Acetaminophen for osteoarthritis

Examples

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Brand Name	Chemical Name
Tylenol	acetaminophen

acetaminophen in combination with narcotics, such as:

Brand Name	Chemical Name
Tylenol with codeine	acetaminophen with codeine

Brand Name	Chemical Name
Vicodin	acetaminophen with hydrocodone

Brand Name	Chemical Name
Ultracet	acetaminophen with nonnarcotic analgesics

Some of the medicines come in long-acting forms that require less-frequent dosing while providing long-lasting pain relief.

How It Works

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Acetaminophen is an analgesic, which helps relieve pain. (Analgesics do not affect inflammation as nonsteroidal anti-inflammatory drugs, NSAIDs, do.)

Why It Is Used

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Doctors use acetaminophen to treat mild to moderate pain caused by osteoarthritis.

If acetaminophen does not relieve pain, or if joint tissue shows signs of inflammation, NSAIDs may be used.

How Well It Works

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Regular use of acetaminophen can provide relief of mild to moderate pain caused by osteoarthritis.

Some studies have shown that acetaminophen and nonsteroidal anti-inflammatory drugs are equally effective for mild to moderate joint pain.¹ Other studies suggest that NSAIDs are more effective than acetaminophen and that side effects are similar.^{2, 3}

Side Effects

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Side effects of acetaminophen are rare but include:

• Nausea.
• Skin rash.
• Possible liver damage, caused by long-term use in high doses (greater than 4,000 mg per day) or at lower doses in people with chronic alcohol use or chronic liver disease.

Stomach pain, nausea, or heartburn are no more common with acetaminophen than with placebo and are less common with acetaminophen than with NSAIDs.

See Drug Reference for a full list of side effects. (Drug Reference is not available in all systems.)

What To Think About

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Acetaminophen and home treatment are the first steps in treatment for osteoarthritis pain.

Acetaminophen does not alter the process of cartilage breakdown that occurs in osteoarthritis.

People with chronic liver disease should check with a health professional about the proper dose before taking acetaminophen.

Complete the new medication information form (PDF) (What is a PDF document?) to help you understand this medication.

References

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Citations

1. Subcommittee on Osteoarthritis Guidelines, American College of Rheumatology (2000). Recommendations for the medical management of osteoarthritis of the hip and knee. Arthritis and Rheumatism, 43(9): 1905–1915.

2. Pincus T, et al. (2004). Patient preference for placebo, acetaminophen (paracetamol) or celecoxib efficacy studies (PACES): Two randomised, double blind, placebo controlled, crossover clinical trials in patients with knee or hip osteoarthritis. Annals of the Rheumatic Diseases, 63(8): 931–939.

3. Towheed TE, et al. (2006). Acetaminophen for osteoarthritis. Cochrane Database of Systematic Reviews (1). Oxford: Update Software.

Credits

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Author	Robin Parks, MS
Editor	Kathleen M. Ariss, MS
Associate Editor	Pat Truman
Primary Medical Reviewer	E. Gregory Thompson, MD - Internal Medicine
Specialist Medical Reviewer	Stanford M. Shoor, MD - Rheumatology
Last Updated	April 20, 2007