Abstract
Acetaminophen is commonly used as the global standard of analgesics. For example, the WHO lists acetaminophen as an essential drug and various clinical guidelines in many countries include acetaminophen as a first-line drug for pain relief because of it's efficacy and safety profile. In particular, there is not significant risk of such as gastrointestinal disorders, renal dysfunctions, bleeding, or cardiovascular events, and it is considered to be a safer option than non-steroidal anti-inflammatory drugs(NSAIDs). In Japan, however, NSAIDs are widely used to treat pain while the use of acetaminophen for pain relief is quite limited. This difference could be attributed to the low approved dose of acetaminophen in Japan, which is less than half of that used elsewhere. This lower approved dose causes difficulty in obtaining analgesic effect with acetaminophen. In January 2011, however, the approved dose of acetaminophen in Japan was increased to the world standard dose, making it easier to obtain an analgesic effect. In the near future, an increase in the use of acetaminophen for pain relief can be expected in Japan. NSAIDs are common drugs for pain in Japan, but often require co-prescription of a gastric mucosal protective agents, H2- blockers, or proton pump inhibitors(PPI) to prevent gastrointestinal disorders. On the other hand, acetaminophen has much less risk of such adverse reactions and there is no need for co-prescription of digestive medicines. Thus, increased use of acetaminophen could decrease the cost for pain relief in Japan. (Jpn J Pharmacoepidemiol 2012; 17(2): 75-86)
