Table 1.

Increased risk of adverse outcomes with frequent paracetamol dosing

Adverse outcomes	Repeat use, low MPR	Repeat use, medium MPR	Repeat use, high MPR	Repeat use, very high MPR
All-cause mortalitya [RR (95% CI)] [25]	0.95 (0.92–0.98)	1.08 (1.05–1.11)	1.27 (1.21–1.33)	1.63 (1.58–1.68)
Gastrointestinal AEsb [RR (95% CI)] [25]	1.11 (1.04–1.18)	1.25 (1.12–1.40)	1.49 (1.29–1.72)	1.49 (1.34–1.66)
	PCM 1 day/week	PCM 2–3 days/week	PCM 4–5 days/week	PCM 6–7 days/week
Cardiovascular AEsc [risk ratio (95% CI)] [42]	0.94 (0.62–1.43)	1.23 (0.94–1.61)	1.49 (0.99–2.24)	1.50 (1.10–2.05)

Data compiled from Roberts et al. [24]

AEs adverse events, CI confidence interval, IV instrumental variables, MPR medication possession ratio (based on repeat prescription frequency), PCM paracetamol, RR relative risk

^aThe RR (IV, fixed) of all-cause mortality in patients taking paracetamol versus patients not taking paracetamol

^bThe RR (IV, fixed) of upper gastrointestinal AEs (gastroduodenal ulcers, and complications such as upper gastrointestinal haemorrhages) in patients taking paracetamol versus patients not taking paracetamol

^cThe risk ratio (IV, fixed) of cardiovascular AEs (confirmed or probable non-fatal myocardial infarction, non-fatal stroke, fatal coronary heart disease or fatal stroke) in patients taking paracetamol versus patients not taking paracetamol