Painkillers, paracetamol - Interactions with other medicines

When two or more medicines are taken at the same time, the effects of one of the medicines can be changed by the other.

This is known as a drug-drug interaction. In some cases, it may not be safe to take one medicine with another because of interaction.

To check that your medicines are safe to take with paracetamol, you can:

• ask your GP or local pharmacist
• read the patient information leaflet that comes with your medicine
• check the Medicines information tab at the top of this page

Known medication interactions

The pain-relieving effects of paracetamol may be accelerated by taking it alongside:

• metoclopramide – relieves sickness and treats a number of conditions, including indigestion

The liver-damaging effect of an overdose of paracetamol may be worse if taken with:

• carbamazepine – treats a number of conditions, including epilepsy and some types of pain
• phenobarbital or phenytoin – used to control seizures

The effects of paracetamol may be reduced by taking it alongside:

• colestyramine – treats a number of conditions, including the itchiness caused by primary biliary cirrhosis (a type of liver disease)
• lixisenatide – used to treat type 2 diabetes

Paracetamol may reduce how quickly the following medications take effect:

• busulfan given intravenously (directly into a vein) – used to treat some types of cancer

Paracetamol should be taken with caution if taken alongside:

• imatinib – used to treat certain types of leukaemia

Taking paracetamol regularly over a long period of time may increase the blood-thinning (anticoagulant) effect of the following medications, which could increase the risk of bleeding:

• warfarin

Paracetamol-containing medicines

Unless otherwise directed by your GP or pharmacist, you should not take paracetamol with other products that contain paracetamol, such as co-dydramol, co-codamol and Tramacet.

This is due to the risk of overdosing on paracetamol.