Paracetamol should be preferred OTC analgesic
Paracetamol remains a better option than non-steroidal anti-inflammatory drugs (NSAIDs) for most patients requiring an over-the-counter analgesic.
So says the author of one of six papers covering the topic of analgesia
published
in the American Journal of Therapeutics this week.
The author outlines the safety considerations that need to be taken into
account with the use of NSAIDs, even at OTC doses, such as adverse effects
and contraindications in patients groups such as the elderly.
The author refers to a UK survey of
555 customers who had purchased ibuprofen from a community pharmacy.
One week after purchasing the drug, 32 per cent were
still taking it and 8 per cent had exceeded
the recommended daily dose at least once. Furthermore, the drug had been
taken by
4 per cent of people who had a current
or previous peptic ulcer and by 7 per cent of people with asthma or a
history of asthma.
He concludes that despite the risk of
hepatotoxicity in overdose, paracetamol
remains a better option than NSAIDs for OTC analgesia (2005;12:67).
Other papers include a report on the evidence of paracetamol interacting
with other drugs. It says that apart from increased risk of hepatoxocity
in overdose, and some controversy surrounding an interaction with
warfarin, paracetamol has no other confirmed serious drug interactions
(ibid p56).
A further paper analysing the use of analgesics for osteoarthritis in
primary and secondary care says that practice guidelines are generally
followed and that paracetamol is still seen as the cornerstone of osteoarthritis
treatment (ibid p98). |
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Pharmaceutical Journal
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