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Safety of Acetaminophen in the Elderly

  • EurekAlert!

New research, led by experts at the University of Nottingham, has found that repeated doses of paracetamol in people aged 65 and over, can lead to an increased risk of gastrointestinal, cardiovascular and renal complications.

The new study, which is published in Arthritis Care and Research, shows that care must be taken when repeated doses are required for chronic painful conditions such as osteoarthritis in older people.

The study was led by Professor Weiya Zhang, from the NIHR Biomedical Research Centre in the School of Medicine at the University of Nottingham.

Professor Zhang 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.”

The study analysed data from the Clinical Practice Research Datalink-Gold. Participants were aged 65 and over with an average age of 75,  and had been registered with a UK GP practice for at least a year between 1998 and 2018.

Researchers looked at the health records of 180,483 people who had been prescribed paracetamol repeatedly (≥2 prescriptions within six months) during the study. Their health outcomes were then compared to 402,478 people of the same age who had never been prescribed paracetamol repeatedly.

The findings showed that prolonged paracetamol use was associated with an increased risk of peptic ulcers, heart failure, hypertension and chronic kidney disease.

Professor Zhang adds: “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.”
The full study can be found here.


 

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Charles Pritchard

| Dec 15, 2024 12:34 pm

Clearly there is bias. Why do the one group take paracetamol and the other didn't. Is the second group healthier?

Jack Cush, MD

| Dec 15, 2024 8:00 pm

Charles - Agreed! there's clearly a channeling bias, those on vs. those not on acetaminophen - the groups had to be different. But, I might argue that incredibly large numbers may mitigate a channeling bias? This UK Clinical practice data set is gigantic- comparing 180,483 acetaminophen-users and 402,478 non-users.. Would the numbers alone make you think, well maybe there is some risk to acetaminophen use? I cant say that Im worried about my recommending it to elderly patients who need pain management.

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