Paracetamol: not as safe as we thought? A systematic literature review of observational studies

Annals of the Rheumatic Diseases
Emmert RobertsPhilip G Conaghan

Abstract

We conducted a systematic literature review to assess the adverse event (AE) profile of paracetamol. We searched Medline and Embase from database inception to 1 May 2013. We screened for observational studies in English, which reported mortality, cardiovascular, gastrointestinal (GI) or renal AEs in the general adult population at standard analgesic doses of paracetamol. Study quality was assessed using Grading of Recommendations Assessment, Development and Evaluation. Pooled or adjusted summary statistics were presented for each outcome. Of 1888 studies retrieved, 8 met inclusion criteria, and all were cohort studies. Comparing paracetamol use versus no use, of two studies reporting mortality one showed a dose-response and reported an increased relative rate of mortality from 0.95 (0.92 to 0.98) to 1.63 (1.58 to 1.68). Of four studies reporting cardiovascular AEs, all showed a dose-response with one reporting an increased risk ratio of all cardiovascular AEs from 1.19 (0.81 to 1.75) to 1.68 (1.10 to 2.57). One study reporting GI AEs reported a dose-response with increased relative rate of GI AEs or bleeds from 1.11 (1.04 to 1.18) to 1.49 (1.34 to 1.66). Of four studies reporting renal AEs, three reported a dose-response with o...Continue Reading

References

Oct 24, 2002·Archives of Internal Medicine·Gary C CurhanMeir J Stampfer
Nov 2, 2002·Hypertension·Julien DedierGary C Curhan
Aug 6, 2003·American Journal of Kidney Diseases : the Official Journal of the National Kidney Foundation·Tobias KurthJ Michael Gaziano
Sep 5, 2003·Journal of Clinical Epidemiology·Loren LipworthJørgen H Olsen
Dec 3, 2003·Annals of the Rheumatic Diseases·K M JordanUNKNOWN Standing Committee for International Clinical Studies Including Therapeutic Trials ESCISIT
Jul 28, 2004·Archives of Internal Medicine·Gary C CurhanMeir J Stampfer
Jan 22, 2009·Nephrology, Dialysis, Transplantation : Official Publication of the European Dialysis and Transplant Association - European Renal Association·Marie EvansCarl-Gustaf Elinder
Jul 28, 2009·Journal of Clinical Epidemiology·David MoherUNKNOWN PRISMA Group
Aug 19, 2010·British Journal of Clinical Pharmacology·Frank de VriesTjeerd-Pieter van Staa
Nov 1, 2011·Annals of the Rheumatic Diseases·Burkhard Hinz, Kay Brune
Apr 1, 2014·Expert Review of Clinical Pharmacology·Marissa BliedenRami Ben-Joseph
Jul 30, 2014·Lancet·Christopher M WilliamsChung-Wei Christine Lin

