Background Among palliative care (PC) patients who are administered paracetamol, the subcutaneous (SC) route is often an alternative to the intravenous (IV) route. Yet pharmacological and clinical data on whether these are equivalent pharmacokinetically are lacking. Many French palliative teams are now empirically using paracetamol by the SC route, but there are no data to support this practice. This trial aims to compare the pharmacokinetic (PK) parameters of paracetomol between the IV and SC routes in PC patients. Methods/design This is a randomized, open, crossover study in two PC centers. The primary endpoints are AUC0-t, AUC0-∞, Cmax, Vd, and t1/2. All adverse events will be reported for a safety analysis. Twenty adult PC patients with an IV device having spontaneous pain not related to care, with a numeric pain rate scale > 3/10, or having a systematic prescription of paracetamol as the usual treatment will be included. All patients also have to meet all eligibility criteria. Conclusion This is the first study comparing PK parameters for IV paracetamol versus SC paracetamol in PC patients. Trial registration ClinicalTrials.gov, NCT03944044. Registered on 4 June 2019. Committee for the protection of persons (CPP) 18.09.05.58206 approval 4 October 2018. National Drug Safety Agency (ANSM; Agence Nationale de Sécurité Médicament) MEDAECNAT-2018-09-00009 approval 29 November 2018.

Background :Among palliative care patients, the subcutaneous route is often an alternative to the intravenous route, yet pharmacological and clinical data are lacking. Many French palliative teams are now empirically using paracetamol by the subcutaneous route, but there are no data to support this practice. Aim :Compare pharmacokinetic parameters between the intravenous and subcutaneous routes for PC patients. Design : A randomized, open, crossover study in two palliative care centres. The primary endpoints are AUC0-t, AUC0-∞, Cmax, and Vd et t1/2. All adverse events will be reported for a safety analysis. Setting/participants 20 adult palliative care patients with an IV device, having spontaneous pain, not related to care, with a numeric pain rate scale > 3/10, or having a systematic prescription of paracetamol in the usual treatment. They also have to meet all eligibility criteria. Conclusion : First pilot study comparing paracetamol intravenous versus subcutaneous route pharmacokinetics.