It’s the most commonly used painkiller in the world, one you’ve probably taken yourself at some point over the last few weeks.
But is paracetamol, which is used to treat everything from headaches to fevers to back pain, as safe as it appears?
The average Briton pops around 70 tablets every year – nearly six doses a month – and the latest official figures reveal the NHS in England dished out more than 15million prescriptions for the painkiller in 2024/25, at a cost of £80.6million.
But several recent studies have linked regular use of the drug to liver failure, high blood pressure, gastrointestinal bleeding and heart disease – and even to issues such as tinnitus and developmental problems such as autism and ADHD.
Some doctors now say that, while it might be fine to take a couple of paracetamol to combat a headache or any kind of pain that will pass quickly, it should not be used regularly – and certainly not for longer than a few weeks at a time – because it can cause liver damage, even at the ‘safe’ dose.
Professor Andrew Moore, a member of the respected Cochrane Collaboration’s Pain, Palliative Care and Supportive Care group – which analyses evidence from international research – writing in online publication The Conversation, said that the ‘conventional view’ that paracetamol is safe and a ‘go-to’ treatment for pain was ‘probably wrong’.
‘[The studies] we have tell us that paracetamol use is associated with increased rates of death, heart attack, stomach bleeding and kidney failure,’ he says.
‘Paracetamol is known to cause liver failure in overdose but it also causes liver failure in people taking standard doses for pain relief. The risk is only about one in a million, but it is a risk. All these different risks stack up.’
His views are echoed by GPs, including Doncaster-based GP Dr Dean Eggitt, who adds: ‘People think paracetamol is harmless because it’s easy to get so people take it like Smarties. But even if you’re not exceeding the recommended amount in one day, you can still overdose.’
The dose considered ‘safe’ is 4g a day, the equivalent of taking two 500mg tablets four times in a 24-hour period.
But even just slightly exceeding the recommended dose every day for 10 days or more could be enough to cause permanent liver and kidney damage, Dr Eggitt has warned.
Reviews of the evidence also suggest that paracetamol is not even as effective as people think for pain relief.
‘For postoperative pain, perhaps one in four people benefit,’ Prof Moore writes. ‘For headache, perhaps one in ten. These are robust and trustworthy results. If paracetamol works for you, that’s great. But for most, it won’t.’
So what does the evidence say, and are you taking too much?
