Researchers supported by the University of Nottingham have reported that repeated paracetamol doses within a six-month period are “associated with several serious complications”, “despite [the drug’s] perceived safety”.
The report, published on November 24, analysed some 20 years of GP data to “examine the safety of oral acetaminophen” – known as paracetamol in the UK.
It said that researchers compared 180,500 over-65s, who had “at least two acetaminophen prescriptions within six months of the first acetaminophen prescription”, to 402,500 “unexposed participants”.
Read more: Stop retailers from offering multi-buy paracetamol deals, RPS urges
The study found that increased paracetamol exposure was linked to an “increased risk” of lower gastrointestinal bleeding, heart failure, hypertension and chronic kidney disease.
It added that the “association among developing perforation or ulceration or bleeding (PUB), uncomplicated peptic ulcers and chronic renal failure” also increased with the number of paracetamol prescriptions.
“No provision” for OTC study
Researchers said that one “significant caveat to the study is that there is no provision for recording over-the-counter (OTC) prescriptions”.
“This limitation was a reason to restrict the study to people aged ≥65 years, who were eligible for free prescriptions and therefore were less likely to purchase [paracetamol] independently,” they added.
“Despite this, OTC usage might have affected both the exposure and non-exposure groups,” they said, adding that in “populations where OTC remedies are more common across ages, the observed associations might differ”.
Read more: C+D investigation exposes breaches of paracetamol guidelines
“Furthermore, acetaminophen is often taken episodically and for multiple reasons, making it difficult” to define patients who have and haven’t been exposed to paracetamol, researchers added.
In 2023, the Royal Pharmaceutical Society (RPS) urged the government to bring in new laws that would prevent retailers from offering multi-buy deals on paracetamol.
Such offers can encourage people to buy more paracetamol than they need, which “poses a risk of accidental or impulsive overdose”, the RPS warned at the time.
And in 2015, a C+D investigation found that six out of 12 non-pharmacy retailers were willing to sell three 16-tablet packs, despite the MHRA recommending a two-pack limit.
