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NICE keeps paracetamol in UK guidelines on osteoarthritis

BMJ 2014; 348 doi: https://doi.org/10.1136/bmj.g1545 (Published 14 February 2014) Cite this as: BMJ 2014;348:g1545
  1. Jacqui Wise
  1. 1London

New guidance on osteoarthritis from the National Institute for Health and Care Excellence has stressed the importance of exercise, but it has left paracetamol (acetaminophen) unchanged as a first line analgesia option—despite the draft guidelines having said that it should be avoided.1

The draft guidelines, published last August, recommended that paracetamol should not routinely be offered as it may not help to relieve the symptoms of osteoarthritis and because taking the maximum daily dose over a long period may be linked to side effects.

But the Royal College of General Practitioners, the Primary Care Rheumatology Society, and the British Society for Rheumatology raised concerns that removing paracetamol as an analgesia option could result in the increased use of oral non-steroidal anti-inflammatory drugs (NSAIDs) and opiates.

Mark Baker, director of the centre for clinical practice at NICE, said that the institute had decided to leave unchanged its recommendations on the pharmacological management of …

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