Paracetamol is known worldwide as the 'most commonly used drug.' As an over-the-counter medication, meaning it does not need a prescription to dispense, paracetamol is frequently bought and used by people for adults and kids alike.
Paracetamol is very popular for alleviating fever and some acute pains, e.g., headache, toothache, etc. Sometimes, it can be utilised for chronic pain, e.g., osteoarthritis, as well. The reason it’s so popular is it has a very good safety profile; even pregnant and breastfeeding women are sometimes prescribed paracetamol (caution: consult a physician before providing any medication to the expecting or nursing mothers). Paracetamol can reduce the fever of children who are as early as 02 months old.
Because Paracetamol can be bought without a prescription, and due to its traditional use as a drug to manage fever and mild pain, it is found in almost all houses in Bangladesh. Headache? Tooth pain? Back pain? No worries, just take some paracetamol! But popping paracetamol like candies is not a healthy thing to do.
Despite a good safety profile, we must understand that paracetamol entails side effects like other drugs. There could be allergies, lower count of blood cells, fast heartbeats and many other adverse effects.
Long-term use or overdose (e.g., 8 or more tablets/day) are very dangerous, leading to liver failure. The primary cause of liver failure in the USA is paracetamol overdose, with a high mortality rate. In 2015, Health Authorities in Australia and New Zealand issued alerts about paracetamol-induced liver damage in children.
Similar incidents happened in Bangladesh before. Researchers from the University of Edinburgh conducted a study. They identified that paracetamol has the potential to damage the liver in the long run. More alarming news was published in British Medical Journal in 2015, where scientists showed evidence that regular large daily doses over a few years can increase the risk of heart and kidney problems and raise the chance of death.
The link between long-term regular paracetamol consumption with heart disease, high blood pressure and stroke has also been emphasised by British Heart Foundation. One of their investigators, Professor David Webb of the University of Edinburgh, said that if the patient needs to take paracetamol long-term to avoid such issues, it is best to start with a low dose and increase it gradually over time.
But does it mean we shouldn’t take paracetamol? Of course not! We should be cautious and use it judiciously. If need be, we can always seek medical assistance before using this drug.
Patients should regularly review whether there is an ongoing need to take a medication, even if it is something like paracetamol. There should always be a weighing of benefits and risks. Dr Nilesh made it clear that the occasional use of ≤3 days to manage a headache or other acute pain if perfectly fine unless we take too many tablets. If we need to use paracetamol longer than 03 days to control the pain, it is better to reach out to a physician.
We must be cautious when using any drug, including paracetamol. The medicines usually come with a leaflet with relevant information about the drug; this should be read. The safest thing to do, however, is to talk to the doctor and get checked out.