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APIRETAL 24 mg/mL ORAL SUSPENSION

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About the medicine

How to use APIRETAL 24 mg/mL ORAL SUSPENSION

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This page provides general information and does not replace a doctor’s consultation. Always consult a doctor before taking any medication. Seek urgent medical care if symptoms are severe.

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Introduction

Package Leaflet: Information for the Patient

Apiretal 24 mg/ml Oral Suspension

Paracetamol

Read this package leaflet carefully before starting to take this medicine, as it contains important information for you.

  • Keep this package leaflet, as you may need to read it again.
  • If you need advice or more information, consult your pharmacist.
  • If you experience side effects, consult your doctor, pharmacist, or nurse, even if they are not listed in this package leaflet.
  • You should consult a doctor and stop treatment if the pain persists for more than 3 days in children or 5 days in adults (2 days for throat pain), or if the fever persists for more than 3 days, or if the pain or fever worsens, or if other symptoms appear.

Contents of the Package Leaflet:

  1. What Apiretal is and what it is used for
  2. What you need to know before taking Apiretal
  3. How to take Apiretal
  4. Possible side effects
  5. Storage of Apiretal
  6. Package Contents and Additional Information

1. What Apiretal is and what it is used for

Apiretal belongs to a group of medicines called analgesics and antipyretics.

This medicine is indicated for the symptomatic treatment of febrile states and for the relief of mild or moderate pain.

Doctor consultation

Not sure if this medicine is right for you?

Discuss your symptoms and treatment with a doctor online.

2. What you need to know before taking Apiretal

Do not take Apiretal:

  • If you are allergic (hypersensitive) to paracetamol or to any of the other components of this medicine (listed in section 6).

Warnings and Precautions

Consult your doctor or pharmacist before starting to take Apiretal.

  • Do not exceed the recommended dose in "Section 3 - How to take Apiretal". Check that you are not using other medicines that contain paracetamol at the same time.
  • Patients with heart or lung disease and patients with anemia should consult their doctor before taking this medicine.
  • If you have liver problems (including Gilbert's syndrome) or kidney problems, or if you suffer from chronic malnutrition or dehydration, consult your doctor, as you may need a reduction in the dose of paracetamol.
  • If you are an asthmatic sensitive to acetylsalicylic acid, consult your doctor before using this medicine.
  • In chronic alcoholics, caution should be exercised not to take more than 2 g of paracetamol per day.
  • If the symptoms worsen or if the fever persists for more than 3 days or the pain for more than 3 days in children or 5 days in adults (2 days for throat pain), you should consult your doctor.

During treatment with Apiretal, inform your doctor immediately if:

  • You have serious diseases, such as severe renal failure or sepsis (when bacteria and their toxins circulate in the blood, causing damage to organs), or if you suffer from malnutrition, chronic alcoholism, or if you are also taking flucloxacillin (an antibiotic). A serious disease called metabolic acidosis (an anomaly in the blood and fluids) has been reported in patients in these situations when paracetamol is used at regular doses for a prolonged period or when paracetamol is taken with flucloxacillin. The symptoms of metabolic acidosis may include: severe breathing difficulties with deep and rapid breathing, drowsiness, feeling of discomfort (nausea) and vomiting.

Children

In children under 2 years of age, consult your doctor to indicate the dose to be taken.

Taking Apiretal with other medicines

Inform your doctor or pharmacist if you are taking, have taken, or may need to take any other medicine recently.

In particular, if you are using medicines that contain any of the following active ingredients, as it may be necessary to modify the dose or interrupt treatment of either of them:

  • Antibiotics (flucloxacillin), due to a serious risk of blood and fluid anomaly (called metabolic acidosis) that requires urgent treatment (see section 2).
  • Oral anticoagulants (acenocoumarol, warfarin).
  • Antiepileptics (lamotrigine, phenytoin, or other hydantoins, phenobarbital, primidone, carbamazepine).
  • Antituberculars (isoniazid, rifampicin).
  • Barbiturates (used as hypnotics, sedatives, and anticonvulsants).
  • Medicines used to treat gout (probenecid and sulfinpyrazone).
  • Certain medicines used to increase urine elimination (loop diuretics such as furosemide).
  • Propranolol used in the treatment of high blood pressure (hypertension) and heart rhythm disorders (cardiac arrhythmias).
  • Zidovudine (used in the treatment of patients infected with the human immunodeficiency virus, which causes AIDS).
  • Colestyramine (used to decrease blood cholesterol levels).
  • Metoclopramide and domperidone; used to prevent nausea and vomiting.

