Age-Related Changes in the Hepatic Pharmacology and Toxicology of Paracetamol

Abstract EN

Optimal pharmacotherapy is determined when the pharmacokinetics and pharmacodynamics of the drug are understood.

However, the age-related changes in pharmacokinetics and pharmacodynamics, as well as the increased interindividual variation mean optimal dose selection are a challenge for prescribing in older adults.

Poor understanding of how hepatic clearance and toxicity are different with age results in suboptimal dose selection, poor efficacy, and/or increased toxicity.

Of particular concern is the analgesic paracetamol which has been in use for more than 50 years and is consumed by a large proportion of older adults.

Paracetamol is considered to be a relatively safe drug; however, caution must be taken because of its potential for toxicity.

Paracetamol-induced liver injury from accidental overdose accounts for up to 55% of cases in older adults.

Better understanding of how age affects the hepatic clearance and toxicity of drugs will contribute to evidence-based prescribing for older people, leading to fewer adverse drug reactions without loss of benefit.