Is Acetaminophen Safe for Older Patients With Diabetes?

Acetaminophen use was associated with an increased risk of stroke in nursing home (NH) patients with diabetes, according to the results of a recent study. For those without diabetes, no affect was observed.

In order to challenge the results of recent studies that have suggested a relationship between therapeutic dosage of acetaminophen and increased risk of adverse events and mortality, the researchers conducted a prospective study using data from 5429 participants in the Impact of Educational and Professional Supportive Interventions on Nursing Home Quality Indicators project (IQUARE), a multicenter, individually tailored, nonrandomized controlled trial in NHs in southwestern France.

Rates of myocardial infarction and strokes were observed over an 18-month follow-up period. Of the 5429, 2239 participants were taking, on average, 2352 ± 993 mg of acetaminophen daily.

Overall, the researchers observed no associations between acetaminophen use and the risk of mortality or myocardial infarction. However, in one of the group’s models, acetaminophen use was associated with a significantly increased risk of stroke in patients with diabetes (hazard ratio 3.19).

“Despite old age, polypharmacy, and polymorbidity, acetaminophen was found safe for most, but not all, of our NH study population. Pain management in NHs is a health priority, and acetaminophen remains a good therapeutic choice as a first‐line analgesic. More studies are needed on older diabetic patients,” the researchers concluded.

—Michael Potts

Reference:

Girard P, Sourdet S, Cantet C, et al. Acetaminophen safety: risk of mortality and cardiovascular events in nursing home residents, a prospective study [published online March 26, 2019]. JAGS. https://doi.org/10.1111/jgs.15861.