The NHS has issued a warning for anyone using a common painkiller, highlighting possible harmful interactions with other medications. Across the UK, many people turn to over-the-counter medicines for daily aches, colds, and minor illnesses. Among these, paracetamol is one of the most widely used, often taken for headaches, back pain, and cold symptoms. But, like any medication, it carries certain risks.Who Should Be Careful?The NHS has provided guidance on using paracetamol safely, including which drug combinations should be avoided. “Paracetamol is not suitable for some people,” the health body explains. This includes individuals who take warfarin, a drug that prevents blood clots. If you are on warfarin, you should check with your GP before taking paracetamol, the NHS advises. “Paracetamol can raise the risk of bleeding in those who regularly take warfarin.”Safe Dosing GuidelinesSmall doses of paracetamol alongside warfarin are generally considered safe. The NHS adds: “It’s safe to take paracetamol if you’re on warfarin. Stick to the lowest dose that relieves your pain. Exceeding four 500mg tablets in 24 hours for more than a few days can slow your blood clotting, putting you at risk of bleeding.”Avoid Double DosingCombining paracetamol with other medicines containing the same ingredient—like co-codamol or some cold and flu remedies—can be risky due to the danger of overdose. Other common painkillers, such as ibuprofen, aspirin, or codeine, do not contain paracetamol and can safely be taken at the same time.Check with Your DoctorThe NHS advises consulting a doctor before taking paracetamol if you’re on medications for epilepsy or tuberculosis (TB), as these combinations can also pose risks.Herbal Remedies and SupplementsGenerally, paracetamol is not affected by herbal supplements, though the NHS notes: “There isn’t enough information to say whether herbal remedies, complementary medicines, or supplements are safe with paracetamol. They are not tested the same way as prescription or pharmacy medications and may interact differently.” Patients should inform their doctor or pharmacist about any other medicines or supplements they are taking.Side Effects of ParacetamolWhen taken at the recommended dose, paracetamol “very rarely” causes side effects. For a full list, refer to the information leaflet inside the packaging.Serious Allergic ReactionsIn rare cases, a serious allergic reaction (anaphylaxis) can occur. The NHS advises calling 999 immediately if you notice:Swelling of lips, mouth, throat, or tongueRapid or labored breathing, wheezing, or a choking sensationA tight throat or difficulty swallowingSkin, lips, or tongue turning blue, grey, or pale (on darker skin, check palms or soles)Sudden confusion, extreme drowsiness, or dizzinessFainting and unresponsivenessA child appearing limp, floppy, or unresponsive, with difficulty lifting or focusing their head
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