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Can You Take Paracetamol With … ?

Can you take paracetamol with ...

Paracetamol is one of the most commonly purchased over-the-counter medications. It is still one of the most commonly prescribed drugs in the UK with more than 17mln items prescribed in the last 12 months (Sep ’18—Aug ’19), costing NHS over £46 mln (Openprescribing.net, 2019).

I previously wrote a couple of posts on the use of paracetamol and naproxen and paracetamol and ibuprofen. Can you take paracetamol with … covers concomitant use of paracetamol with other common drugs, purchased from the pharmacy or prescribed.

Can You Take Paracetamol With Ibuprofen?

 

Paracetamol and ibuprofen can be taken together. This advice generally applies to anyone who is 16 and over (NHS, 2017).  There is no interaction between drugs.

Is Taking Paracetamol And Ibuprofen Together More Effective In Reducing Pain Than Taking Drugs Alone?

Ibuprofen belongs to a group of drugs called nonsteroidal anti-inflammatory drugs (NSAIDs). NSAIDs reduce pain, help with fever and decrease inflammation. The inflammatory action of ibuprofen is the main difference when compared to paracetamol, which is mainly used to manage pain and fever. The distinct mechanism of action contributes to better-combined analgesic effectiveness.

Cochrane reviewed information from three clinical trials and compared the effectiveness of paracetamol and ibuprofen as single and combined doses in patients who had a wisdom tooth removed (moderate to severe pain in over 1600 patients). This review concluded that ibuprofen plus paracetamol combinations provided better analgesia than either drug alone, when the same dose was given (Derry et al, 2013). A combination product, Nuromol, contains both paracetamol and ibuprofen. Nuromol can be purchased from the pharmacy.


Can You Take Paracetamol With Naproxen?

Paracetamol and naproxen can be taken together. There is no interaction between drugs. More details can be found in a separate post: Taking naproxen and paracetamol together.

Can You Take Paracetamol With Codeine?

paracetamol with codeine

Paracetamol and codeine can be taken together. There is no interaction between drugs. Combination products (Co-codamol) containing both paracetamol and codeine exist in various forms, and in lower strength, co-codamol can be purchased from the pharmacy,

for example, co-codamol (8mg of codeine and 500mg of paracetamol per tablet) or slightly higher strength as a branded product, Solpadine Max (12.8mg of codeine and 500mg of paracetamol per tablet). Higher strengths of co-codamol (containing 15mg or 30mg of codeine) in combination with paracetamol can only be prescribed on prescription.

Read related post: Codeine over the counter.

Is Co-codamol More Effective In Reducing Pain Than Paracetamol Alone?

A single dose of codeine, possibly combined with paracetamol, has greater analgesic efficacy than paracetamol alone (Prescrire Int., 2016), but the advantages of this combination product have not been demonstrated (BNF, 2019).

Is It Ok To Take Paracetamol With Co-codamol?

Paracetamol and co-codamol should not be taken at the same time. Co-codamol contains a combination of paracetamol and codeine. One can alternate between both drugs e.g. a dose of co-codamol can be followed (after six hours) with a dose of paracetamol.

Can You Take Paracetamol With Aspirin?

 

Paracetamol can be taken together with aspirin. Aspirin similar to ibuprofen and naproxen is an NSAID. Combined products containing both paracetamol and aspirin can be purchased, for example, Anadin Extra.

Anadin Extra contains paracetamol and aspirin in a single product.

 

 

Can You Take Paracetamol With Antibiotics?

 

paracetamol with antibiotics

 

Paracetamol can be taken with antibiotics such as penicillins (amoxicillin, phenoxymethylpenicillin), metronidazole, clarithromycin, etc. There is no listed interaction between paracetamol and any antibiotic.

When in doubt, always read the product information leaflet or speak to a pharmacist.

References:

Twycross, R.G., 1984. Analgesics. Postgraduate medical journal, 60(710), p.876. Available at: https://bnf.nice.org.uk/treatment-summary/analgesics.html Accessed on 13/11/2019

Derry, C.J., Derry, S. and Moore, R.A., 2013. Single dose oral ibuprofen plus paracetamol (acetaminophen) for acute postoperative pain. Cochrane Database of Systematic Reviews, (6). Available at: https://www.cochrane.org/CD010210/SYMPT_single-dose-oral-ibuprofen-plus-paracetamol-acetaminophen-acute-postoperative-pain Accessed on 09/11/2019