Paracetamol, also known as acetaminophen and APAP, is a medicine used to treat pain and fever. It is typically used for mild to moderate pain relief. Evidence for its use to relieve fever in children is mixed. It is often sold in combination with other medications, such as in many cold medications. In combination with opioid pain medication, paracetamol is also used for severe pain such as cancer pain and pain after surgery. It is typically used either by mouth or rectally, but is also available intravenously. Effects last between 2 and 4 hours.Paracetamol is generally safe at recommended doses. The recommended maximum daily dose for an adult is 3 or 4 grams. Higher doses may lead to toxicity, including liver failure. Serious skin rashes may rarely occur. It appears to be safe during pregnancy and when breastfeeding. In those with liver disease, it may still be used, but in lower doses. It is classified as a mild analgesic. It does not have significant anti-inflammatory activity and how it works is not entirely clear.Paracetamol was first made in 1877. It is the most commonly used medication for pain and fever in both the United States and Europe. It is on the World Health Organization's List of Essential Medicines, the most effective and safe medicines needed in a health system. Paracetamol is available as a generic medication with trade names including Tylenol and Panadol, among others. The wholesale price in the developing world is less than US$ 0.01 per dose. In the United States, it costs about US$0.04 per dose.