New research published in JAMA Network Open and Highlighted by ETH News
This research led by PhD Candidate Adrian Martinez de la Torre identified that there was an increase in the number of paracetamol-related poisonings reported to the National Poisong Centre in Switzerland following the availability of high-dose 1,000 milligram (1 gram) oral paracetamol tablets.
This National study of Swiss data found that paracetamol-related poisonings significantly increased following the availability of the high-dose 1000 milligram (mg) or 1 gram (g) paracetamol tablets in October 2003. There was a rapid uptake of the 1,000-mg tablets with the total tablets sold surpassing the 500-mg sales in 2005, only 2-years after market entry. And since 2012, the 1,000-mg tablets have outsold the 500-mg tablets in a 10-1 ratio. Following 2005, when the 1,000-mg tablets outsold the 500-mg tablets, there was a marked 40% increase in poisoning cases within just three years, going from 561 cases in 2005 to 786 cases in 2008. Additionally, there was a higher proportion of poisonings above 10,000 milligrams among those with the 1,000 milligram tablets than with the 500 milligram tablets.
With accumulating evidence of the potential for harm with high-doses of paracetamol, public health measures restricting the availability of 1,000-mg tablets to community-dwelling patients should be considered. In particular, the use of 500 milligram tablets should replace the 1,000 milligram tablets, as these can be dose adjusted when medically needed to reach higher doses but can minimize the risk of reaching toxic doses that can lead to irreversible liver damage and death.
This research was conducted in collaboration with external pagePharmaSuissecall_made and the external pageNational Poison Centrecall_made (Tox Info Suisse). To read more on this work please see the following links:
external pageFull research article published by JAMA Network Opencall_made
ETH News article
external pagePharmaJournal articlecall_made