Pain Management > > Pain Management– Not so stomach-safe?
by John Gever, Contributing Writer, MedPage Today November 26, 2024
Prevalent belief holds that the popular over the counter pain reliever acetaminophen does not trigger stomach ulcers, however a brand-new research study from Great Britain puts that in doubt.
General practice records from 1998 to 2018 in the U.K reveal that, amongst some 180,000 individuals age 65 and older who got prescriptions for acetaminophen (likewise called paracetamol in Britain), dangers for peptic ulcers, bleeding from ulcers, and any kind of lower intestinal (GI) bleeding were increased from 20% to 36% compared to more than 400,000 individuals not recommended the drug, according to Jaspreet Kaur, PhD, MPH, of the University of Nottingham in England, and coworkers.
Acetaminophen usage was likewise connected with increased rates of more basic illness consisting of cardiac arrest, persistent kidney illness, and high blood pressure, the group reported in Arthritis Care & & Research
“Despite its viewed security, acetaminophen is related to numerous major problems,” Kaur and associates composed. “Given its very little analgesic efficiency, making use of acetaminophen as the first-line oral analgesic for long-lasting conditions in older individuals needs cautious reconsideration.”
Acetaminophen's security has actually mainly been taken for given– WebMD, for example, states flatly that it “will not lead to peptic ulcers”– the authors kept in mind that proof to the contrary has actually been collecting. A years earlier, Britain's National Institute for Health and Care Excellence pointed out research studies recommending that the representative does, in reality, regulate the exact same cyclooxygenase-related paths as do nonsteroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen, with the capacity for increasing threat for negative GI impacts. And in 2022, the institute officially dropped acetaminophen from its advised treatments for osteoarthritis, both for security and due to the fact that it didn't appear extremely efficient.
Kaur and coworkers developed their research study to analyze the dangers in the basic senior population. They took a look at the U.K.'s Clinical Practice Research Datalink, searching for individuals age 65 and older provided a minimum of 2 acetaminophen prescriptions throughout a 6-month duration without a concomitant order for another analgesic. They likewise consisted of just those clients who had actually not gotten any acetaminophen scripts in the 12 months preceding the very first certifying prescription, “to prevent common users.” Follow-up for negative occasions, as taped in clients' charts, started 12 months after the very first prescription.
Each acetaminophen user was then matched in differing ratios to clients not certifying as a user (either “common” or by the preceding addition requirements), by age, sex, and basic practice place. In all, the analysis made up 180,483 users and 402,478 non-users. Kaur's group likewise matched users 1:1 with non-users by tendency scoring, with 79,024 clients in each group.
Mean client age had to do with 75 and simply over 60% were ladies. Without tendency matching, users varied significantly from non-users in lots of attributes. Users likewise took opioids, NSAIDs, aspirin, proton pump inhibitors, and other medication types at greater rates; they were likewise most likely to be obese or overweight,
