Acetaminophen and gastrointestinal side effects

Evidence Summaries

Level of Evidence = B

Acetaminophen (paracetamol) appears not to increase the risk of gastrointestinal bleeding.

The safety of acetaminophen has been shown in a large number of studies. In a Spanish study of 875 patients with upper gastrointestinal bleeding and 2682 hospital controls 1, the odds ratio for acetaminophen did not significantly differ from 1, but for aspirin it was 7.2 and for piroxicam 19.1.

Comment: The quality of evidence is upgraded by strong association.

The following decision support rules contain links to this evidence summary:


1. Laporte JR, Carné X, Vidal X, Moreno V, Juan J. Upper gastrointestinal bleeding in relation to previous use of analgesics and non-steroidal anti-inflammatory drugs. Catalan Countries Study on Upper Gastrointestinal Bleeding. Lancet 1991 Jan 12;337(8733):85-9.  [PMID:1670734]

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