Paracetamol tablets are good for you… and for the planet

Paracetamol is one of the most popular and used medicines in Spain and the rest of the world. Despite the fact that in general ideology it is associated with minor ailments, we are talking about a star drug whose presence extends to the entire hospital environment, including intensive care units. It was in one of them that a study was developed, the conclusion of which provides new data on “competitive advantage” of oral paracetamol compared to its intravenous administration.

Based on a study that equated the effectiveness of oral or intravenous paracetamol in critically ill patients, a paper conducted at Erasmus MC University (Rotterdam, the Netherlands) entitled Paracetamol challenge focuses on a new aspect: which indication is most appropriate from an environmental point of view.

Paracetamol challenge

The first stage of the study was to analyze the use of paracetamol in the intensive care unit over two months, April and May 2023. During these periods, the use of intravenous paracetamol accounted for 42 and 55% of total paracetamol use. Given the huge environmental gap between the two indications with the same degree of effectiveness, a target was set to reduce the use of intravenous paracetamol by 25%.

With a poster highlighting the difference in both grams of waste and price between the two paracetamol presentations, the project began with more than 40 hospitals joining. The results obtained show remarkable results. reducing waste and carbon emissions. Specifically, intravenous paracetamol administration per patient increased from over 10 in April 2023 to 5.2 in the same month in 2024, representing 106 kg of waste and 458 kg less emissions, as well as cost savings of €1,380. .

Oral paracetamol: good, beautiful and cheap

The university estimates that “we administer a total of 40,000 intravenous doses of paracetamol each year.” “If all departments are up to the task, it will represent saving 10,000 IVs, equivalent to 1,430kg of waste, 6,200kg of CO2 and €18,200 in potential savings.”he adds.

The result of the study is positive, but there is a blind spot related to the effect obtained from the trial. Moreover, a decrease in the dose of paracetamol for intravenous administration was not accompanied by an increase in the same level when taken orally. While this is indeed considered an “additional benefit,” the study acknowledges that the impact of this on patients’ pain scores was not studied.