Paracetamol tablets are the world’s most commonly used painkillers. According to a recent study published in the British journal Annals of the Rheumatic Diseases, prolonged use of the drug can have very harmful side effects. EURACTIV France reports.
The ubiquitous paracetamol tablet may not be as harmless as it first appears. According to a team of British researchers directed by Professeur Philip Conaghan of Leeds hospital, “the medical community has underestimated the risks of taking paracetamol over the long-term”.
With or without a prescription, paracetamol is the most consumed and the most widespread painkiller in the world. In France alone, nearly 500 million packets were sold in 2012.
>> Read: French lead in drugs consumption
“A pharmaceutical product always has side effects,” said Michèle Rivasi, a French MEP and member of the European Parliament Committee on Public Health. “This is why medicines are subject to specific regulation and are not considered a consumer product under law. We should not assume that a product is harmless because it is widely used. An extreme example of this is tobacco: a widespread, but very dangerous product,” she added.
Heart and kidney damage
The researchers examined the risks associated with the overconsumption of paracetamol, and established that long-term consumption of high doses of the drug can be very harmful to patients’ health.
Through a comparison of eight existing studies, the British researchers demonstrated that over-consumption of paracetamol can increase the risk of cardiovascular disease, especially heart attacks and strokes, by 20%.
According to the study published in the journal Annals of the Rheumatic Diseases, regular consumption of high doses of paracetamol can also double the patient’s chances of developing kidney problems.
“The patient’s individual details are the real key. Who knows that someone over 50kg should never exceed the dose of 4g of paracetamol per day?” Michèle Rivasi said. She added that the availability of clinical information used to obtain marketing authorisations should be more transparent. “If we look at the information on a packet of Doliprane or Efferalgan sold in France, neither mentions the cardiovascular risks revealed in the British study,” the MEP said.
Over the counter Vs regulated sale
The Green MEP believes “it is essential that the European Commission discourage member states from selling drugs over the counter”.
Sweden authorised the sale of paracetamol in supermarkets in 2009, and has since reversed the decision. Five years ago, in an effort to make up for the low number of pharmacies in the country (less than 12 per 100,000 inhabitants), the Swedish government authorised the sale of paracetamol by tobacconists, service stations and other shops.
Since the end of the pharmacy monopoly, “the number of hospitalisations for paracetamol overdoses has more than doubled,” according to the International Journal of Medicine. The over the counter sale of paracetamol led to such a rise in hospitalisations for poisoning in Sweden that the government decided to reverse their decision last October, once again restricting the sale of all medicines to pharmacies. A paracetamol overdose can cause sudden kidney failure, and is also a common means of attempted suicide in the United Kingdom.
>> Read: Self-medication on the rise in Europe (in French)
French policy is moving in the opposite direction. The sale of paracetamol may soon be authorised in the country’s supermarkets. In a survey carried out by Ipsos for the supermarket chain E.Leclerc, 54% of people questioned said they would buy non-prescription medicines from shops other than pharmacies. But the debate is ongoing, as Marisol Touraine, the French Minister for Health, is in favour of retaining the pharmacy monopoly on medicine sales.
Access to medication varies from one member state to another. In France, all medicines must be bought from a pharmacy, with or without a prescription. But in other countries, like the United Kingdom, non-prescription drugs can be sold off the shelf in supermarkets. This means patients are free to buy medicines like paracetamol without receiving any advice from their pharmacist. The Swedish government legalised the sale of medicines in supermarkets in 2009, but back-tracked in October 2014 following a sharp rise in cases of paracetamol poisoning.