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Acetaminophen
Acetaminophen
25
26
is generally first line therapy for mild to moderate pain because it is considered
safe for older people. 
It
is also recommended as first line therapy by the American College of Rheumatology
Guidelines for Recommendations for the Medical Management of Osteoarthrits of
the Hip and Knee27
Some highlights and cautionary statements regarding acetaminophen are enumerated
below:
Should be administered around-the-clock for treatment of chronic pain (given as one gram every six hours) with a maximum dose not exceeding four grams/day, because of increased risk of hepatic toxicity.
Use caution in patients with existing liver disease and avoid in patients with chronic alcohol abuse; caution is also advised in the frail elderly during fasting conditions (eg., viral illness with GI symptoms, dehydration).26
Has weak association with end-stage renal disease, although the National Kidney Foundation recommends it as the drug of choice in patients with impaired renal function.28
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