Study finds paracetamol may pose risks for older adults' safety

A recent study highlights potential safety concerns associated with paracetamol use in older adults. While commonly considered a safe pain reliever, findings suggest it may pose health risks for this age group, urging caution and a reassessment of its use.

New research led by experts from the University of Nottingham has uncovered significant health risks associated with repeated doses of paracetamol in individuals aged 65 and over. The findings indicate that prolonged use of this commonly recommended pain reliever may lead to an increased risk of gastrointestinal, cardiovascular, and renal complications. Published in Arthritis Care and Research, the study emphasizes the importance of exercising caution when prescribing paracetamol for chronic painful conditions, such as osteoarthritis, in older adults.

The study was spearheaded by Professor Weiya Zhang from the NIHR Biomedical Research Centre at the University of Nottingham's School of Medicine. According to Professor Zhang, paracetamol has long been considered a safe and reliable first-line drug for managing osteoarthritis, particularly in older adults who are more susceptible to adverse effects from medications. He explained, "Due to its perceived safety, paracetamol has been widely recommended in treatment guidelines for osteoarthritis, especially for older individuals who face a higher risk of drug-related complications." However, this perception of safety is now being challenged by new evidence.

The research team conducted a thorough analysis using data from the Clinical Practice Research Datalink-Gold (CPRD-Gold). This dataset included health records of participants aged 65 and over, with an average age of 75. All participants had been registered with a UK general practice for at least one year between 1998 and 2018. The study involved comparing the health outcomes of two groups: one group of 180,483 individuals who had been prescribed paracetamol repeatedly (defined as two or more prescriptions within six months), and a second group of 402,478 individuals of the same age who had not received repeated paracetamol prescriptions.

The analysis revealed concerning results. Prolonged use of paracetamol was linked to an elevated risk of developing several serious health conditions, including peptic ulcers, heart failure, hypertension, and chronic kidney disease. These findings suggest that while paracetamol is often chosen for its reputation as a safer alternative to other pain-relief medications, it may not be as benign as previously assumed when used extensively over time.

Professor Zhang acknowledged that further studies are needed to validate these findings. Nevertheless, he emphasized the need to reconsider the role of paracetamol as a first-line treatment for long-term pain management in older adults. He stated, "Given its minimal pain-relief effect and the risks revealed in our study, the use of paracetamol for chronic conditions like osteoarthritis in older people should be carefully evaluated."

The implications of this study are particularly significant for healthcare providers and policymakers responsible for creating treatment guidelines. Osteoarthritis is a prevalent condition among older adults, and paracetamol has traditionally been recommended as a safe and accessible option for managing its symptoms. However, the new evidence underscores the necessity of balancing the benefits and risks of this medication, particularly for vulnerable populations.

In light of these findings, healthcare practitioners may need to explore alternative pain management strategies for older patients with osteoarthritis and other chronic conditions. Non-pharmacological approaches, such as physical therapy, exercise, and weight management, could offer safer and equally effective options for managing pain without the associated risks of long-term medication use. Additionally, further research into alternative medications with better safety profiles for older adults is essential.

The study also highlights the importance of personalized medicine in addressing the diverse needs and risks faced by older adults. By taking into account individual health conditions, medication history, and susceptibility to adverse effects, clinicians can develop tailored treatment plans that minimize risks and optimize outcomes.

While paracetamol remains an important tool in pain management, this study serves as a reminder that even medications with a long-standing reputation for safety can carry risks, particularly when used repeatedly over extended periods. Older adults, who are often managing multiple health conditions simultaneously, are particularly vulnerable to the cumulative effects of medication use.

The findings from this study mark a critical step toward improving our understanding of the potential risks associated with long-term paracetamol use. As healthcare systems continue to prioritize patient safety and effective pain management, it is essential to incorporate emerging evidence into clinical practices and guidelines. This research underscores the need for ongoing vigilance, further investigation, and a holistic approach to managing chronic pain in older populations.

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Source: worldpharmanews‍