They are convenient, but their packaging increases the risk of overdose in children. The review Prescrire warns about certain presentations of paracetamol, in the form of drinkable suspensions or granules.
Since 2020, the message “Overdose = danger” has been prominently displayed on the boxes of medicines containing paracetamol, both for adults and for children. “Exceeding the dose may destroy the liver” is also prominently written, as liver damage is the main risk of a paracetamol overdose. A potentially deadly risk.
Hence the alert launched by the review Prescribe concerning certain packaging specially intended for children: these are presentations in sticks, containing paracetamol in the form of a drinkable suspension or granules. Practical packaging (the drug is easily transportable and can be consumed without water), attractive (they look like sugar sachets) and flavors appreciated by children: vanilla, strawberry, caramel, and soon grapefruit and red fruits.
Risks for children… and parents
But if the practicality of these packaging is undeniable, it is also a risk factor, according to Prescribe : “Opening the sachets is easy. There is no safety system that could prevent or delay the opening of the sachet by a child. The attractiveness of the flavors and the presentation in sticks trivialize the use of paracetamol, and particularly expose children to overdoses”.
This is not the only danger: one of these presentations targets, for example, children from 16 to 48 kg, a range of approximately 4 to 15 years. Up to 24 kg, the dosage should not exceed 4 sachets per day (one every 6 hours); it can go up to 6 per day (one every 4 hours) for children up to 30 kg, and up to 8 sachets per day (2 per dose every 6 hours) for children up to 48 kg . Suffice to say that even the most attentive parent is not immune to an accidental overdose.
To avoid this, it is best to keep the instructions for use of these drugs (the dosage according to weight is not always specified on the sticks). But also to be very attentive to the presence of paracetamol in medicines taken concomitantly, so as not to exceed the maximum recommended daily dose: “approximately 60 mg/kg/day, to be divided into 4 doses, i.e. approximately 15 mg/kg every 6 hours or 10 mg/kg every 4 hours”recalls the High Authority for Health.