People on common medications warned 'do not mix' with paracetamol or ibuprofen

The NHS has issued a warning to people taking specific medicines as they could prove hazardous when mixed with certain widely-used painkillers. You should consult your GP before using paracetamol or ibuprofen if this concerns you, the health service advised.

Countless people depend on non-prescription painkillers for routine complaints.Paracetamol is one such medicinefrequently used for headaches, back pain and colds among other conditions.

Ibuprofen is equally accessible across the UK, employed for various aches and pains, including back pain, period pain, toothache and managing symptoms of colds, flu or even COVID-19. While these tablets are typically safe to consume provided you adhere to the guidance on the packaging, they do carry certain warnings.

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On its website, the NHS clarifies that particular other medicines should not be consumed alongside paracetamol and ibuprofen.

Paracetamol

The NHS states that paracetamol is "not suitable" for everyone. This includes people who routinely take warfarin, a drug to prevent blood clots.

If this applies to you, you should speak with your doctor before using paracetamol, the health authority states. The NHS adds: "Paracetamol can increase the risk of bleeding if you take it [warfarin] regularly."

Nevertheless, it remains safe to consume 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."

It's also potentially hazardous to take the painkiller in conjunction with other medications that contain paracetamol, such as co-codamol or certain cold and flu tablets, due to the risk of overdose.

However, ibuprofen, aspirin and codeine are other painkillers that do not contain paracetamol and are safe to take alongside it. The NHS advises that you should consult your doctor before taking paracetamol if you are on medication for epilepsy or tuberculosis (TB) as this can also pose a risk.

Ibuprofen

The NHS websitecautions: "Ibuprofen does not mix well with some medicines." The health body has urged people to avoid taking ibuprofen concurrently with other nonsteroidal anti-inflammatory drugs (NSAIDs).

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

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

• Medicines that aid in preventing blood clots, such as warfarin
• Medicines for high blood pressure
• Steroid medicines like 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 further advised that you should seek medical attention immediately or call 111 if you have been taking ibuprofen and you experience:

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