ReviewCurrent therapeutic research, clinical and experimental2015
Clinical pharmacology of paracetamol in neonates: a review.
Review in Current therapeutic research, clinical and experimental, 2015. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 44 papers, 4 of them syntheses that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
44 citing papers in PubMed, 4 syntheses or guidelines pooled it, 99 citations in OpenAlex.
- Therapeutic Management of Idiosyncratic Drug-Induced Liver Injury and Acetaminophen Hepatotoxicity in the Paediatric Population: A Systematic Review.Drug safety · 2022Pooled it
- Analgesia for retinopathy of prematurity screening: A systematic review.Pain practice : the official journal of World Institute of Pain · 2022Pooled it
- Guidelines for treatment of acute pain in children - the consensus statement of the Section of Paediatric Anaesthesiology and Intensive Therapy of the Polish Society of Anaesthesiology and Intensive Therapy.Anaesthesiology intensive therapy · 2022Guideline
- Paracetamol overdose in the newborn and infant: a life-threatening event.European journal of clinical pharmacology · 2021Pooled it
- A pilot randomised blinded placebo-controlled trial of paracetamol for later treatment of a patent ductus arteriosus.Journal of perinatology : official journal of the California Perinatal Association · 2019Trial
- Polymorphic Expression of UGT1A9 is Associated with Variable Acetaminophen Glucuronidation in Neonates: A Population Pharmacokinetic and Pharmacogenetic Study.Clinical pharmacokinetics · 2018Trial
- Neonatal Maturation of Paracetamol (Acetaminophen) Glucuronidation, Sulfation, and Oxidation Based on a Parent-Metabolite Population Pharmacokinetic Model.Clinical pharmacokinetics · 2016Trial
- Acetaminophen versus Ibuprofen for the management of hemodynamically significant patent ductus arteriosus in very low birth weight infants: randomized trial.Jornal de pediatriaTrial
- Prolonged Low-Dose Paracetamol Prophylaxis Accelerates Ductal Closure in Extremely Preterm Neonates: A Randomized Trial.Neonatology · 2026Article
- Semi-Physiological Population Pharmacokinetic Modeling of Oral and Intravenous Paracetamol to Quantify Presystemic Metabolism and Enterohepatic Recirculation.CPT: pharmacometrics & systems pharmacology · 2026Article
- Pharmacological therapy of neonatal analgosedation: current status, dilemmas, and perspectives.Frontiers in pediatrics · 2026Review
- Efficacy and Safety of Paracetamol and NSAIDs for Fever and Pain Management in Children with Chronic Diseases: A Narrative Review.Children (Basel, Switzerland) · 2026Review
- Changes in the Fraction Metabolized in Children Younger than Four Years; When is Clearance Scaling for the Dominant Elimination Route in Adults Appropriate?Pharmaceutical research · 2025Article
- A Single Early-Life Acetaminophen Exposure Causes Persistent Abnormalities in the Murine Lung.American journal of respiratory cell and molecular biology · 2025Article
- Dexmedetomidine: Shifting Paradigms in Neonatal Sedation and Pain Control.Children (Basel, Switzerland) · 2025Review
- The Utilization of Acetaminophen for Managing PGE1-Induced Fever in Neonates with Critical Congenital Heart Disease.Children (Basel, Switzerland) · 2024Article
- Enhanced Recovery After Surgery (ERAS) consensus recommendations for opioid-minimising pharmacological neonatal pain management.BMJ paediatrics open · 2024Review
- Postnatal acetaminophen exposure and neurodevelopmental outcomes at 18-21 months corrected gestational age in preterm infants <29 weeks gestation: a retrospective cohort study.Pediatric research · 2024Article
- How to translate neurocognitive and behavioural outcome data in animals exposed to paracetamol to the human perinatal setting?Archives of medical science : AMS · 2024Article
- Biomarkers for assessing pain and pain relief in the neonatal intensive care unit.Frontiers in pain research (Lausanne, Switzerland) · 2024Review
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
2 authors at 2 institutions in 2 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Paracetamol is commonly used to control mild-to-moderate pain or to reduce opioid exposure as part of multimodal analgesia, and is the only compound recommended to treat fever in neonates. Paracetamol clearance is lower in neonates than in children and adults. After metabolic conversion, paracetamol is subsequently eliminated by the renal route. The main metabolic conversions are conjugation with glucuronic acid and with sulphate. In the urine of neonates sulphated paracetamol concentration is higher than the glucuronidated paracetamol level, suggesting that sulfation prevails over glucuronidation in neonates. A loading dose of 20 mg/kg followed by 10 mg/kg every 6 hours of intravenous paracetamol is suggested to achieve a compartment concentration of 11 mg/L in late preterm and term neonates. Aiming for the same target concentration, oral doses are similar with rectal administration of 25 to 30 mg/kg/d in preterm neonates of 30 weeks' gestation, 45 mg/kg/d in preterm infants of 34 weeks' gestation, and 60 mg/kg/d in term neonates are suggested. The above-mentioned paracetamol doses for these indications (pain, fever) are well tolerated in neonates, but do not result in a significant increase in liver enzymes, and do not affect blood pressure and have limited effects on heart rate. In contrast, the higher doses suggested in extreme preterm neonates to induce closure of the patent ductus arteriosus have not yet been sufficiently evaluated regarding efficacy or safety. Moreover, focussed pharmacovigilance to explore the potential causal association between paracetamol exposure during perinatal life and infancy and subsequent atopy is warranted.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.