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Acetaminophen (APAP) in humans has robust effects with a high therapeutic index in altering postoperative and inflammatory pain states in clinical and experimental pain paradigms with no known abuse potential. This review considers the literature reflecting the preclinical actions of acetaminophen in a variety of pain models. Significant observations arising from this review are as follows: 1) acetaminophen has little effect upon acute nociceptive thresholds; 2) acetaminophen robustly reduces facilitated states as generated by mechanical and thermal hyperalgesic end points in mouse and rat models of carrageenan and complete Freund's adjuvant evoked inflammation; 3) an antihyperalgesic effect is observed in models of facilitated processing with minimal inflammation (eg, phase II intraplantar formalin); and 4) potent anti-hyperpathic effects on the thermal hyperalgesia, mechanical and cold allodynia, allodynic thresholds in rat and mouse models of polyneuropathy and mononeuropathies and bone cancer pain. These results reflect a surprisingly robust drug effect upon a variety of facilitated states that clearly translate into a wide range of efficacy in preclinical models and to important end points in human therapy. The specific systems upon which acetaminophen may act based on targeted delivery suggest both a spinal and a supraspinal action. Review of current targets for this molecule excludes a role of cyclooxygenase inhibitor but includes effects that may be mediated through metabolites acting on the TRPV1 channel, or by effect upon cannabinoid and serotonin signaling. These findings suggest that the mode of action of acetaminophen, a drug with a long therapeutic history of utilization, has surprisingly robust effects on a variety of pain states in clinical patients and in preclinical models with a good therapeutic index, but in spite of its extensive use, its mechanisms of action are yet poorly understood.

Abstract licence: CC BY-NC

Retraction: R. Polat , K. Peker , Ç. T. Gülöksüz , J. Ergil , T. Akkaya , “,” Kaohsiung Journal of Medical Sciences 31 , no. ( 2015 ): 468 – 472 . https://doi.org/10.1016/j.kjms.2015.07.001 . The above article, published online on 06 August 2015, in Wiley Online Library ( wileyonlinelibrary.com ), and has been retracted by agreement between the journal Editor‐in‐Chief, Wan‐Long Chuang; Kaohsiung Medical University; and John Wiley and Sons Australia, Ltd. In 2021, a third party raised concerns regarding evidence of unlikely similarity in the standard deviation values presented in Figures 1 and 2. The journal contacted the authors, who provided original data for evaluation by the journal. Following further correspondence, the journal and publisher concluded that the authors' response satisfied their concerns and that the investigation should be closed without further action. In 2024, the complainant appealed to the journal and publisher to re‐open the investigation based on the substantial evidence of errors. The publisher accepted this appeal and re‐opened the investigation. The editors have conducted a review of the evidence and the provided dataset and found that the data includes substantial numbers of duplicated values across pairs of patients. The editors have determined that the substantial quantity of duplicated values is incompatible with a genuine randomized controlled trial and that the evidence compromises the conclusions of the article. As such, the parties agree that a retraction is necessary. The authors disagree with the retraction.

Abstract licence: CC BY 4.0