Fizzy paracetamol and risk of death in the elderly

Sodium-containing acetaminophen (fizzy or soluble drug preparations) was associated with increased cardiovascular and mortality risk in older people, according to a report sounding the alarm on the potential dangers of fast-acting prescription and over-the-counter drugs alike.

A large U.K. database of electronic health records revealed significant excess in 1- year incidence of myocardial infarction, stroke, and heart failure associated with sodium-containing acetaminophen therapy use compared with standard formulations:

A 59% relative increase in risk for those with hypertension (5.6% vs 4.6%)

A 45% relative increase in risk for those without hypertension (4.4% vs 3.7%)

All-cause mortality risk over 1 year was twofold elevated in the hypertension patients taking sodium-containing acetaminophen and 87% elevated in users without hypertension. Risk increased in step with more prescriptions and longer durations of use of these medications, according to the study authors.

Similar risks were observed for the subgroups of patients also using sodium- containing ibuprofen or ranitidine.

Eur Heart J 2022