A recent study has found that paracetamol, a widely used over-the-counter medication and generally perceived as 'harmless', may increase the risk of gastrointestinal, heart, and kidney complications in adults aged 65 and older.
Commonly taken to relieve mild to moderate fever, paracetamol is also the first-choice treatment for osteoarthritis, a chronic condition that causes joint pain, stiffness and swelling due to wear and tear. It is often favoured for its effectiveness, safety, and accessibility.
However, some studies challenge its effectiveness in pain relief, while others suggest that long-term use may increase the risk of gastrointestinal side effects like ulcers and bleeding.
The latest research, conducted by the University of Nottingham, UK, found that paracetamol use was associated with a 24 percent increased risk of peptic ulcer bleeding (bleeding from an ulcer in the digestive tract) and a 36 percent increased risk of lower gastrointestinal bleeding. Additionally, it raised the risk of chronic kidney disease by 19 percent, heart failure by 9 percent, and hypertension by 7 percent.
“This study highlights significant gastrointestinal, cardiovascular, and renal side effects in older adults who are repeatedly prescribed paracetamol in the UK,” the authors noted in their study published in Arthritis Care and Research.
Lead researcher Weiya Zhang from the University of Nottingham's School of Medicine explained, “Due to its perceived safety, paracetamol has long been the preferred first-line treatment for osteoarthritis, particularly in older adults who are more vulnerable to drug-related complications.”
Zhang also emphasised the need for further research, adding, “Given its limited pain-relief effect, the use of paracetamol as a first-line painkiller for long-term conditions like osteoarthritis in older adults should be carefully reconsidered.”
For their analysis, the researchers examined health records of 1,80,483 people aged 65 and older who were repeatedly prescribed paracetamol (more than two prescriptions within six months). Their health outcomes were compared with those of 402,478 people of the same age who were never repeatedly prescribed the drug.
The study analysed data from the Clinical Practice Research Datalink-Gold, focusing on participants registered with a UK general practitioner between 1998 and 2018.
In a related 2016 study published in The Lancet, researchers from the University of Bern analysed data from 76 randomized trials involving 58,451 patients, conducted between 1980 and 2015. They found that paracetamol did not provide significant pain relief or improve physical function in patients with knee and hip osteoarthritis.