Exactly who should consult a doctor before taking paracetamol for pain relief
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Paracetamol, a widely-used over-the-counter drug, is well-known for its effectiveness in relieving various aches, pains, and flu symptoms. In the UK alone, approximately 200 million packets are purchased annually without a prescription.

However, it is important to acknowledge that paracetamol may not be suitable for everyone. The NHS advises that five specific groups should consult with a doctor or pharmacist before using this medication.

These groups include individuals with a history of allergic reactions to paracetamol or any other medicines, as well as those who have liver or kidney problems. According to official guidelines, it also encompasses the following:

  1. People who take certain medications
  2. People with liver or kidney problems
  3. Anyone who regularly drinks more than the maximum amount of alcohol recommended (14 units per week)
  4. People who weigh less than 50kg (eight stone) might require a lower dosage
  5. Anyone who has ever had an allergic reaction to paracetamol or another medicine

“Most individuals over the age of 16 can take paracetamol. It is also safe to use during pregnancy or while breastfeeding,” states NHS guidance. “Paracetamol can start working in up to an hour and continues to be effective for about five hours.”

While paracetamol is typically safe to use with most prescription medications and antibiotics, there are certain exceptions. If you are on warfarin to prevent blood clots, or medications for epilepsy or tuberculosis, it is advisable to consult a doctor before taking paracetamol.

Regarding other painkillers, the NHS advises: “It is safe to take paracetamol alongside painkillers that do not contain paracetamol, such as ibuprofen, aspirin, or codeine.

“Do not take paracetamol alongside other medicines that contain paracetamol. If you take two different medicines that contain paracetamol, there’s a risk of overdose.”

Typical adults can take two 500mg tablets, four times in 24 hours, with at least four hours between doses. It is advised not to exceed eight tablets within this period.

Although paracetamol is therefore considered safe in most circumstances, this advice comes shortly after a University of Nottingham study raised concerns about its long-term use. Published last November, the research indicated that repeated doses in elderly patients might increase the risk of heart, gastrointestinal, and kidney issues.

During their investigation, scientists analysed medical records from 180,483 people aged 65 and over who had been prescribed paracetamol. They compared them with 402,478 similar-aged people who had not used the medication.

The results were alarming, showing that ‘prolonged paracetamol use’ can substantially increase the risk of ‘serious complications’ such as heart failure, high blood pressure, stomach ulcers, and chronic kidney disease. The research team subsequently urged a ‘careful reconsideration’ of prescribing paracetamol as a first-choice treatment for long-term pain management.

Lead author Professor Weiya Zhang explained at the time: “Whilst further research is now needed to confirm our findings, given its minimal pain-relief effect, the use of paracetamol as a first-line pain killer for long-term conditions such as osteoarthritis in older people needs to be carefully considered.”

For more information on paracetamol, visit the NHS website.

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