New study links paracetamol to several side effects among senior citizens

Paracetamol, a common over-the-counter medication, may increase the risk of gastrointestinal, heart- and kidney-related complications among adults aged 65 and above, a new study has found.

Taken commonly for treating mild-to-moderate fever, paracetamol is also the first drug recommended for treating osteoarthritis -- a chronic condition causing pain, stiffness and swelling in the joints due to wear-and-tear -- as it is considered effective, relatively safe and accessible.

However, some studies have provided evidence to contest the effectiveness of paracetamol in relieving pain while others have shown increased risks of gastrointestinal side effects, such as ulcers and bleeding, from prolonged use.

The latest study, conducted by researchers from the University of Nottingham, UK, found that paracetamol use was linked to a 24 per cent and 36 per cent increase in risk of peptic ulcer bleeding (bleeding due to ulcer in the digestive tract) and lower gastrointestinal bleeding, respectively.

Taking the drug may also increase the risk of chronic kidney disease by 19 per cent, heart failure by 9 per cent and hypertension by 7 per cent.

"This study shows a significant incidence of renal, cardiovascular and gastrointestinal side effects in older people, who are prescribed acetaminophen (paracetamol) repeatedly in the UK," the authors wrote in the study published in the journal Arthritis Care and Research.

"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," said lead researcher Weiya Zhang from the University of Nottingham's School of Medicine.

"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," Zhang said.

For their analysis, the researchers looked at health records of 1,80,483 (1.80 lakh) people repeatedly prescribed paracetamol (more than two prescriptions within six months).

Their health outcomes were compared to those of 4,02,478 (4.02 lakh) people of the same age who were never prescribed paracetamol repeatedly.

Data from the Clinical Practice Research Datalink-Gold was analysed for the study. The participants were aged 65 and over (average age 75) and had been registered with a UK general practitioner for at least a year between 1998 and 2018.

A 2016 study in The Lancet journal pooled and analysed data from 76 randomised trials, involving 58,451 patients, published between 1980 and 2015. Researchers from the University of Bern found that paracetamol did not provide the minimum levels of effective pain relief or improve physical function in patients with knee and hip osteoarthritis.