Paracetamol Overuse During Cold and Flu Season

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A total of 14,481 adults who took paracetamol for treating cold and flu season-associated fever and pain were selected from national online panels.
A total of 14,481 adults who took paracetamol for treating cold and flu season-associated fever and pain were selected from national online panels.

During the cold and flu season, the use and overuse of paracetamol is common, which may be driven in part by higher use of over-the-counter combination medications for the treatment of upper respiratory cold/flu symptoms, according to a study published in the British Journal of Clinical Pharmacology.

A total of 14,481 adults who took paracetamol to treat cold and flu season-associated fever and pain were selected from national online panels. The participants were not aware of the study's goal of assessing paracetamol use during cold and flu season.

Participants recorded daily medication use (ie, quantity, time of intake) in diaries for 7 days. Investigators compared symptoms, paracetamol use, and consumption of the recommended daily maximum of paracetamol (>4 g) during cold and flu season and off season.

Up to 6.3% of the study participants took >4 g of paracetamol at least 1 day during the study period (95% CI, 5.9%-6.7%), and 3.7% of usage days had >4 g of paracetamol intake (95% CI, 3.5%-3.8%). During cold and flu season vs off season, participants were more likely to exceed the maximum daily dose (6.5% vs 5.3%, respectively; odds ratio [OR], 1.24; 95% CI, 1.04-1.48) and to have a greater number of days of paracetamol use >4 g (3.9% vs 2.8%, respectively; OR, 1.37; 95% CI, 1.11-1.69). 

The higher rate of paracetamol use observed during cold and flu season vs off season was primarily the result of the increased use of over-the-counter combination medications for upper respiratory cold and flu symptom treatment (usage days, 33.2% vs 24.8%, respectively; OR, 1.58; 95% CI, 1.46-1.72).

“These findings suggest the need for consumer education about the proper use of paracetamol medications, including limiting the dose to that specified in the medication directions, with some special emphasis during [cold and flu season] on limiting intake of medications treating upper respiratory symptoms,” concluded the study authors.

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Reference

Shiffman S, Battista DR, Kelly JP, Malone MK, Weinstein RB, Kaufman DW. Prevalence of exceeding maximum daily dose of paracetamol, and seasonal variations in cold-flu season [published online March 7, 2018]. Br J Clin Pharmacol. doi: 10.1111/bcp.13551

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