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module menu icon Cochrane blog

The study triggered further headlines when a Cochrane blog revisited paracetamol's effectiveness. Writing for Evidently Cochrane in August 2016, leading analgesics researcher Professor Andrew Moore said:

€A Cochrane review is unequivocal €“ it doesn't work. Not immediately, not later. At no stage between one and 12 weeks is 4,000mg daily any better than a placebo. Nor does the review find any evidence that it works in chronic back pain either.€10

He also noted that the most recent data on paracetamol use in osteoarthritis indicates the drug has a €barely significant and tiny benefit€ compared to placebo, and €ranks barely above placebo in a network meta-analysis€. Furthermore: €For chronic neuropathic pain an ongoing Cochrane review reveals a complete lack of any evidence for paracetamol at all. Paracetamol is without effect in cancer pain, and it is the poor relation in acute postoperative pain and migraine.€

Turning to safety, Prof Moore's article refers to other research, indicating:

  • Increased mortality in cardiovascular and gastrointestinal events and renal impairment
  • Increased risk of acute liver failure associated with non-overdose levels of paracetamol compared to NSAIDs 
  • A four times increased risk of abnormal liver function tests among people taking paracetamol for chronic pain 
  • Similar adverse event rates for paracetamol and ibuprofen over three months when taken for arthritis.

ACTION POINT

Identify patients with long-term conditions and discuss their OTC pain management

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