The NHS has warned people who take certain medications that they could be dangerous when combined with some popular painkillers. You should talk to your doctor before taking paracetamol or ibuprofen if this applies to you, the health body said.

Many people rely on over-the-counter painkillers for everyday ailments. Paracetamol is one such medication often taken for headaches, back pain and colds among other issues.

Ibuprofen is similarly readily available in the UK, used for a range of aches and pains, including back pain, period pain, toothache and treating symptoms of colds, flu or even COVID-19.

While these pills are generally safe to take as long as you follow the instructions on the package, they do come with some warnings.

On its website, the NHS explains that certain other medications should not be taken alongside paracetamol and ibuprofen.

Paracetamol

According to the NHS, paracetamol is “not suitable” for some people. This includes people who regularly take warfarin, a medicine to prevent blood clots.

If this affects you, you should talk to your GP before taking paracetamol, the health body says. The NHS adds: “Paracetamol can increase the risk of bleeding if you take it [warfarin] regularly.”

However, it is safe to take low-dose paracetamol with warfarin. 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. This puts you at risk of bleeding.”

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It is also potentially dangerous to take the painkiller alongside other medications that contain paracetamol such as co-codamol or certain cold and flu tablets. This is because there is a risk of overdose.

But ibuprofen, aspirin and codeine are other painkillers that do not contain paracetamol and are safe to take with it. The NHS adds that you should speak to your doctor before taking paracetamol if you are on medicine to treat epilepsy or tuberculosis (TB) as this can also be risky.

Ibuprofen

The NHS website warns: “Ibuprofen does not mix well with some medicines.” The health body urged people to avoid taking ibuprofen at the same time as other nonsteroidal anti-inflammatory drugs (NSAIDs).

These include aspirin, diclofenac, celecoxib and naproxen, and taken together could increase the risk of side effects such as bleeding in your stomach or kidney problems. “NSAIDs are also used in medicines you can buy from pharmacies, such as cough and cold remedies,” the NHS says.

“Before taking any other medicines, check the label to see if they contain aspirin, ibuprofen or other NSAIDs.” For your safety, you should also tell your doctor if you’re taking any of the following medicines before you start taking any type of ibuprofen:

• Medicines that help to prevent blood clots, such as warfarin
• Medicines for high blood pressure
• Steroid medicines such as betamethasone, dexamethasone, hydrocortisone or prednisolone
• Antibiotics such as ciprofloxacin, levofloxacin, moxifloxacin, norfloxacin or ofloxacin
• Antidepressants such as citalopram, fluoxetine, fluvoxamine, venlafaxine, paroxetine or sertraline
• Diabetes medicines such as gliclazide, glimepiride, glipizide or tolbutamide.

You should also avoid taking ibuprofen with gingko biloba supplements as it can “increase the chance of bleeding”. The NHS added that you should see a doctor as soon as possible or call 111 if you have been taking ibuprofen and you experience:

• Black poo or blood in your vomit – these can be signs of bleeding in your stomach
• Swollen ankles, blood in your pee or not peeing at all – these can be signs of a kidney problem.