Greater Glasgow and Clyde Medicines

Restrictions:

Dispersible and effervescent formulations are considerably more expensive and should be restricted to patients with swallowing difficulties. Their high sodium content (up to 8g daily) exceeds the WHO daily salt intake recommendation of 6g daily and may compromise the treatment of hypertension, heart failure and renal disease.

Prescribing Notes:

Paracetamol 500mg tablet is the preferred formulation for use in adults.

Consider dose reduction in patients with low body weight (< 50kg), renal/hepatic impairment or glutathione deficiency (chronic malnourishment, chronic alcoholism) to 15 mg/kg/dose up to four times daily (max 60mg/kg/day) An example is: paracetamol oral 500 mg four times daily.

BNF Link

Prescribing Notes:

• National guidance on the pharmacological management of migraine can be found in SIGN 155 (March 2023).
• Local guidance and referral pathway for migraine is also available here (2021 booklet)

BNF Link

Restrictions:

The infusion should be only be used when the IV route can be clinically justified over other routes of administration. The dose of the IV preparation may need to be reduced in the presence of risk factors (e.g. low weight or renal impairment).

Prescribing Notes:

Consider dose reduction in patients with low body weight (< 50kg), renal/hepatic impairment or glutathione deficiency (chronic malnourishment, chronic alcoholism) to 15 mg/kg/dose up to four times daily (max 60mg/kg/day).

BNF Link