Paracetamol, also known as acetaminophen, is one of the most commonly used drugs in the world. It’s available over-the-counter and is the go-to treatment for fever and pain, and many believe it will continue to be used for a long time.
New research led by experts at the University of Nottingham examined the safety of oral acetaminophen at its therapeutic dose in adults aged 65 years or more. It found that repeated doses of paracetamol may not be as safe as perceived in older people.
In people aged 65 and over, it can lead to an increased risk of gastrointestinal, cardiovascular, and renal complications.
The new study highlights the need to take care when repeated doses are required for chronic painful conditions in older people.
The study looked at data from the Clinical Practice Research Datalink-Gold. It included people aged 65 and older, with an average age of 75, who had been registered with a UK GP for at least one year between 1998 and 2018.
Researchers studied the health records of 180,483 people who had been given paracetamol multiple times (at least two prescriptions within six months) during the study. They compared their health outcomes to 402,478 people of the same age who had never been prescribed paracetamol repeatedly.
The results showed that long-term use of paracetamol was linked to a higher risk of peptic ulcers, heart failure, high blood pressure, and chronic kidney disease.
Professor Weiya Zhang from the NIHR Biomedical Research Centre in the School of Medicine at the University of Nottingham said, “Due to its perceived safety, paracetamol has long been recommended as the first-line drug treatment for osteoarthritis by many treatment guidelines, especially in older people who are at higher risk of drug-related complications.”
“Whilst further research is now needed to confirm our findings, given its minimal pain-relief effect, the use of paracetamol as a first line pain killer for long-term conditions such as osteoarthritis in older people needs to be carefully considered.”
Journal Reference:
- Jaspreet Kaur, Georgina Nakafero, et al. Incidence of side effects associated with acetaminophen in people aged 65 years or more: a prospective cohort study using data from the Clinical Practice Research Datalink. Arthritis Care and Research. DOI: 10.1002/acr.25471