New research reveals that repeated doses of acetaminophen in people aged 65 and over can significantly increase the risk of gastrointestinal, cardiovascular, and renal complications.
Researchers from the University of Nottingham have discovered that repeated use of acetaminophen in people aged 65 and older may increase the risk of gastrointestinal, cardiovascular, and kidney problems.
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.
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The research team was led by Professor Weiya Zhang from the NIHR Biomedical Research Centre in the University of Nottingham’s School of Medicine.
“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,” Professor Zhang explained.
Acetaminophen, also known as paracetamol, is a widely used over-the-counter pain reliever and fever reducer. Common brand names include Tylenol, Panadol, and Mapap. It is often recommended for mild to moderate pain such as headaches, muscle aches, and arthritis, as well as for reducing fever.
The study analyzed 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.
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Researchers looked at the health records of 180,483 people who had been prescribed acetaminophen 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 acetaminophen 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.”
Reference: “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” by Jaspreet Kaur, Georgina Nakafero, Abhishek Abhishek, Christen Mallen, Michael Doherty and Weiya Zhang, 24 November 2024, Arthritis Care & Research.
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