“Acetaminophen isn’t free from cardio risk”

Acetaminophen may raise blood pressure
For people with cardiovascular disease who need relief from aches and pains, acetaminophen (Tylenol and its generic cousins) has long been touted as a “safer” alternative to aspirin or nonsteroidal anti-inflammatory drugs (NSAIDs) like ibuprofen. See list of current products containing acetaminophen click here.

Other side effects of acetaminophen include

Some side effects can be serious. If you experience any of the following symptoms, call your doctor immediately:

  • rash
  • hives
  • itching
  • swelling of the face, throat, tongue, lips, eyes, hands, feet, ankles, or lower legs
  • hoarseness
  • difficulty breathing or swallowing

Swiss research study warns that it you should be cautious that it  as with all medication. Acetaminophen isn’t free from cardiovascular side effects. It is worth a try as a first-line drug for pain relief, but it can have negative effect on your blood pressure.
Acetaminophen under the microscope
The Swiss team found that the people suffering  with

  • blood pressure of people with coronary artery disease,
  • angina (chest pain with exercise or stress)
  • anyone who has had bypass surgery or angioplasty
  • those with cholesterol-clogged arteries.

The study

33 men and women with one or more of the health problems listed above

took 1,000 milligrams (mg) of acetaminophen

or

an identical placebo three times a day for two weeks.

Then, after a two-week break, each volunteer took the other treatment. The amount of acetaminophen used in the study is a standard daily dose for pain.

Results
When the participants took acetaminophen, average systolic blood pressure (the top number of a blood pressure reading) increased from 122.4 to 125.3, while the average diastolic pressure (the bottom number) increased from 73.2 to 75.4. Blood pressure stayed steady when participants took the placebo. These increases aren’t large. But they indicate that acetaminophen, like NSAIDs, somehow affects the cardiovascular system. A larger, longer trial would have given more reliable results. It would also have been unethical, since none of the participants were in pain. That means they couldn’t reap any benefit from acetaminophen, but could only be harmed by it.

Making choices
The sudden removal of the popular painkiller Vioxx from the market in October 2004 over concerns that it caused cardiovascular problems put all pain relievers under the spotlight — except acetaminophen. It avoided the “black box” warning about increased risk of cardiac problems that the FDA now requires on the labels of all NSAIDs. And the American Heart Association later recommended it as a safe alternative to NSAIDs.

Acetaminophen is easier on the stomach than aspirin and other NSAIDs, and is probably a good option for people who take warfarin (Coumadin, Jantoven, generic) or clopidogrel (Plavix). But because it is so widely used and perceived as safe, people tend to take it without thinking, one reason acetaminophen is a leading cause of liver failure and transplantation in the United States.
If you have some form of cardiovascular disease, it makes sense to take acetaminophen rather than an NSAID for a fever, headache, pulled muscle, or other occasional problem. But if you need relief every day for pain from osteoarthritis or rheumatoid arthritis, acetaminophen may not be a better option than an NSAID — it doesn’t work that well against inflammatory pain and, like an NSAID, may slightly elevate blood pressure.

The key message from this study is that acetaminophen isn’t free from cardiovascular side effects. It is worth a try as a first-line drug for pain relief, but if it doesn’t control your pain, it is reasonable to switch to an NSAID.

Resources
Excerpts provided courtesy of   http://hvrd.me/fbVSUy

Excerpts provided courtesy of   http://1.usa.gov/ihr61A

Image 1. courtesy of acetaminophen-300×202.jpg

Image 2. courtesy of   http://bit.ly/jFBzjQ

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