The Editorial Executive Committee welcomes letters, which should be less than 250 words. Before a decision to publish is made, letters which refer to a published article may be sent to the author for a response. Any letter may be sent to an expert for comment. When letters are published, they are usually accompanied in the same issue by their responses or comments. The Committee screens out discourteous, inaccurate or libellous statements. The letters are sub-edited before publication. Authors are required to declare any conflicts of interest. The Committee's decision on publication is final.

Letter to the Editor

Editor, – The articles 'The vascular effects of COX-2 selective inhibitors' (Aust Prescr 2004;27:142-5) and 'Perioperative analgesia' (Aust Prescr 2004;27:152-4) advised physicians to opt for paracetamol as a first-line analgesic. Given that the major barrier to more widespread use of paracetamol is the need for at least four doses per day, is there any evidence regarding the benefits or otherwise of extended release paracetamol, and should these drugs be on the Pharmaceutical Benefits Scheme (PBS)?

Nicholas McLernon
Resident Medical Officer, Obstetrics
Osborne Park Hospital
Osborne Park, WA

Authors' comment

Professor R.O. Day and Professor G.G. Graham, authors of 'The vascular effects of COX-2 selective inhibitors', comment:

The idea of a sustained release paracetamol is very reasonable. The reduction in the number of daily doses would make long-term therapy with paracetamol more convenient. The problem is that the dose is large and the optimal sustained release tablet, say one that would last for 12 or even 24 hours, would be very large and too difficult to swallow. Cost-effectiveness would also need to be established for it to be subsidised by the PBS.