It should not be used with other analgesics (pain-relieving medicines) without consulting your doctor.

As a general rule for any medicine, it is recommended to inform your doctor or pharmacist systematically if you are being treated with another medicine. In the case of treatment with oral anticoagulants, it can be administered occasionally as the analgesic of choice.

Interference with analytical tests

If you are going to have any diagnostic tests (including blood tests, urine tests, etc.), inform your doctor that you are taking this medicine, as it may alter the results.

Taking Apiretal with food, drinks, and alcohol

The use of paracetamol in patients who regularly consume alcohol (three or more alcoholic beverages per day: beer, wine, liquor, etc.) may cause liver damage.

Taking this medicine with food does not affect its efficacy.

Pregnancy, breastfeeding, and fertility

Consult your doctor or pharmacist before using any medicine.

In case of necessity, Apiretal can be used during pregnancy. You should use the lowest possible dose that reduces pain or fever and use it for the shortest possible time. Contact your doctor or midwife if the pain or fever does not decrease or if you need to take the medicine more frequently.

Paracetamol passes into breast milk, so breastfeeding women should consult their doctor before taking this medicine.

Driving and using machines

No effects have been described that modify the ability to drive and use machines.

Apiretal contains saccharose, methyl parahydroxybenzoate (E-218), propyl parahydroxybenzoate (E-217), and azorubine (carmoisine) (E-122).

This medicine contains saccharose. If your doctor has told you that you have an intolerance to certain sugars, consult with them before taking this medicine.

Patients with diabetes mellitus should note that this medicine contains 0.4 g of saccharose per ml.

It can cause allergic reactions (possibly delayed) because it contains methyl parahydroxybenzoate (E-218) and propyl parahydroxybenzoate (E-217).

This medicine may cause allergic reactions because it contains azorubine (carmoisine) (E-122). It can cause asthma, especially in patients allergic to acetylsalicylic acid.

3. How to take Apiretal

Follow the administration instructions of the medicine contained in this package leaflet or as indicated by your doctor, pharmacist, or nurse. In case of doubt, ask your doctor, pharmacist, or nurse.

It is necessary to respect the posologies defined according to weight. The child's age according to weight is given for information purposes.

The recommended daily dose of paracetamol is approximately 60 mg/kg/day, divided into 4 or 6 daily doses, i.e., 15 mg/kg every 6 hours or 10 mg/kg every 4 hours.

For administration of 15 mg/kg every 6 hours, the schedule is as follows, where the doses can be repeated with a minimum interval of 6 hours, without exceeding a total of 4 doses in 24 hours.

Child's weight (approximate age)

Maximum dosing (per dose)

Volume (ml)

2.7 - 5 kg (0 to 3 months):

40 - 75 mg

1.7 - 3 ml

5 - 8 kg (4 to 11 months):

80 - 120 mg

3 - 5.0 ml

Up to 10.5 kg (12 to 23 months):

120 - 160 mg

5 - 6.5 ml

Up to 13 kg (2 to 3 years):

160 - 195 mg

6.5 - 8 ml

Up to 18.5 kg (4 to 5 years):

195 - 280 mg

8 - 11.5 ml

Up to 24 kg (6 to 8 years):

280 - 360 mg

11.5 - 15 ml

Up to 32 kg (9 to 10 years):

360 - 480 mg

15 - 20 ml

If the desired effects are not achieved within 3-4 hours of administration, the dose can be advanced every 4 hours, in which case 10 mg/kg will be administered.

Adults and adolescents over 15 years:

The recommended dose is 20 ml to 40 ml per dose as needed every 4-6 hours. The doses should be spaced at least 4 hours apart. Do not exceed 120 ml(3 g of paracetamol) per day.

Always use the lowest effective dose to control symptoms. The doses should be repeated as long as symptoms persist.

