can i take paracetamol with warfern?

Question

i have a earacke and the pain is killing me

Answer 1

Warfarin is the mostly interacting drug with others, Its interference with coagulation makes it like this, and so Cares should be taken not to make a harmful interaction>
Paracetamol is called a Non-steroidal antiinflammatoy drug NSAID, and its known that NSAID's interfere with coagulation of blood but very mild as it reduce the platelets stickness.... If it will affect, it may add up the activity of Warfarin as an anti-coagulant...

Answer 2

Try to have about 2 hours inbetween the two doses. Like, take the one at 2 & the other one at 4.

Answer 3

Paracetamol is called acetaminophen (tylenol) in the States.

Answer 4

iv just checked the bnf (British national formulary) witch is the book all health pros use when giving out any drugs and you can take the two together but if your i&r flucuates more than useal see your doc

Answer 5

yes i believe you can but take advice by getting on to the NHS online now

Answer 6

if you take warfarin you mustnt take any drugs without speaking to a pharmasist first, extremely dangerous

Answer 7

Yes you can ,its aspirin you cant take with it.

Answer 8

are you a parrot lol

Answer 9

why u asked this twice?

Answer 10

Are you refering to Warfarin? There is no clinical significant interactions between paracetamol and warfarin.
Extra info:
Anticoagulants + Paracetamol (Acetaminophen)
The anticoagulant effects of acenocoumarol, anisindione, dicoumarol, phenprocoumon and warfarin are normally not affected, or only slightly increased by small occasional doses of paracetamol, but larger doses taken regularly for longer periods may have a greater effect. There is evidence from large-scale studies that concurrent use increases the incidence of upper gastrointestinal bleeding.

Clinical evidence
(a) Prothrombin times unchanged
Ten patients on warfarin showed no changes in their prothrombin times when given paracetamol 3.25 g daily for 2 weeks. 1 A further study in 10 patients given warfarin or phenprocoumon found that two 650-mg doses of paracetamol similarly had no effect on prothrombin times measured over the following 48 hours. 2

The pharmacokinetics and prothrombin time of a single 20-mg dose of warfarin was not significantly altered in 20 healthy subjects who took paracetamol 4 g daily for 2 weeks. 3

(b) Prothrombin times increased
The prothrombin times of 50 patients taking anisindione, dicoumarol, phenprocoumon or warfarin were increased by an average of 3.6 seconds after they took paracetamol 650 mg four times daily for 2 weeks. 4 Paracetamol 2 g daily for 3 weeks increased the thrombotest times of 10 patients on coumarin anticoagulants (6 on phenprocoumon and 4 on acenocoumarol) by about 20%. The anticoagulant dosage was reduced in 5 out of the 10 patients and in one of the 10 control patients. 5 Fifteen healthy subjects, given enough warfarin to increase their prothrombin time ratios by 1.35 to 1.5 times control, were additionally given paracetamol 4 g daily for 2 weeks. The prothrombin time ratios of 7 subjects rose by more than 20% (to greater than 1.75) compared with one subject taking placebo, and by more than 33% (to greater than 2) in 5 others. The increases were seen from about day 7 and were maximal after 12.5 days. 6

A man on acenocoumarol 2 mg daily and paracetamol 1 to 2 g daily for about 6 months had a stable INR of about 2.5, which decreased to 1.6 within 13 days of stopping paracetamol. The INR rose to 2 within about a week of re-starting paracetamol. 7 The INR of a woman on warfarin rose to 7.5, and she developed a retroperitoneal haematoma after taking 8 to 10 tablets (4 to 5 g) of paracetamol over a period of 4 days. 8 A report describes bleeding (haematuria, gum bleeding) in a woman on warfarin after she took about 1.6 g of paracetamol daily for 10 days in a compound paracetamol and codeine preparation. Her prothrombin time rose to 96 seconds. 9 This case is also reported elsewhere. 10 Another report describes bleeding from the gums, bruising and increased INRs (up to 12) in a woman on warfarin after taking 14 g of paracetamol (in co-dydramol) over 7 days on one occasion, and 14 g of paracetamol as Tylex over 8 days on another. 11 A 74-year-old man stabilised on warfarin for 4 years experienced an increased in his INR to 4 after taking paracetamol. Subsequently paracetamol 1 g four times daily for 3 days produced an increase in his INR from 2.3 to 6.4 on day 4. During the following 6 months he occasionally took paracetamol (up to 2 g weekly) and his INR was maintained in the therapeutic range on warfarin 5 mg daily without adjustment. 12 A retrospective study 13 of the factors that increased the risk of excessive anticoagulation with warfarin found that taking paracetamol 9.1 g or more weekly increased by tenfold the odds of having an INR greater than 6. The increases occurred in a dose-dependent manner. 13 A very large-scale study in Denmark found that the incidence of hospitalisation for upper gastrointestinal bleeding in patients on warfarin or phenprocoumon rose from a standard incidence ratio of 2.8 to 4.4 when paracetamol was also taken. 14

Consider also ‘Anticoagulants + Dextropropoxyphene (Propoxyphene)’ because paracetamol is a component of co-proxamol, which is discussed in this monograph.

Mechanism
Not fully understood. Paracetamol is mainly metabolised by glucuronidation and sulfation, 15,16 but the cytochrome P450 isoenzymes CYP1A2, CYP3A4 and CYP2E1 metabolise up to 15% of paracetamol under normal conditions. 15 R-warfarin is mainly metabolised by CYP3A4 and CYP1A2. 15,16 It has been suggested that in conditions such as ageing, hypoxia or hypertension, the isoenzymes play a more important part in paracetamol metabolism. Consequently paracetamol may then compete with the metabolism of R-warfarin to a sufficient degree to provoke an interaction. 16 However, as the S-warfarin enantiomer has significantly greater anticoagulant activity than the R-warfarin enantiomer, interactions with R-warfarin are considered by some to be of questionable significance. 16

Importance and management
An established interaction although there are unexplained inconsistencies in the evidence. Clinical evidence and common experience indicates that occasional small doses of paracetamol (acetaminophen) (said to be no more than about 2.5 to 3 g weekly 13) are unlikely to cause important INR rises in patients on oral anticoagulants, but there is evidence that if larger amounts are taken the risk of getting INRs above 6 steadily rises in a dose-dependent manner, and only 1.3 g daily for a week may increase the risks up to tenfold. 13 This means that if more than occasional doses are taken for longer than a few days, 17 and because of a high degree of interpatient variability and unpredictability 15 there is some risk that occasional patients will develop raised INRs. However, the study 13 suggesting a dose-dependent paracetamol interaction with anticoagulants has been criticised, because other factors, such as normal dose fluctuations, other interacting medication, diet and concurrent illness (diarrhoea, fever, malignancy) may also be involved, 18-22 and an increase in monitoring is unnecessary. 21 However, the authors of the study considered that even in the presence of other factors the link between paracetamol intake and raised INR was significant. 23

Anticoagulants other than those specifically cited above would be expected to interact similarly. Paracetamol is generally safer than aspirin as an analgesic in the presence of an anticoagulant because it does not affect platelets or cause gastric bleeding.