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We are worried by suggestions that access to paracetamol should be
made more difficult, and even that it should be designated a prescription
only medicine (POM).1 We share the concerns about the effects of
paracetamol taken in overdose. However, making it more difficult for
people needing simple analgesia to gain access to paracetamol may well
cause an increase in mortality and morbidity. Older people would be
especially vulnerable. The importance and wide use of “over the counter”
(OTC) medicines is well-established in older people as well as the general
population.2 The only OTC alternatives for use as simple analgesia are
non-steroidal drugs (NSAIDs) including aspirin. The dangers of such
medications – particularly for older people – have been well documented
elsewhere.2-4 On the other hand paracetamol, taken appropriately, is one
of the safest medications available. We would strongly argue that
restricting access to such a useful drug would be likely to result in far
more harm and misery than it might relieve.
Yours sincerely,
David Griffith, Paul Diggory, Valerie Jones and Anand Mehta
Consultant Physicians - Care of Older People
1) Sheen CL and MacDonald TM. Severity of overdose after restriction
of paracetamol availability. Study’s results conflict with those of other
papers. BMJ 2001; 322: 553 (3March).
2) Medication for Older People (second edition). Royal College of
Physicians London. 1997.
3) Garcia Rodriguez LA and Jick H. Risk of upper gastrointestinal
bleeding and perforation associated with individual non-steroidal anti
inflammatory drugs.
Lancet 1994; 343: 769-772
4) Langman MJS, Weil J, Wainwright P et al. Risks of bleeding peptic
ulcer associated with individual non-steroidal anti-inflammatory drugs.
Lancet 1994; 343: 1075-8.
Availability of Paracetamol
Editor,
We are worried by suggestions that access to paracetamol should be
made more difficult, and even that it should be designated a prescription
only medicine (POM).1 We share the concerns about the effects of
paracetamol taken in overdose. However, making it more difficult for
people needing simple analgesia to gain access to paracetamol may well
cause an increase in mortality and morbidity. Older people would be
especially vulnerable. The importance and wide use of “over the counter”
(OTC) medicines is well-established in older people as well as the general
population.2 The only OTC alternatives for use as simple analgesia are
non-steroidal drugs (NSAIDs) including aspirin. The dangers of such
medications – particularly for older people – have been well documented
elsewhere.2-4 On the other hand paracetamol, taken appropriately, is one
of the safest medications available. We would strongly argue that
restricting access to such a useful drug would be likely to result in far
more harm and misery than it might relieve.
Yours sincerely,
David Griffith, Paul Diggory, Valerie Jones and Anand Mehta
Consultant Physicians - Care of Older People
1) Sheen CL and MacDonald TM. Severity of overdose after restriction
of paracetamol availability. Study’s results conflict with those of other
papers. BMJ 2001; 322: 553 (3March).
2) Medication for Older People (second edition). Royal College of
Physicians London. 1997.
3) Garcia Rodriguez LA and Jick H. Risk of upper gastrointestinal
bleeding and perforation associated with individual non-steroidal anti
inflammatory drugs.
Lancet 1994; 343: 769-772
4) Langman MJS, Weil J, Wainwright P et al. Risks of bleeding peptic
ulcer associated with individual non-steroidal anti-inflammatory drugs.
Lancet 1994; 343: 1075-8.
No competing interests
Competing interests: No competing interests