Patients with liver disease:Consult your doctor before taking this medicine.

You should take the prescribed amount of medicine with a minimum interval of 8 hours between each dose.

Patients with kidney disease:Consult your doctor before taking this medicine.

Depending on your disease, your doctor will indicate whether you should take your medicine with a minimum interval of 6 or 8 hours.

Elderly patients:Consult your doctor before taking this medicine, as you may need a dose reduction.

Instructions for the correct administration of the preparation

The suspension is for oral administration.

Use the oral syringe included in the package to measure the dose, and take the suspension alone, or diluted in water or another liquid, or mixed with milk or pap.

  1. Shake the bottle before use.
  2. Insert the syringe, pressing on the perforated cap.
  3. Invert the bottle and withdraw the necessary amount with the dosing syringe.
  4. Wash the dosing syringe and close the bottle well after each use.

It can be taken with or without food. For rapid relief of pain, take the medicine without food.

Administration of the medicine is subject to the appearance of pain or fever. As they disappear, the medication should be suspended.

If the symptoms worsen or if the fever persists for more than 3 days or the pain for more than 3 days in children or 5 days in adults (2 days for throat pain), you should consult your doctor.

If you take more Apiretal than you should

If you have taken more Apiretal than you should, go to a medical center immediately, even if you do not have symptoms, as they often do not appear until 3 days after ingestion, even in cases of severe poisoning.

The symptoms of overdose may be: dizziness, vomiting, loss of appetite, yellowing of the skin and eyes (jaundice), and abdominal pain.

Paracetamol overdose is considered to be a single dose of more than 6 gin adults and more than 100 mg/kg of body weightin children. Treatment of overdose is most effective if started within 4 hours of taking the medicine.

Patients being treated with barbiturates or chronic alcoholics may be more sensitive to the toxicity of a paracetamol overdose.

In case of overdose or accidental ingestion, go to a medical center immediately or, if not possible, call the Toxicology Information Service, phone 91 562 04 20, indicating the medicine and the amount taken. It is recommended to take the package and package leaflet of the medicine to the healthcare professional.

If you forget to take Apiretal

Do not take a double dose to make up for forgotten doses; simply take the forgotten dose when you remember, taking the following doses with the indicated separation between doses (at least 4 hours).

If you stop treatment with Apiretal

If you have any other doubts about the use of this medicine, ask your doctor, pharmacist, or nurse.

Medicine questions

Started taking the medicine and have questions?

Discuss your symptoms and treatment with a doctor online.

4. Possible side effects

Like all medicines, Apiretal can cause side effects, although not everyone gets them.

Paracetamol's adverse reactions are, in general, rare (may affect up to 1 in 1,000 patients) or very rare (may affect up to 1 in 10,000 patients).

In rare cases, general discomfort or sudden discomfort due to a drop in blood pressure (hypotension) may occur. It is also rare to find elevated levels of certain liver proteins (liver transaminases).

Very rarely, it can damage the liver at high doses or prolonged treatments. Also, very rarely, the following may appear: kidney disease, cloudy urine, allergic dermatitis (skin rash), jaundice (yellowing of the skin), blood disorders (agranulocytosis, leukopenia, neutropenia, hemolytic anemia), and hypoglycemia (low blood sugar).

Very rare cases of serious skin reactions have been reported.

Frequency not known (cannot be estimated from available data): a serious disease that can make the blood more acidic (called metabolic acidosis) in patients with severe disease using paracetamol (see section 2).

If you experience side effects, consult your doctor, pharmacist, or nurse, even if they are not listed in this package leaflet.

5. Storage of Apiretal

Keep this medicine out of the sight and reach of children.

Do not use this medicine after the expiration date indicated on the package after CAD. The expiration date is the last day of the month indicated.

No special storage conditions are required.

Medicines should not be disposed of through wastewater or household waste. Deposit the packages and medicines you no longer need at the SIGRE collection point in the pharmacy. If in doubt, ask your pharmacist how to dispose of packages and medicines you no longer need. This will help protect the environment.

