Acetaminophen (drug interactions)
Acetaminophen is a widely used medication for pain relief and fever reduction, known for its effectiveness and availability under various trade names, including Tylenol and Panadol. However, it is important to be aware of potential drug interactions that can affect its safety and efficacy. Certain herbal supplements and medications may either enhance the risk of toxicity or diminish the drug's effectiveness. For instance, the consumption of alcohol while using acetaminophen poses significant risks, particularly for liver health.
Certain herbs such as chaparral, comfrey, and coltsfoot are known to be liver-toxic and could exacerbate acetaminophen's side effects. Additionally, high doses of vitamin C may increase acetaminophen levels in the body, raising the risk of toxicity. Other medications, like warfarin and carbamazepine, can interact adversely with acetaminophen, leading to complications such as bleeding or reduced effectiveness of the drug. It is crucial for individuals, especially those with liver or kidney issues or those regularly consuming alcohol, to consult healthcare professionals before combining acetaminophen with any other substances. Understanding these interactions is key to using acetaminophen safely and effectively.
Acetaminophen (drug interactions)
DEFINITION: A common drug used to reduce pain and fever.
INTERACTIONS: Chaparral, citrate, coenzyme Q10, coltsfoot, comfrey, methionine, milk thistle, vitamin C, alcohol, various medications, and herbal supplements
TRADE NAMES: Apacet, Arthritis Foundation Oral, Acephen, Aceta, Amaphen, Anoquan, Aspirin Free Anacin, Aspirin Free Excedrin, Bayer Select, Dapacin, Dynafed, Endolor, Esgic, Excedrin P.M., Fem-Etts, Femcet, Feverall, Fioricet, Fiorpap, Genapap, Genebs, Halenol, Isocet, Liquiprin, Mapap, Maranox, Meda, Medigesic, Midol, Neopap, Pamprin, Oraphen-PD, Panadol, Phrenilin, Repan, Ridenol, Sedapap, Silapap, Sominex Pain Relief, Tapanol, Tempra, Tylenol, Uni-Ace, Unisom with Pain Relief
Milk Thistle, Coenzyme Q10 (CoQ10), Methionine
Effect: Possible Helpful Interactions
The herb milk thistle and the supplements CoQ10 and methionine might help protect the liver against damage caused by excessive acetaminophen use. However, excessive acetaminophen use is extremely dangerous.
Vitamin C
Effect: Possible Increased Risk of Toxicity
One study from the 1970s suggests that very high doses of vitamin C (3 grams daily) might increase the levels of acetaminophen in the body. This could potentially put a person at higher risk for acetaminophen toxicity. Problems might occur if one takes higher-than-recommended doses or takes high doses of acetaminophen regularly, such as for osteoarthritis. The risk increases if one has liver or kidney impairment or drinks alcoholic beverages regularly, which further harms the liver.
Chaparral, Comfrey, and Coltsfoot
Effect: Possible Harmful Interaction
Chaparral (Larrea tridentata or L. mexicana), comfrey (Symphytum officinale), and coltsfoot (Tussilago farfara) are liver-toxic herbs. Combined use with acetaminophen could accentuate the medication's liver toxicity.
Citrate
Effect: Possible Harmful Interaction
Potassium citrate, sodium citrate, and potassium-magnesium citrate are sometimes used to prevent kidney stones. These supplements reduce urinary acidity, which can lead to decreased blood levels and decreased effectiveness of acetaminophen.
Other Known Interactions
Several other medications and herbs that interact with acetaminophen. Warfarin can lead to bleeding and anemia when taken with acetaminophen. Carbamazepine, cholestyramine, isoniazid, rifampin, phenytoin, valsartan, and probenecid are medications with known adverse interactions when taken with acetaminophen. Herbs and supplements may also dangerously interact with acetaminophen. Ginkgo may increase the risk of bleeding. Kava, turmeric, garlic, ginger, bilberry, dong quai, feverfew, ginseng, meadowsweet, willow, chamomile, and motherwort are other herbs that interact dangerously with analgesics like acetaminophen. Drinking alcohol while taking acetaminophen is especially dangerous and can lead to liver damage, stomach irritation, and significant health issues.
Bibliography
Farrell, Susan, M.D. "Acetaminophen Toxicity." Medscape, 5 Oct. 2021, emedicine.medscape.com/article/820200-overview. Accessed 8 Dec. 2022.
MacMillan, Amanda. "Herbal Supplements May Interact With Common Medications." Time, 24 Jan. 2018, time.com/5116664/are-herbal-supplements-safe. Accessed 3 Sept. 2024.
Muriel, P., et al. "Silymarin Protects Against Paracetamol-Induced Lipid Peroxidation and Liver Damage." Journal of Applied Toxicology, vol. 12, 1992, pp. 439-442.
Neuvonen, P. J., et al. "Methionine in Paracetamol Tablets: A Tool to Reduce Paracetamol Toxicity." International Journal of Clinical Pharmacology, Therapy, and Toxicology, vol. 23, 1985, pp. 497-500.
Peckham, Alyssa. "Acetaminophen and Alcohol: Safety and Risks." Medical News Today, 17 Jan. 2024, www.medicalnewstoday.com/articles/322813. Accessed 3 Sept. 2024.
2011 PDR for Nonprescription Drugs, Dietary Supplements, and Herbs. Toronto, Ont.: Thomson Health Care, 2010.