Paracetamol may not be as safe as perceived in older people

RESEARCHERS from the University of Nottingham have cautioned on repeated use of acetaminophen, in people aged 65 and older, because it may lead to serious health complications, particularly peptic ulcers, heart failure, hypertension and chronic kidney disease.

The study gave evidence that suggested that repeated use of acetaminophen, also known as paracetamol in people aged 65 and older could have hidden side effects, challenging its perceived safety.

The study, published recently in the medical journal Arthritis Care and Research, highlights the need for caution when prescribing acetaminophen for chronic pain conditions like osteoarthritis in older adults.

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

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They looked at the health records of 180,483 people who had been prescribed acetaminophen repeatedly greater than two times 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.

There was a 24percent increased risk for peptic ulcer bleeding, 36percent increased risk for lower gastrointestinal bleeding: 19% increased risk for chronic kidney disease: 9% increased risk of heart failure, and 7% increased risk for hypertension.

This is particularly concerning given the prevalence of kidney issues in older populations.

Professor Weiya Zhang, who led the research team at the University of Nottingham’s School of Medicine, in a remark, said the study’s finding should cause a rethink on the perceived safety of paracetamol as a first-line treatment for chronic conditions like osteoarthritis, especially for older adults, as it may provide limited pain relief but increase risk of severe complications.

“Considering it has little effect on pain and causes major side effects, its use needs to be balanced against the risks by health care providers,” she said.

Previously, researchers from the University of California, Davis explored the drug’s impact on cardiovascular health and said that even at safe doses equivalent to 500 mg/day, changes that acetaminophen causes in the heart tissue could lead to long-term heart problems, particularly due to oxidative stress and increased toxins as the drug breaks down.

They, therefore, emphasized the importance of using acetaminophen at the lowest effective dose for the shortest possible duration to minimize risks.