6. Package Contents and Additional Information

Composition of Apiretal

  • The active ingredient is paracetamol. Each milliliter of suspension contains 24 mg of paracetamol.
  • The other components (excipients) are: saccharose (0.4 g/ml), methyl parahydroxybenzoate (E-218) (0.9 mg/ml), propyl parahydroxybenzoate (E-217) (0.45 mg/ml), azorubine (carmoisine) (E-122) (0.25 mg/ml), tragacanth gum, raspberry flavor, sodium saccharin, and purified water.

Appearance of the product and package contents

Red/pink suspension with a sweet taste. It is presented in a glass bottle, amber in color, containing 120 ml of suspension, with a safety screw cap and an adapter for incorporating the oral syringe (5 ml), which is also included.

Marketing Authorization Holder

Laboratorios ERN, S.A.

C/Perú, 228

08020 Barcelona, Spain

Manufacturer

Laboratorios INIBSA, S.A.

Crta. Sabadell a Granollers, Km 14.5 (Lliçà de Vall)

08185 Barcelona

Spain

Date of the last revision of this package leaflet:February 2025.

Other sources of information

Detailed and updated information on this medicine is available on the website of the Spanish Agency for Medicines and Health Products (AEMPS) http://www.aemps.gob.es/.

Online doctors for APIRETAL 24 mg/mL ORAL SUSPENSION

Discuss questions about APIRETAL 24 mg/mL ORAL SUSPENSION, including use, safety considerations and prescription review, subject to medical assessment and local regulations.

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Doctor

Daniel Cichi

Family medicine 24 years exp.

Dr Daniel Cichi is a family medicine doctor with over 20 years of clinical experience. He provides online consultations for adults, supporting patients with acute symptoms, chronic conditions, and everyday health concerns that require timely medical guidance. His background includes work in emergency care, ambulance services, and family medicine, which allows him to assess symptoms quickly, identify warning signs, and help patients choose the safest next steps – whether that means home care, treatment adjustment, or in-person evaluation. Patients commonly consult Dr Daniel Cichi for: 

  • acute symptoms: fever, infections, flu-like illness, cough, sore throat, shortness of breath;
  • chest discomfort, palpitations, dizziness, fatigue, and blood pressure concerns;
  • digestive problems: abdominal pain, nausea, diarrhoea, constipation, reflux;
  • sexually transmitted infections, erectile dysfunction;
  • muscle, joint, and back pain, minor injuries, post-traumatic symptoms;
  • chronic conditions: hypertension, diabetes, high cholesterol, thyroid disorders, weight loss, hair loss;
  • review and interpretation of lab tests, imaging reports, and medical documents;
  • medication review and treatment adjustment;
  • medical advice while travelling or living abroad;
  • second opinions and guidance on whether in-person care is needed.

Dr Cichi’s consultations are structured and practical. He focuses on clear explanations, risk assessment, and actionable recommendations, helping patients understand their symptoms and make informed decisions about their health.

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Doctor

Hocine Lokchiri

General medicine 21 years exp.

Dr. Hocine Lokchiri is a French consultant with over 20 years of experience in General and Emergency Medicine. He works with adults and children, helping patients with urgent symptoms, infections, sudden health changes and everyday medical concerns that require timely evaluation. His background includes clinical practice in France, Switzerland and the United Arab Emirates, which allows him to navigate different healthcare systems and manage a wide range of conditions with confidence. Patients value his calm, structured approach, clear explanations and evidence-based decision-making.

Online consultations with Dr. Lokchiri are suitable for many situations when someone needs quick medical guidance, reassurance or a clear next step. Common reasons for booking include:

  • fever, chills, fatigue and viral symptoms
  • cough, sore throat, nasal congestion, breathing discomfort
  • bronchitis and mild asthma flare-ups
  • nausea, diarrhoea, abdominal pain, digestive infections
  • rashes, allergic reactions, redness, insect bites
  • muscle or joint pain, mild injuries, sprains
  • headache, dizziness, migraine symptoms
  • stress-related symptoms, sleep disturbances
  • questions about test results and treatment plans
  • management of chronic conditions in stable phases
Many patients reach out when symptoms appear suddenly and cause concern, when a child becomes unwell unexpectedly, when a rash changes or spreads, or when it’s unclear whether an in-person examination is necessary. His emergency medicine background is particularly valuable online, helping patients understand risk levels, identify warning signs and choose safe next steps.

