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NHS warning as paracetamol should not be combined with these meds

Paracetamol is a common painkiller used to treat a variety of aches and pains – but there are certain risks associated with taking it

The NHS has advised caution when taking a common painkiller as it may interact badly with other medications. In the UK, many of us rely on over-the-counter drugs for everyday aches and illnesses.

Of the pain relief on offer, paracetamol is one of the most commonly used medicines often taken for headaches, back pain and colds among other issues. However, as is the case with any type of medication, taking paracetamol does come with certain risks.

The NHS has issued guidance on the safe use of paracetamol – including which drug combinations should be avoided. “Paracetamol is not suitable for some people,” the health body says.

This includes people who regularly take warfarin – a medicine to prevent blood clots. Should this apply to you, you ought to consult your GP prior to using paracetamol, the health body says.

The NHS adds: “Paracetamol can increase the risk of bleeding if you take it [warfarin] regularly.” However, using low-dose paracetamol alongside warfarin is considered safe.

The NHS continues: “It’s safe to take paracetamol while you’re on warfarin. But take the lowest dose that controls your pain. Taking more than four, 500mg tablets over 24 hours for longer than a few days may make your blood clot more slowly.

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“This puts you at risk of bleeding.” It is also risky to combine the painkiller with other medications containing paracetamol, such as co-codamol or certain cold and flu remedies.

This is due to the potential risk of overdose. Other painkillers including ibuprofen, aspirin and codeine do not contain paracetamol and can be safely taken alongside it.

The NHS advises that you should consult your doctor before taking paracetamol if you are on medication to treat epilepsy or tuberculosis (TB), as this combination can also pose dangers.

Generally, the NHS states that paracetamol is not affected by herbal remedies or supplements. However, it notes: “There’s not enough information to say whether complementary medicines, herbal remedies and supplements are safe to take with paracetamol.

“They’re not tested in the same way as pharmacy and prescription medicines. They’re generally not tested for the effect they have on other medicines.

“Tell your doctor or pharmacist if you’re taking any other medicines, including herbal remedies, vitamins or supplements.”

Side effects of paracetamol

Paracetamol “very rarely” causes side effects when taken at the correct dosage. For a complete list you should check the information leaflet inside the packaging.

In rare instances, it’s possible to experience a serious allergic reaction (anaphylaxis) to paracetamol. The NHS says you should call 999 immediately if:

  • Your lips, mouth, throat or tongue suddenly become swollen
  • You’re breathing very fast or struggling to breathe (you may become very wheezy or feel like you’re choking or gasping for air)
  • Your throat feels tight or you’re struggling to swallow
  • Your skin, tongue or lips turn blue, grey or pale (if you have black or brown skin, this may be easier to see on the palms of your hands or soles of your feet)
  • You suddenly become very confused, drowsy or dizzy
  • Someone faints and cannot be woken up
  • A child is limp, floppy or not responding like they normally do (their head may fall to the side, backwards or forwards, or they may find it difficult to lift their head or focus on your face)
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For more information visit the NHS website here.


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