Can You Take Ibuprofen and Acetaminophen Together?
The question is: Is it safe to combine ibuprofen and acetaminophen?
That’s what I’m going to answer today.
Ibuprofen and acetaminophen are two common over-the-counter (OTC) drugs used for treating fever, headache, nausea, vomiting, muscle aches or other symptoms associated with inflammation. They’re both available without a prescription from your doctor.
Acetaminophen is usually found in Tylenol products, but it’s also sold as an OTC product under such brand names as Norco, Panadol and others. Ibuprofen is commonly found in many different brands of nonprescription cold medicine like Motrin, Advil, Aleve and others.
How Do You Combine These Two Common OTC Drugs?
You can’t just take one drug at a time. If you do, you risk potentially fatal liver damage if the combination causes too much bleeding into your bloodstream. So it’s best to use them separately when possible. 
So how does this work?
Well, there are several ways to combine these two medications. Some of them involve taking multiple doses of each medication before using the other one. Others involve mixing them up so they don’t have any interaction effects.
Can You Take Them at Different Times?
While not the most efficient way to take them, you can definitely take them at different times. Taking acetaminophen or paracetamol an hour or two before taking your ibuprofen will help prevent most of their negative effects. Since the half-life of each medication varies with each person, this doesn’t ensure safety, but should be fine in most cases.
Can You Take Them in Different Forms?
They can also be taken in different forms, such as combining a liquid dose of the acetaminophen or paracetamol with a tablet of the ibuprofen or vice-versa.
Can You Combine Different Dosages?
Combining different dosages introduces a higher risk of liver damage but is generally considered safer than combining a low dosage with a high dosage. Generally, this is only recommended if you’re taking less than 3200mg of ibuprofen.
For example: combining two pills or capsules of 200mg each would be fine and shouldn’t cause any issues. If you’re taking a liquid form with an unknown dosage, you should probably stick with the low-risk dosage recommendations.
What are the Side Effects?
The main concern when it comes to combining these two drugs is liver toxicity. Taking acetaminophen or paracetamol to relieve a headache is generally safe, but taking it with an NSAID like ibuprofen can cause your liver to swell and turn yellow.
Once the swelling becomes too large, it can cause liver failure. On rare occasions, this will lead to death. Most cases can be reversed if the patient stops taking the medications and receives medical treatment immediately.
The good news is that many people take these drugs without any issues. The bad news is that there’s no way of predicting who will have a negative interaction. If you’re taking both drugs for medical reasons, you should keep your doctor updated about all other medications you’re taking in order to prevent liver failure down the road.
If you’re taking a low dose of either drug, you shouldn’t experience any liver problems so long as you take your other meds. If you’re taking a high dosage, it’s still unlikely that you’ll experience any problems as long as you follow the general guidelines above.
What Should You Do?
If you have been experiencing liver issues or are worried about potential liver damage down the road, talk to your doctor about the possible interactions. If you take acetaminophen or paracetamol on a regular basis, your physician may be able to prescribe an alternative drug.
If you take any other meds on a daily basis, ask your doctor about the drug interactions so you can take both safely.
Hopefully, you don’t experience any liver issues but, if you do, this can seriously impact your life in a negative way. Take care of yourself and your liver!
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Sources & references used in this article:
Ibuprofen or acetaminophen for the acute treatment of migraine in children: a double-blind, randomized, placebo-controlled, crossover study by ML Hamalainen, K Hoppu, E Valkeila, P Santavuori – Neurology, 1997 – AAN Enterprises
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Combined acetaminophen and ibuprofen for pain relief after oral surgery in adults: a randomized controlled trial by AF Merry, RD Gibbs, J Edwards, GS Ting… – British journal of …, 2010 – academic.oup.com