The Medical Letter on Drugs and Therapeutics
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In Brief: Does Acetaminophen Increase Blood Pressure?

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 ... more      

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