Analgesic use — prevalence, biomonitoring and endocrine and reproductive effects

Abstract

Paracetamol and NSAIDs, in particular acetylsalicylic acid (aspirin) and ibuprofen, are among the most used and environmentally released pharmaceutical drugs. The differences in international trends in the sale and consumption of mild analgesics reflect differences in marketing, governmental policies, habits, accessibility, disease patterns and the age distribution of each population. Biomonitoring indicates ubiquitous and high human exposure to paracetamol and to salicylic acid, which is the main metabolite of acetylsalicylic acid. Furthermore, evidence suggests that analgesics can have endocrine disruptive properties capable of altering animal and human reproductive function from fetal life to adulthood in both sexes. Medical and public awareness about these health concerns should be increased, particularly among pregnant women.

Trends in analgesic consumption in France over the last 10 years and comparison of patterns across Europe

“…The changing pattern of analgesic consumption observed for France in the present study is consistent with previous reports from France and Europe . Withdrawal and new releases of marketed drugs may have accounted for the changing consumption patterns.…”

Intergenerational effects on mouse sperm quality after in utero exposure to acetaminophen and ibuprofen

“…Nonsteroidal antiinflammatory drugs (NSAIDs) such as acetylsalicylic acid (ASA; aspirin) and ibuprofen (IBU), and analgesic drugs such as N-acetyl-p-aminophenol ABBREVIATIONS: ALC, adult Leydig cell; APAP, N-acetyl-p-aminophenol (acetaminophen, paracetamol); ASA, acetylsalicylic acid (aspirin); CASA, computer-assisted semen analyses; COX1-3, cyclooxygenase 1-3; Dnmt, de novo DNA methylase; dpc, days postcoitum; dpp, days postpartum; ECM, extracellular matrix; EdU, 5-ethynyl-29-deoxyuridine; eSpd, elongated spermatid; F0AI, F0 exposed in utero to N-acetyl-p-aminophenol + ibuprofen; F0WT, F0 wild type; F1AI-AI, male F0AI 3 female F0AI; F1AI-WT, male F0AI 3 female F0WT; F1WT, male F0WT 3 female F0WT; F1WT-AI, male F0WT 3 female F0AI; FACS, fluorescence-activated cell sorting; 5-mC, 5-methylcytosine; GEO, Gene Expression Omnibus; IBU, ibuprofen; LC-MS/MS, liquid chromatography-tandem mass spectrometry; NSAID, nonsteroidal antiinflammatory drug; PAS, periodic acid-Schiff; PG, prostaglandin; PGC, primordial germinal cell; qRT-PCR, quantitative RT-PCR; rSpd, round spermatid; SpgA/B, spermatogonia A/B; Spz, spermatozoa; STR, straightness; TXA2, thromboxane; UPLC, ultraperformance liquid chromatography-tandem mass spectrometry; VAP, average path velocity; VCL, curvilinear velocity; VSL, straight line velocity (APAP; acetaminophen, paracetamol) are widely used to treat inflammation and pain (6). APAP and IBU are among the most commonly prescribed drugs in the first trimester of pregnancy (7)(8)(9), and both APAP and NSAIDs can cross the placental barrier (10,11).…”

Ibuprofen results in alterations of human fetal testis development

“…This is despite the fact that its consumption has continued to increase even though aspirin consumption has decreased16. The percentage of pregnant women reporting ibuprofen use averages 10%, but this varies widely across studies, ranging from 0.5% to over 28%36716293031323334.…”