Day Man, April 26). In our house, Calpol is known as "magic medicine" because it is remarkably effective, but we use it sparingly in the knowledge that long-term paracetemol use may be damaging. Yet it is routinely advised for children as young as three months old, and some parents use it liberally. If adults do not know when to stop their use of such drugs, we must fear for the future health of the Calpol generation."

I had a quick look around the web and couldn't find anything that said long term paracetamol use was harmful. Nearest was this - which simply warns to be careful if giving more than one medicine that you aren't accidentally giving more than the recommended dose.

I've just had a jolly good look on Pubmed without finding anything at all worrying. Obviously if you exceed the dose there are well-publicised problems, as several people have noted (liver damage), but that's not remotely the same as saying that long-term use within the guidelines can cause problems. I really wouldn't have thought it was anything to worry about, especially the 2 week kind of thing you're concerned about, SamboM. I can't in all honesty imagine for one minute that addiction is a problem.

Paracetamol is not addictive, and as far as I am aware there are no known common effects of long term use. As many other people have said, overdose is known to give problems, but that is not the same sort of thing. Paracetamol is often given to adults for the longer term control of mild to moderate pain, as it has less irritant effects of the lining of the stomach wall. The warnings not to give it for more than three days is more because you don't want to risk the child having something that is more serious that should be treated with something else.

There is nothing in my copy of Martindale (31st ed). The data sheet for calpol does mentions a single case of someone who developed liver damage after taking a normal doses, daily, for a year. However studies of patients with chronic liver disease did not show any significant links to paracetamol useage, and the condition did not imporove on staopping taking the drug. So not much of a link there.

I am not a pharmacist, but I did used to work in the drug safely buisness. I use calpol with my children, and I don't think that I am putting them at risk of liver damage. Two weeks isn't long term use, and remeber that lots of elderly people use it to control the pain of artritis every day. Try not to worry.

I wonder if the letter writer is thinking of a problem that has been noted in adults with migraine/headache who take paracetmol long term? Long term usage can apparently cause headache and its subsequent withdrawal also provokes headache. Neither problem is long term. ( Migraine Action )

But I can't see that this is relevant to children at all, especially in the low doses we're talking about here. I reckon we should ignore that letter, unless they come up with some decent research to prove their point.

Could it be that the writer was trying to infer that use of Paracetamol at such an early age means medication swallowing becomes second nature as an adult?
I have noticed that my children, especially 9 year old, will ask for Calpol for various ailments - sore head, sore knee, sore tummy.
Sometimes I have been known to give her it to silence her whining!
I have thought that this is a bad thing to do - not because of liver damage of possible addiction - but because it means she thinks these things will not resolve by themselves. I don't want her to turn into a hypochondriac.
Do not worry SamboM. You are doing no harm by using Calpol in the way you are.
I have to say that I have re-evaluated my use of it and try to get the kids to use other alternatives than resorting to medication that is not actually needed.

If you stick to dosage recommendations and only use it when necessary (i.e. child is visibly unwell, or occasional use for 'unexplained irritability' which might be linked to e.g. teething pain etc) then Calpol is absolutely safe.
I suspect what the writer was referring to is the fact that Calpol has become something of a 'magic medicine' - the answer for everything in some households. I once heard of a mother who gave her daughter a spoonful EVERY NIGHT before bedtime because 'it helped her get off to sleep better' ! IMO that's definitely not OK. I DO think this sort of use (to sedate normal lively children) is actually more common than it might be admitted - when you're tired, irritable and at your wits end it's easy to reach for the medicine cabinet.
The long term affects of paracetamol overdose are liver damage, but we're talking about at MANY times the recommended levels. However, like others have said, it's probably not good to get into a habit of using medication as the answer to everything.