Article Text

Download PDFPDF
Patient knowledge of the paracetamol content of over-the-counter (OTC) analgesics, cough/cold remedies and prescription medications
  1. David M Wood1,
  2. Edward English2,
  3. Saera Butt2,
  4. Hanna Ovaska3,
  5. Francesca Garnham4,
  6. Paul I Dargan
  1. 1Clinical Toxicology, Guy's and St Thomas' NHS Foundation Trust and King's Health Partners, London, UK
  2. 2School of Medicine, King's College London, London, UK
  3. 3Clinical Toxicology, Guy's and St Thomas' NHS Foundation Trust, London, UK
  4. 4Emergency Department, Guy's and St Thomas' NHS Foundation Trust, London, UK
  1. Correspondence to David Wood, Medical Toxicology Office, 2nd Floor, Bermondsey Wing, Guy's Hospital, Great Maze Pond, London SE1 9RT, UK; David.Wood{at}


Aims To test, by completion of a simple questionnaire, patient knowledge of whether 15 commonly used over-the-counter and prescription analgesics and cough/cold remedies contained paracetamol and patient knowledge of the 4 g maximum daily dose of paracetamol.

Methods Patients in the emergency department triage waiting area of a busy London teaching hospital were asked to complete a standardised one-page questionnaire. From a list of 15 commonly used over-the-counter and prescription products, patients were asked which contained paracetamol, responding ‘yes’, ‘no’ or ‘not sure’ for each. They were also asked to state the recommended maximum daily dose of paracetamol.

Results 910 patients were enrolled in the study (mean age 39 years, 53% women). The mean±SD score was 6.5±2.5. The maximum score was 14 (n=2) and the minimum score was 0 (n=11). For the recommended maximum daily dose, 93.7% (n=853) of patients gave an answer. Of these, 53.8% answered correctly, 4.7% quoted a supratherapeutic dose and 41.5% a subtherapeutic dose.

Conclusions Patient knowledge of paracetamol-containing products and of the maximum daily dose is currently insufficient to ensure safe use of the drug. Interventions are required to address these knowledge gaps to prevent unintentional repeated supratherapeutic ingestion of paracetamol. These interventions could include targeted public education and/or appropriate and effective medication labelling.

  • Paracetamol
  • acetaminophen
  • patient knowledge
  • analgesia
  • drug safety
  • emergency department
  • analgesia/pain control
  • mental health
  • overdose
  • toxicology

Statistics from

Request Permissions

If you wish to reuse any or all of this article please use the link below which will take you to the Copyright Clearance Center’s RightsLink service. You will be able to get a quick price and instant permission to reuse the content in many different ways.


  • Competing interests PD has acted as a specialist adviser to the US Food and Drug Administration and to McNeil Pharmaceuticals on paracetamol (acetaminophen). The other authors have no competing interests to declare.

  • Ethics approval This study was conducted with the approval of the UK National Research Ethics Service (NRES), reference number 08/H0809/46.

  • Provenance and peer review Not commissioned; externally peer reviewed.

Linked Articles

  • Primary survey
    Steve Goodacre