In Brief: Does Acetaminophen Increase Blood Pressure?
The Medical Letter on Drugs and Therapeutics • April 18, 2011 (Issue 1362) p. 29
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A recent article in Circulation reported that acetaminophen (Tylenol, and others; paracetamol outside the US) increased blood pressure in patients with coronary artery disease. This conclusion was based on a randomized, placebo-controlled crossover trial in 33 patients; acetaminophen 1 g three times daily for 2 weeks was associated with statistically significant increases in blood pressure of 2.9 mmHg systolic and 2.2 mmHg diastolic.1
NSAIDs can increase blood pressure; the mechanism is thought to be inhibition of cyclooxygenase leading to decreased renal prostaglandin activity. Acetaminophen also inhibits cyclooxygenase (primarily COX-2) and decreases prostaglandin activity.2
The small increases in blood pressure reported with acetaminophen would probably be inconsequential in low-risk patients, but might be a concern for those with cardiovascular disease. Like most drugs, acetaminophen should be used in the lowest effective doses for the shortest possible time. Mild to moderate pain due to osteoarthritis or headache generally responds to a dose of 650 mg.3
1. I Sudano et al. Acetaminophen increases blood pressure in patients with coronary artery disease. Circulation 2010; 122:1789.
3. Drugs for pain. Treat Guidel Med Lett 2010; 8:25.
This article has been freely provided.