Some situations are not suitable for online care. If a patient has loss of consciousness, severe chest pain, uncontrolled bleeding, seizures, major trauma or symptoms suggesting a stroke or heart attack, he will advise seeking immediate local emergency services. This improves safety and ensures patients receive the right level of care.

Dr. Lokchiri’s professional training includes:

  • Advanced Trauma Life Support (ATLS)
  • Basic and Advanced Cardiac Life Support (BLS/ACLS)
  • Pediatric Advanced Life Support (PALS)
  • Prehospital Trauma Life Support (PHTLS)
  • eFAST and critical care transthoracic echocardiography
  • aviation medicine
He is an active member of several professional organisations, including the French Society of Emergency Medicine (SFMU), the French Association for Emergency Physicians (AMUF) and the Swiss Society of Emergency and Rescue Medicine (SGNOR). In consultations, he works with clarity and precision, helping patients understand their symptoms, possible risks and the safest treatment options.
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Doctor

Tomasz Grzelewski

Dermatology 21 years exp.

Dr Tomasz Grzelewski is an MD, PhD specialist in allergy, paediatrics, general practice and sports medicine, with a clinical focus on dermatology, endocrinology, allergology and sports-related health. He has more than 20 years of clinical experience and completed his medical training at the Medical University of Łódź, where he defended his PhD thesis with distinction. His doctoral research was recognised by the Polish Society of Allergology for its innovative contribution to the field. Throughout his career, he has gained extensive expertise in diagnosing and managing a wide range of allergic and paediatric conditions, including modern allergen desensitisation techniques. For five years, Dr Grzelewski served as the Head of two paediatric departments in Poland, managing complex clinical cases and leading multidisciplinary teams. He also worked in medical centres in the United Kingdom, gaining experience across both primary care and specialist environments. With over a decade of telemedicine experience, he has provided online consultations across Europe and is valued for his clear, structured and evidence-based medical guidance. Dr Grzelewski is actively involved in clinical programmes focused on modern anti-allergic therapies. As a Principal Investigator, he leads research projects on sublingual and oral allergen desensitisation, supporting evidence-based progress in allergy treatment for both children and adults. In addition to his background in allergology and paediatrics, he completed dermatology studies through the Cambridge Education Group (Royal College of Physicians of Ireland) and a Clinical Endocrinology course at Harvard Medical School. This advanced training enhances his ability to manage skin manifestations of allergies, atopic conditions, urticaria, endocrine-related symptoms and complex immunological reactions. Patients commonly seek his care for: 

  • seasonal and perennial allergies
  • allergic rhinitis and chronic nasal symptoms
  • asthma and breathing difficulties
  • food and medication allergies
  • urticaria, atopic dermatitis and skin reactions
  • recurrent infections in children
  • sports-related health questions
  • general family medicine concerns

Dr Tomasz Grzelewski is known for his clear communication style, structured medical approach and ability to explain treatment options in a concise and accessible way. His multidisciplinary background across allergy, paediatrics, dermatology and endocrinology allows him to provide safe, up-to-date and comprehensive care for patients of all ages.

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€80
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Doctor

Andrei Popov

General medicine 7 years exp.

Dr. Andrei Popov is a family physician with specialized training in the management of chronic pain. He provides video consultations for adults in Spain and across Europe: whether you have been living with pain for months that no one has been able to properly explain, or you need to resolve a health issue without waiting weeks for an appointment.

His approach is clear: to listen, organize your case, and provide you with a practical roadmap based on evidence-based medicine and adapted to your medical history and personal needs.

Pain: how he can help

  • Chronic pain (more than 3 months
  • Migraine and recurrent or high-intensity headaches
  •  Neck, lower back, back and joint pain
  •  Post-traumatic pain after injuries or surgeries
  •  Pain of neurological origin: neuralgia, neuropathic pain, fibromyalgia

General medicine

  • Frequent respiratory infections (cold, flu, persistent cough)
  • Hypertension, diabetes and metabolic disorders
  • Review of laboratory tests and MRI/CT reports (explained in clear language)
  • Preventive medicine and health monitoring
  • Second opinions and treatment adjustments (when clinically appropriate)

What the consultation is like
 Each session lasts up to 30 minutes. We review symptoms, medical history, medications and any tests you provide, and you finish the consultation with a clear treatment plan, defined next steps, and criteria to understand when follow-up may be needed. If warning signs are detected, he will clearly advise whether you need in-person care or urgent medical attention.

