Bofalgan 1g/100ml IV Infusion (Paracetamol)

Drug Class: Analgesic (Painkiller) & Antipyretic (Fever Reducer) | Form: Intravenous (IV) Infusion | Prescription Status: Prescription Only (Rx) — DRAP Registered

What is Bofalgan 1g/100ml IV Infusion?

Bofalgan 1g/100ml IV Infusion contains Paracetamol 1g dissolved in 100ml of infusion solution — the intravenous formulation of one of the most trusted and widely used pain-relieving and fever-reducing medicines in the world. Each ready-to-use bag delivers a precise, measured dose of Paracetamol directly into the bloodstream through a slow intravenous drip, providing fast and reliable pain and fever relief when oral or rectal administration is not possible or appropriate.

This formulation is used in hospitals and clinical settings for short-term management of moderate pain — particularly after surgery (بعد از آپریشن درد) — and for reducing high fever in situations where patients cannot swallow tablets, are nil-by-mouth before or after a procedure, are unconscious or sedated, or are vomiting and unable to retain oral medicines. Because it is delivered directly into the bloodstream, Bofalgan IV achieves effective pain and fever-relieving blood levels within 15 minutes of starting the infusion — faster than any oral paracetamol formulation.

Bofalgan 1g/100ml IV Infusion is indicated for adults, adolescents, and children weighing more than 33kg. For patients weighing less than 33kg, a lower-dose formulation is required — the treating doctor will prescribe the appropriate product and dose. This medicine must be prepared and administered exclusively by qualified nurses and doctors in a clinical setting.

What is Bofalgan 1g/100ml IV Infusion Used For?

Bofalgan 1g/100ml IV Infusion is approved for the following indications:

• Post-operative pain management — short-term relief of moderate pain following surgical procedures when the patient cannot take oral medicines (بعد از آپریشن درد کا علاج)
• Post-procedural pain — pain relief following invasive diagnostic or therapeutic procedures where oral intake is temporarily not possible
• Acute moderate pain in hospitalised patients — pain management when oral or rectal paracetamol routes are unavailable, impractical, or clinically inappropriate
• Fever reduction (antipyresis) — rapid reduction of high temperature in hospitalised patients when oral or rectal administration is not feasible (بخار کو تیزی سے کم کرنا)
• Pre-operative analgesia — sometimes administered before surgery as part of a multimodal pain management plan to reduce post-operative opioid requirements
• Pain and fever in patients with swallowing difficulties — neurological patients, post-intubation patients, or those with oesophageal conditions preventing oral intake
• Pain management in nil-by-mouth patients — surgical patients who must not eat or drink before or after procedures

How Does Bofalgan 1g/100ml IV Infusion Work?

Paracetamol works primarily through central mechanisms in the brain and spinal cord — distinguishing it from NSAIDs like Ibuprofen which act peripherally at the site of inflammation:

Pain relief mechanism: Paracetamol inhibits the production of prostaglandins in the central nervous system — particularly in the brain and spinal cord — reducing the intensity of pain signals being processed and transmitted. It also activates descending pain-inhibiting pathways in the brain that reduce the overall perception of pain. This central action makes it effective for a wide range of pain types including post-operative pain, headache, and general body pain.

Fever reduction mechanism: Body temperature is regulated by a region in the brain called the hypothalamus — the body's internal thermostat. During infection or inflammation, prostaglandins cause the hypothalamus to raise the body's set-point temperature, producing fever. Paracetamol blocks prostaglandin production in the hypothalamus, resetting the temperature set-point back to normal and allowing the body to reduce its temperature through natural heat-loss mechanisms such as sweating and increased skin blood flow.

The IV advantage for acute settings:

Intravenous Paracetamol bypasses the digestive system entirely, achieving therapeutic blood levels within 5 to 10 minutes of commencing infusion and reaching maximum effect within 15 minutes — compared to 30 to 60 minutes for oral tablets. This speed of action is clinically critical in the post-operative setting where rapid pain and fever control is required. The IV route also ensures complete and predictable dose delivery regardless of the patient's gut function, nausea, or level of consciousness.

Dosage and Administration

⚠️ Bofalgan 1g/100ml IV Infusion is a hospital-only medicine. It must be prepared, checked, and administered exclusively by qualified nurses and doctors in a clinical or surgical setting. It is never for home use.

