| Popis: |
In Norway, the total consumption of non-opioid analgesics has not changed during the last ten years and was 36 defined daily doses/1,000 inhabitants/day in 1992. However, there has been a clear switch from acetyl-Salicylic acid (ASA) to paracetamol during this period. The consumption of phenazone is relatively high. Phenacetin consumption has never been a problem, and out of 3,000 renal transplanted patients at Rikshospitalet, Oslo, during the last 25 years less than 1% suffered analgesic nephropathy. It is beyond doubt that phenacetin, when taken together with either ASA or phenazone, increases the risk of urothelial cancer, especially of the renal pelvis and ureter in humans. The dramatic reduction in the incidence of analgesic nephropathy after the sale of phenacetin was prohibited has not been paralleled by a decrease in kidney or urothelial cancer. The human carcinogenicity data for paracetamol in the kidney and urinary tract is discussed. Clinical and epidemiological data, including several population based case-control studies, provide inadequate evidence of any carcinogenicity of paracetamol in the kidney or urinary tract in humans. However, chronic use of high doses of paracetamol should be avoided, probably also consumption of paracetamol in combination with ASA. |
