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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