Dosing by Patient Weight and Age:

Critical Dosing Rules:

• Minimum interval between doses: 4 hours — never shorten the interval between infusions
• Maximum daily dose of 4g (4000mg) must never be exceeded in adults — exceeding this causes serious and potentially irreversible liver damage
• Always account for paracetamol contained in all other medicines the patient is receiving — many combination analgesics, cold medicines, and pre-operative medicines also contain Paracetamol; the total daily intake from all sources must not exceed 4g
• Switch to oral Paracetamol tablets as soon as the patient can take oral medicines — the IV route should be used for the shortest clinically necessary duration

Administration Guidelines:

• Administer as a slow IV infusion over 15 minutes — this is the recommended infusion time for adults and children over 33kg
• The 1g/100ml formulation is ready to use — no dilution or reconstitution is required before administration
• Inspect the bag before use — the solution must be clear and colourless to pale yellow; discard if particulate matter, cloudiness, or discolouration is present
• Administer through a dedicated IV line or flush the line thoroughly before and after infusion when sharing IV access with other medicines
• Monitor the patient during and after infusion for therapeutic response and any adverse effects

Active Ingredient

Who Should NOT Receive Bofalgan 1g/100ml IV Infusion?

Do not administer this infusion if the patient:

• Is allergic to Paracetamol or any other ingredient in the formulation
• Has severe active liver disease or acute hepatitis — Paracetamol is metabolised by the liver and can cause fatal liver failure in severe hepatic impairment
• Has severe active alcoholism — chronic heavy alcohol use depletes glutathione — the liver's protective molecule against Paracetamol toxicity — dramatically increasing the risk of liver damage even at standard doses
• Weighs less than 33kg — the 1g formulation delivers too high a dose per kg for smaller patients; a weight-appropriate lower-dose formulation must be used
• Has phenylketonuria (PKU) — if the formulation contains Mannitol as an excipient

Always inform the treating doctor before administration if the patient has any of the following:

• Liver disease of any severity — including chronic hepatitis, cirrhosis, or Gilbert's syndrome — dose reduction and monitoring are required
• Kidney disease — the minimum dosing interval must be extended to at least 6 hours; monitoring is recommended
• Chronic malnutrition or low body weight — depleted glutathione stores increase liver damage risk at standard doses
• G6PD deficiency — rare inherited blood enzyme deficiency; Paracetamol should be used with caution
• Is already receiving other Paracetamol-containing medicines — risk of serious cumulative overdose and liver failure
• Is pregnant or breastfeeding — Paracetamol is generally considered safe at recommended doses during pregnancy and breastfeeding, but the treating doctor must confirm appropriateness of IV use in each individual case

Side Effects

Bofalgan 1g/100ml IV Infusion is one of the best-tolerated IV medicines when used correctly at the recommended dose and frequency. Serious side effects are rare at therapeutic doses but require immediate attention.

Common Side Effects:

• Mild nausea during or after infusion
• Mild headache or dizziness
• Mild pain or discomfort at the infusion site
• Slight drop in blood pressure (hypotension) during infusion — usually mild and transient
• Mild increase in liver enzyme levels on blood tests — usually reversible; more relevant with prolonged use

Infusion-Related Side Effects:

• Redness, swelling, or irritation at the IV insertion site
• Feeling of warmth or flushing during infusion — particularly if infusion runs faster than recommended

Serious Side Effects — Inform Medical Team Immediately:

• Liver damage or acute liver failure — the most serious risk of Paracetamol — caused by exceeding the maximum daily dose, combining with other Paracetamol sources, or administering to patients with liver disease or malnutrition. Signs include yellowing of skin or eyes (یرقان / jaundice), severe upper right abdominal pain, nausea, vomiting, and extreme fatigue — this is a medical emergency
• Severe allergic reaction — sudden rash, hives, swelling of the face, lips, tongue or throat, difficulty breathing, or anaphylactic shock — requires immediate emergency intervention
• Severe skin reactions — Stevens-Johnson Syndrome or Toxic Epidermal Necrolysis — widespread blistering and peeling of skin — very rare but life-threatening; stop immediately
• Serious drop in blood pressure — particularly in patients who are haemodynamically unstable or volume-depleted
• Thrombocytopaenia — abnormal reduction in blood platelet count — very rare with short-term use; manifests as unusual bleeding or bruising
• Neutropaenia or agranulocytosis — very rare reduction in white blood cell count — manifests as unusual susceptibility to infections or persistent fever

If any serious side effect is observed during or after infusion, the medical team must be informed immediately and appropriate emergency measures initiated without delay.

Drug Interactions

The treating doctor and clinical pharmacist must be fully informed of all medicines the patient is currently receiving before Bofalgan IV infusion is initiated.