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Doctor

Anna Biriukova

General medicine 6 years exp.

Dr Anna Biriukova is an internal medicine doctor with clinical experience in cardiology, endocrinology, and gastroenterology. She provides online consultations for adults, offering expert medical support for heart health, hormonal balance, digestive issues, and general internal medicine.

Cardiology – Diagnosis and treatment of:

  • High blood pressure, blood pressure fluctuations, and cardiovascular risk prevention.
  • Chest pain, shortness of breath, arrhythmias (tachycardia, bradycardia, palpitations).
  • Leg swelling, chronic fatigue, reduced exercise tolerance.
  • EKG interpretation, lipid profile evaluation, cardiovascular risk assessment (heart attack, stroke).
  • Post-COVID-19 cardiac monitoring and care.
Endocrinology – Diabetes, thyroid, metabolism:
  • Diagnosis and management of type 1 and type 2 diabetes, and prediabetes.
  • Individual treatment plans including oral medications and insulin therapy.
  • GLP-1 therapy– modern pharmacological treatment for weight management and diabetes control, including drug selection, monitoring, and safety follow-up.
  • Thyroid disorders – hypothyroidism, hyperthyroidism, autoimmune thyroid diseases (Hashimoto’s, Graves’ disease).
  • Metabolic syndrome – obesity, lipid disorders, insulin resistance.
Gastroenterology – Digestive health:
  • Abdominal pain, nausea, heartburn, gastroesophageal reflux (GERD).
  • Stomach and intestinal conditions: gastritis, irritable bowel syndrome (IBS), indigestion.
  • Management of chronic digestive disorders and interpretation of tests (endoscopy, ultrasound, labs).
General internal medicine and preventive care:
  • Respiratory infections – cough, colds, bronchitis.
  • Lab test analysis, therapy adjustments, medication management.
  • Adult vaccinations – planning, contraindications assessment.
  • Cancer prevention – screening strategies and risk assessment.
  • Holistic approach – symptom relief, complication prevention, and quality of life improvement.
Dr Biriukova combines internal medicine with specialist insight, offering clear explanations, personalised treatment plans, and comprehensive care tailored to each patient.
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€60

Frequently Asked Questions

Is a prescription required for APIRETAL 24 mg/mL ORAL SUSPENSION?
APIRETAL 24 mg/mL ORAL SUSPENSION does not require a prescription in Spain. You can check with a doctor online whether this medicine may be appropriate for your situation.
What is the active substance in APIRETAL 24 mg/mL ORAL SUSPENSION?
The active ingredient in APIRETAL 24 mg/mL ORAL SUSPENSION is paracetamol. This information helps identify medicines with the same composition but different brand names.
Who manufactures APIRETAL 24 mg/mL ORAL SUSPENSION?
APIRETAL 24 mg/mL ORAL SUSPENSION is manufactured by Laboratorios Ern S.A.. Pharmacy brands and packaging may differ depending on the distributor.
Which doctors can assess the use of APIRETAL 24 mg/mL ORAL SUSPENSION online?
Doctors such as Family doctors, Psychiatrists, Dermatologists, Cardiologists, Endocrinologists, Gastroenterologists, Pulmonologists, Nephrologists, Rheumatologists, Hematologists, Infectious disease physicians, Allergists, Geriatricians, Paediatricians, Oncologists may assess whether APIRETAL 24 mg/mL ORAL SUSPENSION is appropriate, depending on your situation and local regulations. You can book an online consultation to discuss your symptoms and possible next steps.
What are the alternatives to APIRETAL 24 mg/mL ORAL SUSPENSION?
Other medicines with the same active substance (paracetamol) include ABEZEN 1 G FILM-COATED TABLETS, ANTIDOL 1 G FILM-COATED TABLETS, ANTIDOL 1 G TABLETS. These may have different brand names or formulations but contain the same therapeutic ingredient. Always consult a doctor before switching or starting a new medicine.
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