Cookie policy: This site uses cookies (small files stored on your computer) to simplify and improve your experience of this website. Cookies are small text files stored on the device you are using to access this website. For more information please take a look at our terms and conditions. Some parts of the site may not work properly if you choose not to accept cookies.

Join

Subscribe or Register

Existing user? Login

Viral infections

Study casts doubt on paracetamol use for managing flu symptoms

Study shows no difference between adults given placebo and paracetamol for symptoms of influenza.

Taking regular paracetamol to manage influenza makes no difference in terms of fighting the virus or reducing patients’ temperature or other symptoms, according to research. In the image, close-up of a man with the flu blow his nose

Source: Shutterstock.com

Patients with confirmed influenza recorded similar clinical symptoms whether they took paracetamol or a placebo

Taking paracetamol to manage influenza makes no difference in terms of fighting the virus, reducing patients’ temperature or alleviating other symptoms, according to the results of what researchers claim is the first placebo-controlled trial to assess the impact of the over-the-counter drug on adults with confirmed flu.

“We initially theorised that taking paracetamol might be harmful, as the influenza virus cannot replicate as well at higher temperatures, and by reducing a person’s temperature the virus may have thrived,” says study author Irene Braithwaite, deputy director of the Medical Research Institute of New Zealand. “Fortunately this was found not to be the case.”

The researchers observed no difference between adults given paracetamol or placebo for symptoms scores, temperature, or the time it took for the virus to resolve. But the team caution against abandoning the common public health message for managing the common winter virus.

The paper, published in Respirology[1] on 6 December 2015, says: “It is difficult to infer benefit or harm given the lack of effect of regular paracetamol administered early in the course of an influenza-like illness in this trial; thus, recommendations for or against this practice in the community cannot be made based on these findings. 

The researchers recruited 80 adults aged 18–65 years who had symptoms of influenza-like illness — a history of fever or recorded temperature of more than 37.8 degrees and at least one other symptom of a cough, sore throat, rhinorrhoea, headache, myalgia, fatigue or malaise for less than 48 hours.

The volunteers were screened for influenza A or B strains. Only those who tested positive were eligible for the randomised double-blind placebo-controlled trial. Of the 46 who tested positive, 22 were given 1g of paracetamol four times a day for five days; the other 24 received placebo.

Researchers took nasal swabs to test viral loads at day one, two and five. Temperature and symptom scores were also recorded for 5–14 days or until the viral infection had resolved.

“Regular daily administration of the maximum recommended dose of paracetamol for five days had no effect on viral shedding, temperature or clinical symptoms in participants with PCR-proven influenza infection,” the researchers conclude.

Richard Pebody, head of influenza surveillance at Public Health England, says that while the study is interesting more research is needed.

“Most influenza-like illnesses are self-limiting and the current guidance is to rest, drink plenty of fluids and take analgesics if required (paracetamol for all ages, aspirin may be taken by adults),” he says.

Medical advice should always be sought if symptoms become severe or last more than about a week, he adds, and people with “chronic or long-standing illness may need medical attention earlier”.

A National Institute for Health and Care Excellence (NICE) clinical knowledge summary for influenza — which reflects available evidence and was updated in October 2015 — recommends that patients take regular paracetamol and ibuprofen for the “symptomatic relief of influenza on the basis that they reduce fever and pain (including headache and myalgia)”.

John Smith, chief executive of the Proprietary Association of Great Britain, which represents over-the-counter medicines manufacturers, says: “While we note the findings, the researchers themselves acknowledge that it is difficult to make a recommendation for or against the use of paracetamol in adults with influenza based on these results.”

He adds that paracetamol is widely regarded as an all-round pain reliever and helps lower body temperature and is approved by the UK medicines regulator for relieving the symptoms of pain and flu.

Citation: The Pharmaceutical Journal DOI: 10.1211/PJ.2015.20200258

Have your say

For commenting, please login or register as a user and agree to our Community Guidelines. You will be re-directed back to this page where you will have the ability to comment.

Recommended from Pharmaceutical Press

  • Patient Care in Community Practice

    Patient Care in Community Practice

    Patient Care in Community Practice is a unique, practical guide for healthcare professionals or carers. Covers a range of non-medicinal products suitable for use at home.

    £22.00Buy now
  • Clinical Pharmacokinetics

    Clinical Pharmacokinetics

    A practical guide to the use of pharmacokinetic principles in clinical practice. Includes case studies with questions and answers.

    £33.00Buy now
  • Strategic Medicines Management

    Strategic Medicines Management

    A practical guide to influencing the availability of medicines, and policies of their use. Focuses on the strategic elements of medicines management.

    £33.00Buy now
  • Introduction to Renal Therapeutics

    Introduction to Renal Therapeutics

    Introduction to Renal Therapeutics covers all aspects of drug use in renal failure. Shows the role of the pharmacist in patient care for chronic kidney disease.

    £38.00Buy now
  • Drugs and the Liver

    Drugs and the Liver

    Drugs and the Liver assists practitioners in making pragmatic choices for their patients. It enables you to assess liver function and covers the principles of drug use in liver disease.

    £38.00Buy now

Search an extensive range of the world’s most trusted resources

Powered by MedicinesComplete
  • Print
  • Share
  • Comment
  • Save
  • Print Friendly Version of this pagePrint Get a PDF version of this webpagePDF

Supplementary images

  • Taking paracetamol to manage influenza makes no difference in terms of fighting the virus or reducing patients’ temperature or other symptoms, according to research. In the image, close-up of a man with the flu blow his nose

Newsletter Sign-up

Want to keep up with the latest news, comment and CPD articles in pharmacy and science? Subscribe to our free alerts.