Abstract
Acetaminophen (APAP) is an analgesic used worldwide. However, the usage of APAP was lower and its effectiveness was underestimated in Japan before the indication was revised for APAP in 2011 compared with those in the United States (US) and Europe. This study investigated the prevalence of APAP in Japan. We conducted a questionnaire survey to determine the usage of APAP among hospital pharmacists and received answers from 430 pharmacists in Japan and 35 pharmacists in the US from December 2010 to October 2011. The range of the maximum dose of APAP for cancer pain was 900 -1500 mg/day (49%) in Japan, and 3000-4000 mg/day (83%) in the US. The pharmacists were questioned about the drug of choice among non-opioid analgesics for the treatment of cancer pain by patient age group. American pharmacists chose APAP (31%) and non-steroidal anti-inflammatory drugs (NSAIDs) (31%) for adult patients, while Japanese pharmacists chose APAP (2%) and NSAIDs (77%). American pharmacists chose APAP (49%) and NSAIDs (17%) for elderly patients, while Japanese pharmacists chose APAP (10%) and NSAIDs (64%). In addition, American pharmacists chose APAP (52%) and NSAIDs (17%) for pediatric patients, while Japanese pharmacists chose APAP (45%) and NSAIDs (12%). APAP is mainly prescribed for pediatric patients with cancer pain, and its usage for both adult and elderly patients with cancer pain is lower in Japan than that in the US. Safe, effective, and inexpensive APAP should be used as an adjunctive for the treatment of cancer pain in adult and elderly patients in Japan.
