Many people with ongoing pain take acetaminophen (Tylenol, others) for relief. It’s often considered safer than other pain relievers, such as nonsteroidal anti-inflammatory drugs (NSAIDs, Advil, etc.), when taken long-term. But recent studies have raised questions about acetaminophen’s safety. A new study suggests that the drug may be associated with serious complications in people 65 and older. The study, published in Arthritis Care & Research, used data from the U.K.’s Clinical Practice Research Datalink to compare about 180,000 people who had two or more prescriptions for acetaminophen in a six-month period with about 400,000 people who had fewer than two prescriptions for acetaminophen over the same time span. Those who had two or more prescriptions had a 36% increased risk of gastrointestinal bleeding, a 20% increased risk of peptic ulcers, a 19% increased risk of chronic kidney disease, and single digit increases in heart failure and high blood pressure risks. The study looked at long-term, repeated use of acetaminophen — not taking it for short-term pain such as headache. And the study had an important limitation: It was not able to identify or track use of nonprescription acetaminophen, so it’s possible that people from both groups took the drug on their own.
In the U.K., people over 65 receive free acetaminophen if they have a prescription, but they have to pay for a nonprescription purchase. The researchers accounted for the possibility that people who are more likely to take acetaminophen also may be more likely to take non-prescription NSAIDs such as ibuprofen and naproxen. Mayo Clinic experts say that acetaminophen remains an important option for chronic pain and that more research is needed to understand how it may affect older adults. Talk with your healthcare team to determine the lowest dose that works to relieve your pain. Don’t take more than the recommended dose, and don’t drink alcohol while taking acetaminophen because that raises the risk of kidney or liver damage over time.
CONCLUSION
Although Tylenol is a reasonably safe drug, as in the case of almost all drugs, one should take as little as possible for as brief as possible.
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