A recent study shows that paracetamol overdoses are the leading cause of liver failure in children. Inadvertent medication errors with the drug are the main cause of liver damage.

It’s important when using paracetamol to be sure of the correct dose and how many doses are safe, especially in children with a feverish illness. Failing to read the labelling instructions can lead to too frequent doses (every 2 or 3 hours) and excessively large doses. Where 2 or more caregivers are involved in looking after the child, or where carers are looking after more than one sick child, extra doses can sometimes be mistakenly given.

There is also a risk of doubling up. Paracetamol is the main drug in Panadol but it is also included in many cold and flu products. Giving more than one medicine containing paracetamol will almost certainly lead to paracetamol overdose.

Recommendations for avoiding overdose:

Read the labelling instructions carefully.
Only give 4 doses per 24 hours and never closer than 4 hours apart.
Record all doses given and share this information between caregivers.
Read the ingredients of any medication you give your child to see if it contains paracetamol.
Avoid using more than one medicine containing paracetamol.
Seek review of your child by a doctor if you have been using paracetamol for more than 48 hours.
If you are in any doubt contact your doctor or local pharmacist.

Click on these articles for information on paracetamol dosing, combination cough and cold products and how to work out the ingredients of your medicines.