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New Study Probes Risks Related to Acetaminophen Use

Vanessa Caceres  |  Issue: April 2025  |  April 7, 2025

Prof. Zhang

“Although the incidence of acetaminophen side effects may be lower than that of NSAIDs and COX 2 inhibitors,” the authors said, “their side effect profiles are similar, which reflects the now recognized COX inhibitory effect of acetaminophen. These data further challenge whether acetaminophen should be retained as the first-line oral analgesic, especially in older people for common chronic painful conditions, given its non-clinically meaningful benefits and potential harms, and support the recent recommendation by NICE to not use acetaminophen for OA.”

Future research should focus on confirming these findings and developing a safer pain reliever for older adults, says study author Professor Weiya Zhang, BMed, MMed, PhD, who is with the NIHR Biomedical Research Centre in the School of Medicine at the University of Nottingham.

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Vanessa Caceres is a medical writer in Bradenton, Fla.

References

  1. Kaur J, Nakafero G, Abhishek A, et al. 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 Res (Hoboken). Published online Nov. 24, 2024.
  2. de Vries F, Setakis E, van Staa TP. Concomitant use of ibuprofen and paracetamol and the risk of major clinical safety outcomes. Br J Clin Pharmacol. 2010;70(3):429–438.
  3. Rahme E, Marentette MA, Kong SX, et al. Use of NSAIDs, COX-2 inhibitors, and acetaminophen and associated coprescriptions of gastroprotective agents in an elderly population. Arthritis Rheum. 2002;47(6):595–602.
  4. Rodríguez LA, Hernández-Díaz S. Relative risk of upper gastrointestinal complications among users of acetaminophen and nonsteroidal anti-inflammatory drugs. Epidemiology. 2001;12(5):570–576.
  5. National Clinical Guideline Centre (UK). Osteoarthritis: Care and Management in Adults. London: National Institute for Health and Care Excellence (UK);2014.
  6. Rahme E, Barkun A, Nedjar H, et al. Hospitalizations for upper and lower GI events associated with traditional NSAIDs and acetaminophen among the elderly in Quebec, Canada. Am J Gastroenterol. 2008;103(4):872–882.
  7. Chan AT, Manson JE, Albert CM, et al. Nonsteroidal anti-inflammatory drugs, acetaminophen, and the risk of cardiovascular events. Circulation. 2006;113(12):1578–1587.
  8. Zeng C, Doherty M, Persson MS, et al. Comparative efficacy and safety of acetaminophen, topical and oral non-steroidal anti-inflammatory drugs for knee osteoarthritis: Evidence from a network meta-analysis of randomized controlled trials and real-world data. Osteoarthritis Cartilage. 2021;29(9):1242–1251.
  9. Hinz B, Brune K. Paracetamol and cyclooxygenase inhibition: Is there a cause for concern? Ann Rheum Dis. 2012;71(1):20–25.

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Filed under:AnalgesicsDrug UpdatesOsteoarthritis and Bone DisordersResearch Rheum Tagged with:acetaminophenResearch Reviewresearch reviewsTylenol

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