A narrative review of paracetamol-induced hypotension: Keeping the patient safe

Abstract

Aim: To understand the prevalence and epidemiology of paracetamol-induced hypotension and clinical implications for contemporaneous practice.

Design: Narrative review.

Methods: In May and June 2020, an open-date literature search of English publications indexed in ProQuest, PubMed, and EBSCO was conducted with the search terms 'acetaminophen' and 'hypotension' and related search combinations ('paracetamol', 'propacetamol', 'low blood pressure', 'fever', 'sepsis', and 'shock') to identify peer-reviewed publications of blood pressure changes after paracetamol administration in humans.

Results: A pattern of blood pressure reduction following the administration of paracetamol is demonstrated in the 27 studies included in this review. Haemodynamic intervention often followed persistent blood pressure reduction, and was greatest in febrile critically ill patients who received parenteral paracetamol.

Keywords: and ‘shock’; ‘acetaminophen’ and ‘hypotension’ and related search combinations ‘paracetamol’; ‘fever’; ‘low blood pressure’; ‘propacetamol’; ‘sepsis’.