Why Paracetamol Is Not An NSAID

Paracetamol

Paracetamol (acetaminophen) is classified as a drug that reduces pain and fever. Although, it is not included as a non-steroidal and steroidal antiinflammatory agent. Let us see why paracetamol is not in the league with the others.

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There are different classes of pain medication. They all have different mechanisms of action. But paracetamol, non-steroidal anti inflammatory (NSAID) and steroidal antiinflammatory agent are the most commonly prescribed for all types of pains. NSAID and steroidal antiinflammatory agents have similar mechanisms of action. The only difference is that steroidal agents have a broad range of other effects in addition to the effects of NSAID. That is why they are under controlled drugs.

NSAIDs are drug classes that reduce pain, decrease fever, prevent blood clot and in higher doses decrease inflammation. They inhibit cyclooxygenase (COX) enzyme I and II. Some NSAID inhibit just COX II.

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Paracetamol is a mild analgesic which reduces pain and fever with very low antiinflammatory properties. The way paracetamol works is not fully understood. However, it inhibits Cox II and endocannabinoid/vanilloid anandamide reuptake. It is believed that it reduces COX II and does that exclusively in the central nervous system (CNS) or the brain and not in the rest of the body. This is why it has weak analgesic effect.

Because it has mild activity for pain and inflammation, it was thought to remove it from NSAID which could be the closest to it based on its mechanism of action. So it was removed not because of it has a different mechanism of action but because it is not a strong painkiller and anti-inflammatory agent. So when next you are ask why paracetamol is not an NSAID, you know what to say.

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