A recent study from the University of Nottingham has revealed significant health risks associated with prolonged paracetamol use in adults aged 65 and above. The research calls into question the long-standing perception of paracetamol as a safe and effective treatment for chronic pain and osteoarthritis.
Paracetamol, widely used for treating mild-to-moderate fever and pain, is the first-line recommendation for managing osteoarthritis—a condition characterized by joint pain, stiffness, and swelling. While it is considered affordable and accessible, mounting evidence challenges its safety and efficacy.
The latest study found a 24% increase in peptic ulcer bleeding risk and a 36% increase in lower gastrointestinal bleeding among older adults prescribed paracetamol repeatedly. It also linked the drug to a 19% higher risk of chronic kidney disease, 9% increased heart failure risk, and 7% rise in hypertension cases.
The study analyzed the health records of 1.8 lakh adults aged 65 and above who received more than two paracetamol prescriptions within six months. These outcomes were compared with a control group of 4.02 lakh non-users from the same age bracket. Data from the Clinical Practice Research Datalink-Gold, spanning from 1998 to 2018, was used for the analysis.
Past studies have similarly cast doubts on paracetamol’s effectiveness. A 2016 study in The Lancet, pooling data from 76 randomized trials involving over 58,000 patients, concluded that paracetamol did not provide adequate pain relief or improve physical function in osteoarthritis patients with knee and hip pain.
The researchers emphasized that older adults prescribed acetaminophen repeatedly face significant risks of renal, cardiovascular, and gastrointestinal side effects. They highlighted that paracetamol has long been recommended as a first-line drug for osteoarthritis due to its perceived safety, especially for older people who are more vulnerable to drug-related complications.
Lead researcher Weiya Zhang, from the University of Nottingham’s School of Medicine, remarked that although further research is required to confirm these findings, the minimal pain-relief effect of paracetamol raises concerns about its continued use as the primary painkiller for long-term conditions like osteoarthritis in older adults.
Given the findings, healthcare providers may need to reconsider paracetamol’s role in managing chronic pain for older adults. This could pave the way for exploring alternative treatments that balance pain relief with safety, especially in vulnerable populations.
Reference:
1. Kaur, J., et al. (2024). 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 & Research. doi.org/10.1002/acr.25471.
(Input from various sources)
(Rehash/Dr. Sreelekshmi P/MSM)