Paracetamol, also known as acetaminophen, holds a prominent position in medicine cabinets worldwide, revered for its perceived safety, affordability, and efficacy in alleviating pain. With millions of packets sold over the counter annually, and a substantial number of prescriptions issued by doctors, it has become a cornerstone in pain management. However, recent research has cast a shadow on its seemingly benign reputation, raising concerns about the potential long-term consequences of regular paracetamol use, particularly in older adults.
A study published in Arthritis Care and Research investigated the health records of a large cohort of individuals over 65, comparing those regularly prescribed paracetamol with those who were not. The findings revealed a disturbing correlation between habitual paracetamol consumption and an increased risk of several serious health complications, including peptic ulcer bleeding, lower gastrointestinal bleeding, heart failure, and chronic kidney disease. These findings challenge the widely held belief that paracetamol carries minimal risk, especially for long-term use.
The study indicated a significantly elevated risk of gastrointestinal bleeding among regular paracetamol users, with a 24% increase in peptic ulcer bleeding and a 36% surge in lower gastrointestinal bleeding. Furthermore, the risk of heart failure was found to be 9% higher in those taking the painkiller. While the research doesn’t definitively establish a causal link between paracetamol and these health issues, it strongly suggests the need for a reassessment of its long-term use, particularly in vulnerable populations.
The current guidelines from the National Health Service (NHS) generally consider paracetamol safe for regular use over extended periods, even during pregnancy and breastfeeding. However, these guidelines also acknowledge certain limitations. Individuals weighing less than 50kg may require a lower dose, and those with pre-existing liver or kidney problems may not be suitable candidates for paracetamol use. Furthermore, regular alcohol consumption, exceeding 14 units per week, is a contraindication for paracetamol use due to the added stress it places on the liver. This is a significant concern, given the prevalence of alcohol consumption in many populations.
The new research underscores the importance of a cautious approach to paracetamol use, especially for long-term pain management. Professor Weiya Zhang, the study’s author, emphasized the need for further research to validate these findings. However, given the relatively modest pain-relieving effects of paracetamol, particularly for chronic conditions like osteoarthritis, its role as a first-line treatment in older adults warrants careful consideration. Alternative pain management strategies, with a focus on minimizing potential side effects, should be explored.
Ibuprofen, another common painkiller, often serves as an alternative or complement to paracetamol. It belongs to a class of drugs called non-steroidal anti-inflammatory drugs (NSAIDs) and works by reducing inflammation. According to the NHS, ibuprofen can be safely taken in conjunction with paracetamol. However, it is crucial to avoid combining paracetamol with other medications that also contain paracetamol, as this can lead to an overdose. When using multiple painkillers, always check the ingredients to ensure they don’t contain the same active ingredient. It’s also advisable to consult with a healthcare professional if you have any concerns about combining medications.
