Paracetamol Effect on Prostaglandins and Blood Pressure

Paracetamol Impact Study: Prostaglandin Synthesis and Blood Pressure Effects (PIS-PaB)

This research program aims to investigate the influence of paracetamol on blood pressure and the cyclooxygenase (COX) - prostaglandine (PG) pathway in patients with pain. Through an observational pilot study, we will use advanced LC/ESI-MS/MS methodology to analyze the COX-OG pathway in plasma and urine. The study will assess the effects of paracetamol compared to ibuprofen, considering different types of pain. The primary focus is to understand the changes in blood pressure and the COX-PG pathway upon initiation or discontinuation of paracetamol, with safety analysis as a secondary consideration.

Inclusion Criteria:

• Headache and orosurgical patients treated at the respective charite outpatient clinic.
• Age 18 years or older
• Able to consent
• Patients with migraine type headache treated with paracetamol or ibuprofen within the last 12 hours or not treated with paracetamol or ibuprofen within the last 48 hours
• Patients treated with with paracetamol or ibuprofen undergoing orosurgery for wisedome tooth extraction

Exclusion Criteria:

• Pregnancy
• Arterial hypertension
• Use of beta blockers
• Use of COX inhibitors other than paracetamol or ibuprofen, including low-dose acetylsalicylic acid
• Stable prophylactic therapy of migraine for less than 3 weeks
• Use of tryptans in the last two days (Frovatriptane in the last 6 days)
• Oral surgery patients using paracetamol or ibuprofen in the last 24 hours
• Known allergy to paracetamol or ibuprofen