Acetaminophen (Paracetamol) Induces Hypothermia During Acute Cold Stress

Abstract

This preliminary trial suggests that acetaminophen-induced hypothermia is exacerbated during cold stress. Larger scale trials seem warranted to determine if acetaminophen administration is associated with an increased risk of accidental hypothermia, particularly in vulnerable populations such as frail elderly individuals.

Acetaminophen (Paracetamol): Use beyond Pain Management and Dose Variability

“…Specifically, Tc decreased in the cold condition (10°C 40% RH) with ACT ingestion (range: 0.16–0.57°C) and remained stable within the cold placebo condition whilst Tc stability was maintained in both placebo and ACT thermoneutral conditions (25°C 40% RH). This in vivo human data suggest ACT has inhibitory actions on heat producing mechanisms in certain febrile (Dippel et al, 2001 , 2003b ; Koennecke and Leistner, 2001 ; Kasner et al, 2002 ) and afebrile states (Foster et al, 2016 , 2017 ). Within afebrile states the limited data suggests hypothermic effects present only below the human TNZ (Foster et al, 2016 , 2017 ).…”

“…Such conditions are below the human thermoneutral zone (TNZ) where the body invokes mechanisms to maintain a stable Tc (Stocks et al, 2004 ). Within a similar design to Foster et al ( 2016 ), Foster et al ( 2017 ) demonstrated within cold (10°C 40% RH) compared to thermoneutral conditions (25°C 40% RH), ACT ingestion (20 mg.kg LBM) elicited Tc instability (Foster et al, 2017 ). Specifically, Tc decreased in the cold condition (10°C 40% RH) with ACT ingestion (range: 0.16–0.57°C) and remained stable within the cold placebo condition whilst Tc stability was maintained in both placebo and ACT thermoneutral conditions (25°C 40% RH).…”

“…Children aged 2–12 years are normally given an individualized body weight derived therapeutic dose at 10–15 mg.kg (Jackson et al, 1984 ). ACT has been used beyond its primary functions as an analgesic and antipyretic in attempts to understand or augment athletic performance (Mauger et al, 2010 , 2014 ; Mauger and Hopker, 2012 ; Foster et al, 2014 ) and manipulate/characterize thermoregulation within temperate, cold and hot environments (Dippel et al, 2001 , 2003b ; Coombs et al, 2015 ; Taylor et al, 2015 ; Foster et al, 2016 , 2017 ). From these specific fields of research, no evidence of adverse reactions to ACT have been reported.…”

“…ACT can alter thermoregulation in clinical (Dippel et al, 2001 , 2003b ; Koennecke and Leistner, 2001 ; Kasner et al, 2002 ) and healthy populations (Foster et al, 2016 , 2017 ). Up to half of patients who suffer an acute stroke present with a febrile Tc (Dippel et al, 2001 ).…”

“…Novel research has seen ACT used outside of its typical clinical parameters, including exercise performance domains (Mauger et al, 2010 , 2014 ; Foster et al, 2014 ) and to induce mild hypothermia within afebrile humans (Foster et al, 2016 , 2017 ). ACT use whilst safe in many scenarios (Ong et al, 2007 ; Graham et al, 2013 ) does present risk in others (Hinz and Brune, 2012 ; Aminoshariae and Khan, 2015 ), across research and clinical agendas.…”