by Dr Deborah Lee, Dr Fox Online Pharmacy
https://pixabay.com/photos/pill-medication-drug-paracetamol-4159141/
Paracetamol – active ingredient acetaminophen – is Britain’s most trusted painkiller. In 2020, 235 people died from taking paracetamol in the UK. Around 6.3 tonnes of paracetamol are sold in the UK every year – which works out at 70 paracetamol per year for each UK adult. But what do you really know about paracetamol?
- Is it safe?
- How much paracetamol can you take?
- What happens if you inadvertently take an overdose?
Read on and find out.
Does paracetamol work?
Although paracetamol is used as a painkiller, good quality evidence from a recent Cochrane data review suggests it is no more effective in relieving pain for those with back pain or arthritis, than a placebo.
Is paracetamol safe?
Moreover, paracetamol does have side effects, there is a risk of allergy, including anaphylaxis, and it can cause liver failure, even if taken at normal doses (although this is rare). One 2016 systematic review showed that those taking standard doses of paracetamol had a 19% increased risk of cardiovascular disease, an 11% increase in gastrointestinal bleeds and a significantly increased risk of kidney disease.
In a 2022 American study, 172 out of 109, 280 people (0.16%) were found to have blood in their urine. They were more likely to be female, aged 60 or over, and have been taking paracetamol for over one month.
Paracetamol can damage the kidney, leading to a condition called analgesic nephropathy. This comes on slowly with long-term paracetamol usage and can lead to kidney failure. It is probably more likely in older people, those with a BMI of under 50, or who already have liver or kidney disease.
We Brits are confused about paracetamol
It seems that we, the British public, are confused about paracetamol.
- In one London survey, around half of those questioned thought that ibuprofen contained paracetamol (It doesn’t!).
- In a study of parents’ knowledge of paracetamol for administration to children, only 50.9% knew that paracetamol was harmful in overdose. 38% did not use a syringe to correctly measure the child’s dose.
- In an American study, half of those asked did not know that Tylenol contained paracetamol.
- In the UK, around 1 in 4 adults frequently take more than the recommended 4 x 2 500mg paracetamol tablets per day.
Accidental overdose of paracetamol
One of the problems is that you may not know that you are already taking paracetamol, and inadvertently take paracetamol on top.
For example, paracetamol is added to many cough, cold and flu remedies, for example, Night Nurse and Lemsip – so it’s vital not to take additional paracetamol if you are taking these preparations. There are 89 ‘combi’ preparations listed on drugs.com, many of which contain paracetamol (acetaminophen). Prescribed drugs such as co-codamol, codydramol and Tramacet also contain paracetamol. It can be very confusing to know what you are taking.
How to take paracetamol safely
I would strongly advise you not to take any medication – paracetamol, natural or herbal remedies – unless it’s really necessary and you feel confident about what you are taking – not even a simple paracetamol.
Always read the labels on the packet of any pain killers of cough, cold, and flu remedies, and check if there is paracetamol (acetaminophen) in the preparation before you swallow the tablets.
Never exceed the maximum dose – for adults, this is 4 x 2, 500mg paracetamol tablets in a 24-hour period, with at least 4 hours between doses. Never take any more than this. If you miss out on a dose, don’t worry, do not take two doses at once (4 tablets).
Be especially careful with babies and children, to follow the recommended dosing regime and measure out their paracetamol with care.
What to do if you have overdosed
If you take extra paracetamol either deliberately or by mistake, get help immediately. The NHS states that 1 or 2 extra tablets are unlikely to harm, but 3 or more extra tablets means you should take action without delay.
- Go to nhs.uk
- Call 111
- Go to your nearest A and E – and take the packet of paracetamol with you.
Tell your doctor before you start to take any regular medication, including paracetamol or natural herbal remedies. This is especially the case if you suffer from any chronic diseases or take other regular medication.
Paracetamol is riskier for older people, who have naturally declining kidney function with age.
Why not ask your pharmacist for a free NHS Medicine Use Review (MUR)?
Final thoughts
- Is it time to rethink the way you use paracetamol?
- How could you use it more safely and wisely?
- In fact, do you need to be taking it all?
