Pain in the elderly

The pharmacokinetic and pharmacodynamic changes produced by age, comorbidities and polypharmacy contribute to an increase in adverse drug reactions in the elderly. The correct prescription of analgesics in this age group depends on the proper valuation of these factors. Due to it's profile of pharmacologic activity, efficacy, safety and low cost paracetamol is a first-line drug in the treatment of mild to moderate pain. It does not induce gastrotoxicity, renal function impairment or antiplatelet effects so it can be administered in the elderly when NSAID are contraindicated. The dosage depends on the type of pain and the characteristics of the patient. Moreover it should be adjusted in renal failure, hepatic insufficiency and alcoholism. In other cases, it is recommended the minimum effective dose without exceeding 4 g daily.