- Safety & Recalls
- Regulatory Updates
- Drug Coverage
- COPD
- Cardiovascular
- Obstetrics-Gynecology & Women's Health
- Ophthalmology
- Clinical Pharmacology
- Pediatrics
- Urology
- Pharmacy
- Idiopathic Pulmonary Fibrosis
- Diabetes and Endocrinology
- Allergy, Immunology, and ENT
- Musculoskeletal/Rheumatology
- Respiratory
- Psychiatry and Behavioral Health
- Dermatology
- Oncology
Study finds acetaminophen increases blood pressure in patients with coronary artery disease
The commonly used pain reliever-acetaminophen-causes a significant increase in blood pressure in patients with pre-existing coronary artery disease, according to a randomized controlled trial published ahead of print in the October 18, 2010, Circulation.
The commonly used pain reliever-acetaminophen-causes a significant increase in blood pressure in patients with pre-existing coronary artery disease (CAD), according to a randomized controlled trial published ahead of print in the October 18, 2010, Circulation.
Traditional nonsteroidal anti-inflammatory drugs have been associated with increased risk for acute cardiovascular events. Consequently, current treatment guidelines recommend acetaminophen as the first-line analgesic of choice on the assumption of its greater cardiovascular safety. "This study demonstrates for the first time a significant increase in ambulatory blood pressure in patients with CAD treated with acetaminophen," the researchers emphasized. "Thus, the use of acetaminophen should be evaluated as rigorously as traditional nonsteroidal anti-inflammatory drugs and cyclooxygenase-2 (COX-2) inhibitors, particularly in patients at increased cardiovascular risk."
In this trial, researchers randomly administered acetaminophen at a dose of 1 g 3 times daily followed by matching placebo, or the reverse, to 33 patients with CAD as part of a cross-over trial. All patients received each therapy for a 2-week period and remained on their standard of care cardiovascular drugs. The study demonstrated that acetaminophen resulted in a significant increase in mean systolic (from 122.4 ± 11.9 to 125.3 ± 12.0 mmHg, P=.02 versus placebo) and diastolic (from 73.2 ± 6.9 to 75.4 ± 7.9 mmHg, P=.02 versus placebo) blood pressures. Acetaminophen was not found to significantly affect other cardiovascular safety markers including heart rate, platelet, or endothelial cell function (P>.05 for all).
William B. White, MD, a hypertension expert from the University of Connecticut School of Medicine, concurred with the researchers' conclusions, stressing, "Despite broad recommendations to use acetaminophen as first-line therapy for pain and arthritis in patients with heart and vascular disease, the agent is simply not that effective, and as supported by new findings by Sudano et al, a lot more is unknown about this drug from a cardiovascular safety perspective than we know about the conventional NSAIDs and selective COX-2 inhibitors."
The researchers conclude their paper by noting that acetaminophen's highly prevalent use and the blood pressure increases observed in their study suggest "a major public health concern."
SOURCES
Sudano I, Flammer AJ, Périat D, et al. Acetaminophen increases blood pressure in patients with coronary artery disease. Circulation. 2010;Oct 18. [Epub ahead of print]
White WB, Campbell P. Blood pressure destabilization on nonsteroidal antiinflammatory agents: acetaminophen exposed? Circulation. 2010;Oct 18. [Epub ahead of print]
Coalition promotes important acetaminophen dosing reminders
November 18th 2014It may come as a surprise that each year Americans catch approximately 1 billion colds, and the Centers for Disease Control and Prevention estimates that as many as 20% get the flu. This cold and flu season, 7 in 10 patients will reach for an over-the-counter (OTC) medicine to treat their coughs, stuffy noses, and sniffles. It’s an important time of the year to remind patients to double check their medicine labels so they don’t double up on medicines containing acetaminophen.
Support consumer access to specialty medications through value-based insurance design
June 30th 2014The driving force behind consumer cost-sharing provisions for specialty medications is the acquisition cost and not clinical value. This appears to be true for almost all public and private health plans, says a new report from researchers at the University of Michigan Center for Value-Based Insurance Design (V-BID Center) and the National Pharmaceutical Council (NPC).
Management of antipsychotic medication polypharmacy
June 13th 2013Within our healthcare-driven society, the increase in the identification and diagnosis of mental illnesses has led to a proportional increase in the prescribing of psychotropic medications. The prevalence of mental illnesses and subsequent treatment approaches may employ monotherapy as first-line treatment, but in many cases the use of combination of therapy can occur, leading to polypharmacy.1 Polypharmacy can be defined in several ways but it generally recognized as the use of multiple medications by one patient and the most common definition is the concurrent use of five more medications. The presence of polyharmacy has the potential to contribute to non-compliance, drug-drug interactions, medication errors, adverse events, or poor quality of life.
Medical innovation improves outcomes
June 12th 2013I have been diagnosed with stage 4 cancer of the pancreas, a disease that’s long been considered not just incurable, but almost impossible to treat-a recalcitrant disease that some practitioners feel has given oncology a bad name. I was told my life would be measured in weeks.
