Paracetamol, the UK's most popular over-the-counter painkiller, is facing renewed scrutiny over its safety and effectiveness. Despite being widely regarded as cheap and safe, recent studies suggest that long-term use may cause serious side-effects, including internal bleeding, liver damage, and rare but severe skin reactions.
In 2013, GPs wrote 22.5 million prescriptions for paracetamol, and around 200 million packets are sold annually. However, research by Professor Michael Doherty at Nottingham University found that one in five patients taking paracetamol for chronic knee pain experienced internal bleeding, a rate comparable to those taking ibuprofen. Dr John Dickson, a retired GP, warns that paracetamol can cause kidney and liver problems and gastrointestinal bleeding.
The US Food and Drug Administration has issued warnings about rare but potentially fatal skin conditions linked to paracetamol, including Stevens-Johnson Syndrome. In the UK, the National Institute for Health and Care Excellence initially advised against prescribing paracetamol for osteoarthritis due to limited benefit and links to cardiovascular, gastrointestinal, and renal issues, but later reversed its stance pending a review by the Medicines and Healthcare Products Regulatory Agency.
Experts caution that accidental overdose is easy, as many cold and flu products contain paracetamol. The maximum 24-hour dose is 4g, but as little as 5g can cause liver complications. Professor Andrew Moore of Oxford University notes that people often do not check labels, risking unintentional overdose.
