Paracetamol is a useful adjunct when used in combination with “weak opioids” for chronic pain in palliative care patients with advanced cancer, however it is not certain that there is continuing benefit when used in conjunction with “strong” opioids. N-of-1 trials allowed individual treatment decisions to be made for each participant: there was no added benefit for any of the participants, although no conclusion about the added benefit of paracetamol above regular opioids was possible for the group, due to insufficient numbers recruited. Paracetamol may not provide added benefit above regular opioids; this should assessed on a case by case basis to justify the extra tablet load.