Paracetamol may not be as safe as previously thought when used regularly by older patients, a study suggests.
Researchers analysed medical records from more than 180,000 over 65s who received at least two prescriptions within six months, and their health compared with 402,000 people people who did not use the medication.
Prolonged paracetamol use was linked to a 35% higher risk of lower gastrointestinal bleeding and around a fifth higher risk of peptic ulcers.
Frequent users were also 19% more likely to suffer from chronic kidney disease, 9% more likely to have heart failure and 7% more likely to have high blood pressure.
Professor Weiya Zhang, from the NIHR Biomedical Research Centre at the University of Nottingham, said: “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.
“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.”
Paracetamol has often been used as a first-line treatment for pain caused by osteoarthritis, provided free on prescription for over 65s.
However, the National Institute for Health and Care Excellence warned in 2022 that it should not be routinely used for those with chronic pain due to a lack of strong evidence of benefit.
An estimated 10 million people in the UK have osteoarthitis, a degenerative condition that affects the joints.
The paper noted that other factors may have played a role and the study could not check whether patients had bought paracetamol over the counter without a prescription.
The findings were published in the journal Arthritis Care and Research.
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