Storage Instructions

• Store unopened bags below 25°C in a cool, dry place
• Do not refrigerate or freeze the infusion bags — cold storage can cause precipitation of the solution
• Protect from direct sunlight — store in original outer packaging until immediately before use
• Keep out of reach of children (بچوں کی پہنچ سے دور رکھیں)
• Inspect every bag carefully before use — the solution must be clear and colourless to pale yellow and completely free of visible particles; discard immediately if the bag is leaking, cracked, discoloured, or contains visible particles
• Use immediately once the bag seal is opened or punctured — do not store a partially used or opened bag for later administration under any circumstances
• Discard all used bags and infusion sets according to hospital clinical waste disposal protocols
• Do not use after the expiry date printed on the infusion bag label or outer carton

Frequently Asked Questions

Why is IV Paracetamol used instead of Paracetamol tablets after surgery?

After surgery, patients are typically nil-by-mouth — they cannot eat or drink, and swallowing tablets is not possible or safe. Even once some oral intake is permitted, nausea and vomiting following anaesthesia are extremely common and would prevent reliable absorption of oral tablets. Bofalgan IV bypasses the digestive system completely, delivering the full 1g dose directly into the bloodstream within minutes — guaranteeing fast, predictable, and complete pain relief exactly when post-operative patients need it most. As soon as the patient can tolerate oral medicines, the doctor will switch to oral Paracetamol to complete the pain management course.

How quickly does Bofalgan IV Infusion relieve pain and reduce fever?

Because it is delivered directly into the bloodstream, Bofalgan IV begins exerting its effects within 5 to 10 minutes of commencing the infusion, with maximum pain relief and fever reduction achieved within approximately 15 minutes of completing the 15-minute infusion. This is significantly faster than oral Paracetamol, which typically takes 30 to 60 minutes to reach its peak effect through gut absorption. This speed is particularly valuable in the immediate post-operative period and in patients with acutely high fever requiring rapid temperature reduction.

What is the maximum safe dose and why is it so important not to exceed it?

The absolute maximum daily dose of Paracetamol for adults is 4g (4000mg) per 24 hours — equivalent to 4 bags of Bofalgan 1g. Exceeding this limit — even slightly or temporarily — can cause serious liver damage because a toxic metabolite of Paracetamol called NAPQI accumulates faster than the liver can neutralise it. At toxic levels, NAPQI directly destroys liver cells, causing acute liver failure that can be fatal if not treated promptly with the antidote N-acetylcysteine. The 4g limit must account for Paracetamol from all sources — including any tablets, combination medicines, or other IV products the patient is receiving.

Is Bofalgan IV safe for patients with liver disease?

Caution is required — Paracetamol is processed exclusively by the liver, and in patients with impaired liver function, its toxic metabolite accumulates more easily and causes damage at lower doses. Mild to moderate liver disease does not necessarily preclude IV Paracetamol use, but dose reduction, extended intervals between doses, and close liver function monitoring are mandatory. In severe active liver disease or acute hepatitis, Paracetamol IV is contraindicated. The hepatologist or treating specialist must be involved in the decision to use IV Paracetamol in any patient with known liver disease.

Can Bofalgan IV be used in elderly patients?

Yes — elderly patients can receive the standard adult dose of Bofalgan 1g IV, but with additional care and monitoring. Older patients are more likely to have reduced liver and kidney function, lower body weight, and are frequently on multiple medications — increasing both the risk of cumulative Paracetamol overdose from combination products and the risk of liver toxicity. The prescribing doctor will review all concurrent medicines, assess organ function, and may extend the dosing interval to every 6 hours rather than every 4 hours as a precautionary measure.

Why must Bofalgan IV never be given to patients weighing less than 33kg?

The 1g formulation is specifically designed for adults and patients over 33kg. For a patient weighing less than 33kg, a 1g dose exceeds the safe weight-based limit of 15mg/kg per dose — potentially causing Paracetamol toxicity and liver damage. Children and smaller patients must receive a lower-concentration IV Paracetamol formulation where the dose can be accurately adjusted to their body weight. The paediatrician or anaesthetist will prescribe the appropriate weight-based formulation for smaller patients.

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⚕️ Medical Disclaimer: This product description is provided for general informational purposes only and does not replace professional medical advice, diagnosis, or treatment. Bofalgan 1g/100ml IV Infusion is a prescription-only hospital medicine that must be administered exclusively by qualified healthcare professionals under strict clinical supervision. The maximum daily dose of 4g must never be exceeded and all sources of Paracetamol must be accounted for. Any adverse reactions during or after infusion must be reported to the medical team immediately.

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DRAP Registered | Prescription Required (Rx) | For hospital and clinical use under strict medical supervision only — administer as slow IV infusion over 15 minutes — never for home use — do not exceed 4g Paracetamol total daily from all sources