❮ Previous
Next ❯

Citations

Dec 15, 2015·Drugs & Aging·Leticia A Deveza, David J Hunter
Apr 23, 2016·Annals of Physical and Rehabilitation Medicine·Christelle NguyenFrançois Rannou
May 7, 2016·Nature Reviews. Endocrinology·David M KristensenBernard Jégou
May 21, 2016·Thérapie·Caroline Saint-MartinThierry Trenque
Apr 22, 2015·Annals of the Rheumatic Diseases·Romain J Forestier, Fatma Begum Erol Forestier
Jun 29, 2015·Autoimmunity Reviews·I HollanP L Meroni
May 12, 2016·Annals of the Rheumatic Diseases·Alessandro BattaggiaFrancesco Lapi
Oct 14, 2016·Nature Reviews. Disease Primers·Johanne Martel-PelletierJean-Pierre Pelletier
Nov 16, 2016·Current Medical Research and Opinion·Hans Georg Kress, Gerald Untersteiner
Mar 23, 2017·Current Medical Research and Opinion·Giustino VarrassiCarmelo Scarpignato
Mar 22, 2016·Lancet·Nicholas MooreSinem Ezgi Gulmez
Apr 28, 2017·British Journal of Pharmacology·Anthony Kenneth Peter Jones, Christopher Andrew Brown
Jun 27, 2017·Journal of Gerontological Nursing·Paul ArnsteinHoward K Butcher
Aug 5, 2017·The Cochrane Database of Systematic Reviews·Tess E CooperChristopher Eccleston
Dec 28, 2016·The Cochrane Database of Systematic Reviews·Philip J WiffenR Andrew Moore
Feb 15, 2018·Journal of Psychopharmacology·Emmert RobertsAllan H Young
Oct 11, 2016·Therapeutic Advances in Musculoskeletal Disease·Anne TournadreMartin Soubrier
Jul 7, 2017·SLAS Discovery·David A Walsh, Joanne Stocks
Jun 9, 2016·The Cochrane Database of Systematic Reviews·Bruno T SaragiottoChristopher G Maher
Jul 13, 2017·The Cochrane Database of Systematic Reviews·Philip J WiffenBee Wee
Mar 4, 2018·Drug Safety : an International Journal of Medical Toxicology and Drug Experience·Ian C ScottDavid L Scott
Jun 5, 2018·British Journal of Clinical Pharmacology·J C McCraeD J Webb
Jun 16, 2018·Drug and Therapeutics Bulletin
Jan 25, 2017·Arthritis Care & Research·Cyrus CooperJean-Yves Reginster
Mar 17, 2016·Stroke; a Journal of Cerebral Circulation·Jaime Gonzalez-ValcarcelUNKNOWN PERFORM Investigators
Aug 30, 2018·Annals of the Rheumatic Diseases·Margreet KloppenburgLoreto Carmona
Jan 9, 2019·Expert Review of Clinical Pharmacology·Marco SchreijenbergChung-Wei Christine Lin
Mar 9, 2018·British Journal of Sports Medicine·Adrian C TraegerChris G Maher
Jun 7, 2015·BMC Pharmacology & Toxicology·Per-Jostein SamuelsenAnne Elise Eggen
May 25, 2016·Nature Reviews. Rheumatology·David J Hunter, Manuela L Ferreira
Apr 21, 2019·International Journal of Molecular Sciences·Laura MicheliLorenzo Di Cesare Mannelli
Sep 15, 2019·Journal of the American Geriatrics Society·Philippe GirardYves Rolland

❮ Previous
Next ❯

Software Mentioned

Review Manager

Related Concepts

Trending Feeds

COVID-19

Coronaviruses encompass a large family of viruses that cause the common cold as well as more serious diseases, such as the ongoing outbreak of coronavirus disease 2019 (COVID-19; formally known as 2019-nCoV). Coronaviruses can spread from animals to humans; symptoms include fever, cough, shortness of breath, and breathing difficulties; in more severe cases, infection can lead to death. This feed covers recent research on COVID-19.

Blastomycosis

Blastomycosis fungal infections spread through inhaling Blastomyces dermatitidis spores. Discover the latest research on blastomycosis fungal infections here.

Nuclear Pore Complex in ALS/FTD

Alterations in nucleocytoplasmic transport, controlled by the nuclear pore complex, may be involved in the pathomechanism underlying multiple neurodegenerative diseases including Amyotrophic Lateral Sclerosis and Frontotemporal Dementia. Here is the latest research on the nuclear pore complex in ALS and FTD.

Applications of Molecular Barcoding

The concept of molecular barcoding is that each original DNA or RNA molecule is attached to a unique sequence barcode. Sequence reads having different barcodes represent different original molecules, while sequence reads having the same barcode are results of PCR duplication from one original molecule. Discover the latest research on molecular barcoding here.

Chronic Fatigue Syndrome

Chronic fatigue syndrome is a disease characterized by unexplained disabling fatigue; the pathology of which is incompletely understood. Discover the latest research on chronic fatigue syndrome here.

Evolution of Pluripotency

Pluripotency refers to the ability of a cell to develop into three primary germ cell layers of the embryo. This feed focuses on the mechanisms that underlie the evolution of pluripotency. Here is the latest research.

Position Effect Variegation

Position Effect Variagation occurs when a gene is inactivated due to its positioning near heterochromatic regions within a chromosome. Discover the latest research on Position Effect Variagation here.

STING Receptor Agonists

Stimulator of IFN genes (STING) are a group of transmembrane proteins that are involved in the induction of type I interferon that is important in the innate immune response. The stimulation of STING has been an active area of research in the treatment of cancer and infectious diseases. Here is the latest research on STING receptor agonists.

Microbicide

Microbicides are products that can be applied to vaginal or rectal mucosal surfaces with the goal of preventing, or at least significantly reducing, the transmission of sexually transmitted infections. Here is the latest research on microbicides.