Table 3.
Guideline recommendations for pain treatment with paracetamol.
| Organization/Society | First Author, Year | Condition | Recommendation | Comments |
|---|---|---|---|---|
| ASAS-EULAR | van der Heijde, 2016 | axSpA | R | to be considered after NSAIDs failed |
| OPTIMa | Wong, 2016 | LBP | R | recommended in acute LBP |
| NICE | NICE 2020 | LBP | CR | not recommended alone, recommended in association with opioids |
| EBM | EBM 2019 | LBP | R | recommended for acute and chronic LBP |
| ACR | Kolasinski, 2020 | OA | CR | recommended for patients intolerant to NSAIDs, monitor liver function |
| AAOS/ASRA | Fillingham, 2020 | OA | R | |
| ESCEO | Bruyere, 2014 | OA | R | first line for short-term treatment (<3 g/day); not for long-term treatment |
| NICE | NICE 2020 | OA | R | to be considered ahead of NSAIDs |
| OARSI | Bannuru, 2019 | OA | CNR | |
| ACP/AAFP | Qasem, 2020 | MSP | CR | |
| AGS | AGS Panel, 2009 | MSP | R | contraindicated in liver failure; not exceed max 4 g/day dose |
| BGS, BPS | Abdulla, 2013 | MSP | R | elderly population; not to exceed max 4 g/day dose |
| AHS | Marmura, 2018 | HA | R | |
| EFNS | Bendtsen, 2010 | HA | R | 1 g for acute therapy |
| NICE | NICE, 2021 | HA | R | indicated for migraine and tension headache |
| ASCO | Paice, 2016 | CP | R | avoid drug interaction |
| ESMO | Fallon, 2018 | CP | NR | |
| WHO | WHO, 2019 | pain | R |
Recommendations by medical societies for pain management with paracetamol in different clinical conditions. Each society followed specific criteria to grade quality evidence and recommendations that should be consulted. Abbreviations: same as in Table 1. Recommendations: light red-CNR: conditionally not recommended (probably ineffective); light green-CR: conditionally recommended (effective in some patients); yellow-NR: no recommendation (not enough reason to support or refute its use); green-R: strongly recommended or recommended (effective or probably effective).