Paracetamol: long-term risks may be underestimated says new review
The long-term health risks that could be associated with the commonly-taken painkiller paracetamol need to be reassessed, says a group led by Prof Philip Conaghan of the Leeds Institute of Rheumatic and Musculoskeletal Medicine.
The team reviewed eight studies that looked at the association between chronic use of paracetamol and major adverse events in the general adult population. Key findings were:
• One study showed an increased relative rate of death for those on higher standard doses of paracetamol.
• Another found an increased risk ratio of all cardiovascular adverse events.
• A third study indicated a higher probability of gastrointestinal adverse events and bleeding.
• One other study linked paracetamol use to a more likely decrease in glomerular filtration rate (a test used to check how well the kidneys are working).
Do note, however, that the people who took part in these studies tend to have lots of medical problems requiring other medication so the results could be biased to some extent.
But the findings still suggest a consistent dose-response relationship between paracetamol at standard doses and adverse events typical of those often observed with non-steroidal anti-inflammatory drugs (ie ibuprofen, diclofenac, celecoxib and Aspirin).
“Based upon the data presented above, we believe the true risk of paracetamol prescription to be higher than that currently perceived in the clinical community,” the research team explains. “Given its high usage and availability as an over-the-counter analgesic, a systematic review of paracetamol’s efficacy and tolerability in individual conditions is warranted.”
A spokesman for Arthritis Research UK comments:
“These risks associated with paracetamol emphasise the current gap in the market for painkillers for long-term conditions without side effects. We and others are working hard to find alternative sources of safe and effective pain relief for the ten million people in the UK who are in pain because of their arthritis.
“People with arthritis who are concerned about taking paracetamol over a long period of time should consult their GP about alternative medications or other approaches to pain management.”
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Image credit: Raymond Bryson
