Where are we now with paracetamol?
BMJ 2015; 351 doi: https://doi.org/10.1136/bmj.h3705 (Published 10 July 2015) Cite this as: BMJ 2015;351:h3705
- James W Dear, senior clinical lecturer1,
- Daniel J Antoine, lecturer2,
- B Kevin Park, professor2
- 1University/British Heart Foundation Centre for Cardiovascular Science, University of Edinburgh, Queen’s Medical Research Institute, Edinburgh EH16 4TJ, UK
- 2MRC Centre for Drug Safety Science, Department of Molecular and Clinical Pharmacology, Institute of Translational Medicine, University of Liverpool, Liverpool, UK
- Correspondence to: J W Dear james.dear{at}ed.ac.uk
When a doctor recommends a new medicine there are questions that a patient would hope to have answered. Will the treatment work for my clinical problem? Are there side effects? How many tablets do I take? Paracetamol was introduced into UK medical practice in 1956. It is the most widely used and prescribed drug in the UK and is generally considered to be effective and safe in therapeutic doses. In recent years, however, studies have raised questions regarding its efficacy and safety.1 2 Where are we with regard to the patient’s three questions?
Will the treatment work for my clinical problem?
Paracetamol is recommended in guidelines produced by agencies such as the UK National Institute for Health and Care Excellence. It is an effective mild analgesic but may not work for all types of pain. Paracetamol is effective for postoperative dental pain.3 For headache, it is superior to placebo but less effective than other analgesics.4 For the common cold, the evidence is insufficient to draw conclusions.5 Randomised trial data report that paracetamol is no more effective than placebo for back pain.2 For hip …
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