Acetaminophen, also known as paracetamol or the brand name Tylenol, may come with added health risks, according to a new study.
The drug, which is commonly used as a painkiller or an ingredient in other medications, was associated with an increased risk of ulcers, heart failure, high blood pressure and chronic kidney disease.
This is according to a study by scientists at the University of Nottingham, England, looking at repeated prescribed doses of the painkiller among older adults.
"Due to its perceived safety, paracetamol has long been recommended as the first line drug treatment for osteoarthritis by many treatment guidelines, especially in older people who are at higher risk of drug-related complications," said Professor Weiya Zhang, biomedical researcher at Nottingham and lead author of the study, in a statement.
"Whilst further research is now needed to confirm our findings, given its minimal pain-relief effect, the use of paracetamol as a first line painkiller for long-term conditions such as osteoarthritis in older people needs to be carefully considered."
However, that's not to say that taking this medication is unsafe, nor that everybody should now be wary of it.
Professor Alan Silman, epidemiologist and rheumatologist at the University of Oxford, told Newsweek: "Acetaminophen is one of the most widely used painkillers worldwide. It is available over the counter and in normal doses is extremely well tolerated and particularly proved to be a very useful painkiller for self-medication."
He said there were some limitations with the Nottingham study, for instance the scientists only looked at adults aged 65 and older who were repeatedly prescribed acetaminophen by their doctor—not those who might buy the painkiller without a prescription, as many people do.
"The results of this study—suggesting there may be some increases in risk of, for example, gastrointestinal bleeding—are of interest, but these are small increases in the incidence of rare events," said Silman, adding that the increased risk associated with acetaminophen may be partly due to "methodological issues."
The study was only observational, so the scientists found a correlation between acetaminophen prescription and certain health effects, but this does not mean the medication caused that increased risk.
The Nottingham scientists analyzed the health records of more than 180,000 older adults who had been prescribed acetaminophen at least twice during a six-month period.
They then compared the health outcomes of these people with more than 400,000 adults of the same age who had not been repeatedly prescribed acetaminophen.
The study found an increased risk of health complications related to the gut, heart, blood and kidneys in the group who had been prescribed the acetaminophen.
"Official guidance for the use of painkillers, including over the counter, is always to use the smallest dose for the shortest possible time," said Silman. "Predominantly safe painkillers such as acetaminophen are rightly available over the counter to relieve symptoms, but patients should always read the accompanying information carefully and report any problems to their general practitioner."
Newsweek has reached out to Tylenol for comment via telephone.
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Reference
Kaur, J., Nakafero, G., Abhishek, A., Mallen, C., Doherty, M., Zhang, W. (2024). Incidence of side effects associated with acetaminophen in people aged 65 years or more: a prospective cohort study using data from the Clinical Practice Research Datalink, Arthritis Care & Research. https://doi.org/10.1002/acr.25471
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