ReviewBritish journal of clinical pharmacology2018
Long-term adverse effects of paracetamol - a review.
Review in British journal of clinical pharmacology, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 117 papers, 5 of them syntheses that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
117 citing papers in PubMed, 5 syntheses or guidelines pooled it.
- The nature of self-medication in Uganda: a systematic review and meta-analysis.BMC public health · 2025Pooled it
- Effects of major analgesics on male fertility: A systematic literature review.JBRA assisted reproduction · 2024Pooled it
- Nonpharmacological approaches for pain and symptoms of depression in people with osteoarthritis: systematic review and meta-analyses.Scientific reports · 2023Pooled it
- Systematic review of guideline-recommended medications prescribed for treatment of low back pain.Chiropractic & manual therapies · 2022Pooled it
- Safety and efficacy of mesotherapy in musculoskeletal disorders: A systematic review of randomized controlled trials with meta-analysis.Journal of rehabilitation medicine · 2021Pooled it
- Comparison of analgesic effectiveness between nefopam and propacetamol in living kidney donors following rectus sheath block after hand-assisted living donor nephrectomy: a prospective, randomized controlled trial.BMC anesthesiology · 2024Trial
- Intermittent intravenous paracetamol versus continuous morphine in infants undergoing cardiothoracic surgery: a multi-center randomized controlled trial.Critical care (London, England) · 2024Trial
- Efficacy of auriculotherapy in the control of pain, edema, and trismus following surgical extraction of the lower third molars: a split-mouth, randomized, placebo-controlled, and triple-blind study.Oral and maxillofacial surgery · 2024Trial
- Trial
- Fused Azine Derivatives Mitigate Long-Term Paracetamol-Induced Liver Fibrosis in Mice: Role of JNK1/ASK1 and Nrf2/HO-1 Signaling Pathways.Inflammation · 2026Article
- Paracetamol: A History of Assumptions, Errors, and Evidence Reversals in Pain Management.Current pain and headache reports · 2026Review
- Vestitol Ameliorates Ferroptosis-Associated Features and Osteoarthritis Progression Through Modulation of the GSK3B/Nrf2/GPX4 Pathway.Cell biochemistry and biophysics · 2026Article
- Quantifying the Equine Pain Response to Paracetamol Administration in Horses With Chronic Lameness Already Receiving Non-Steroidal Anti-Inflammatories.Veterinary medicine and science · 2026Article
- Metal nanocrystals and nanoclusters with paracetamol passivation and for paracetamol detection: a critical review.Nanoscale advances · 2026Review
- Paracetamol as analgesic and risk of bronchopulmonary dysplasia in extremely preterm infants: a secondary analysis of the BeNeDuctus trial.Pediatric research · 2026Article
- Gestational Paracetamol (Acetaminophen) Toxicity Induces Behavioral and Structural Brain Defects in Rats.Current issues in molecular biology · 2026Article
- Review
- Association of serum acetaminophen levels with hepatorenal toxicity: A prospective observational study in Tripura, India.Indian journal of pharmacology · 2026Observational
- Optimizing Recovery After Thoracotomy: Evidence-Based Non-Opioid and Multimodal Analgesia - A Narrative Review.Current pain and headache reports · 2026Review
- Supervised machine learning model to predict total knee replacement in a large osteoartrhitis real-world evidence dataset using retrospectively 20-year insurance data from Israel.BMC medical informatics and decision making · 2026Article
57 more citing papers are in PubMed but not listed here.
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
5 authors.
Funding
Abstract
Paracetamol (acetaminophen) is the most commonly used drug in the world, with a long record of use in acute and chronic pain. In recent years, the benefits of paracetamol use in chronic conditions has been questioned, notably in the areas of osteoarthritis and lower back pain. Over the same period, concerns over the long-term adverse effects of paracetamol use have increased, initially in the field of hypertension, but more recently in other areas as well. The evidence base for the adverse effects of chronic paracetamol use consists of many cohort and observational studies, with few randomized controlled trials, many of which contradict each other, so these studies must be interpreted with caution. Nevertheless, there are some areas where the evidence for harm is more robust, and if a clinician is starting paracetamol with the expectation of chronic use it might be advisable to discuss these side effects with patients beforehand. In particular, an increased risk of gastrointestinal bleeding and a small (~4 mmHg) increase in systolic blood pressure are adverse effects for which the evidence is particularly strong, and which show a degree of dose dependence. As our estimation of the benefits decreases, an accurate assessment of the harms is ever more important. The present review summarizes the current evidence on the harms associated with chronic paracetamol use, focusing on cardiovascular disease, asthma and renal injury, and the effects of in utero exposure.
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Identifiers
What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.