Shop products for Acetaminophen 
Also indexed as: 222 AF®, Abenol®, Acetab®, Acet®, Alisphene Forte®, Alvedon®, Anadin Paracetamol®, APAP, Apo-Acetaminophen®, Artritol®, Atasol®, Boots Children’s Pain Relief Syrup®, Boots Cold Relief Hot Blackcurrant®, Boots Cold Relief Hot Lemon®, Boots Infant Pain Relief®, Calpol 6 Plus®, Calpol Infant®, Calpol Pediatric®, Calpol®, Cephanol®, Children’s Acetaminophen®, Children’s Feverhalt®, Cupanol Over 6®, Cupanol Under 6®, Disprol®, Dom-Acetaminophen®, Fanalgic®, Fennings Children’s Cooling Powders®, Hill’s Balsam Flu Strength Hot Lemon Powders®, Infadrops®, Lem-Plus Powders®, Medinol®, Novogesic®, Pain Aid Free®, Paldesic®, Panaleve 6+®, Panaleve Junior®, Pandol®, Panodol Baby and Infant®, Paracetamol, Paracets®, Paraclear®, Paramin®, Pediatrix®, PMS Acetaminophen®, Resolve®, Robigesic Elixir®, Rounox®, Salzone®, Tantaphen®, Tempra®, Tixymol®, Tramil® 500, Trianon®, Tylenol®, WestCan Extra Strength Acetaminophen®, WestCan Regular Strength Acetaminophen®
Combination drugs: Alka-Seltzer Plus®, Co-Proxamol, Coalgesic®, Darvocet® N, Distalgesic®, Endocet®, Excedrin® PM, Fioricet®, Lortab®, Midrin®, Nyquil®, Nyquil® Hot Therapy Powder, Percocet®, Phrenilin®, Propacet 100®, Roxicet®, Theraflu®, Tylenol® Allergy Sinus, Tylenol® Cold, Tylenol® Flu NightTime Maximum Strength Powder, Tylenol® Multi-Symptom Hot Medication, Tylenol® PM, Tylenol® Sinus, Tylenol® with Codeine, Vicodin®, Wygesic®
Paracetamol is used to reduce pain and fever. Unlike NSAIDs (nonsteroidal anti-inflammatory drugs), it lacks anti-inflammatory activity. Paracetamol is available by itself or in nonprescription and prescription-only combination products used to relieve pain and the symptoms associated with colds and flu.
Summary of
Interactions with Vitamins, Herbs, and Foods
In some cases, an herb or supplement may appear in more than one category, which may seem
contradictory. For clarification, read the full article for details about the summarized
interactions.
 May be Beneficial: Side effect
reduction/prevention—Taking these supplements may help reduce the likelihood and/or
severity of a potential side effect caused by the medication. |
Milk thistle* N-acetyl cysteine |
| May be Beneficial: Supportive
interaction—Taking these supplements may support or otherwise help your medication
work better. |
Vitamin C* |
 Check: Other—Before taking any of these supplements
or eating any of these foods with your medication, read this article in full for details. |
Schisandra |
| Depletion or interference |
None known |
| Reduced drug absorption/bioavailability |
None known |
| Adverse interaction |
None known |
An asterisk (*) next to an item in the summary indicates that the interaction is supported only by weak, fragmentary, and/or contradictory scientific evidence.
Interactions with Dietary Supplements
N-acetyl cysteine
(NAC)
Hospitals use oral and intravenous N-acetyl cysteine (NAC) to treat liver damage induced by
paracetamol overdose poisoning.1 NAC is often administered intravenously by
emergency room doctors. Oral NAC appears to be effective for paracetamol toxicity.
An uncontrolled trial compared intravenous NAC with oral NAC in children with paracetamol poisoning and found that both methods were equally effective in reversing paracetamol-induced liver toxicity.2 However, paracetamol toxicity is a potential medical emergency, and should only be managed by qualified healthcare professionals.
Vitamin C
Taking 3 grams vitamin C with paracetamol has been shown to prolong the amount of time
paracetamol stays in the body.3 This theoretically might allow people to use less
paracetamol, thereby reducing the risk of side effects. Consult with a doctor about this
potential before reducing the amount of paracetamol.
Interactions with Herbs
Milk thistle
(Silybum marianum)
Silymarin is a collection of complex flavonoids found in milk thistle that has been shown to
elevate liver glutathione levels in rats.4 Paracetamol can cause liver damage,
which is believed to involve glutathione depletion.5 In one study involving rats,
silymarin protected against paracetamol-induced glutathione depletion.6 While
studies to confirm this action in humans have not been conducted, some doctors recommend
silymarin supplementation with 200 mg milk thistle extract, containing 70–80% silymarin,
three times per day for people taking paracetamol in large amounts for more than one year
and/or with other risk factors for liver problems.
Schisandra
(Schisandra chinensis)
Gomisin A is a constituent found in the Chinese herb schisandra. In a study of rats given
liver-damaging amounts of paracetamol, gomisin A appeared to protect against some liver damage
but did not prevent glutathione depletion7 (unlike milk thistle, as reported
above). Studies have not yet confirmed this action in humans.
Interactions with Foods and Other Compounds
Food
Food, especially foods high in pectin (including jellies), carbohydrates, and large amounts of
cruciferous vegetables (broccoli, Brussels sprouts,
cabbage, and others) can interfere with paracetamol absorption.8 It is unclear how
much effect this interaction has on paracetamol activity.
Alcohol
Moderate to high amounts of paracetamol have caused liver damage in people with
alcoholism.9 To prevent problems, people taking paracetamol should avoid
alcohol.
References
1. Vale JA, Proudfoot AT. Paracetamol (acetaminophen) poisoning. Lancet 1995;346:547–52.
2. Perry HE, Shannon MW. J Pediatr 1998;132:149–52.
3. Houston JB, Levy G. Drug biotransformation interactions in man. VI: Acetaminophen and ascorbic acid. J Pharm Sci 1976;65:1218–21.
4. Valenzuela A, Aspillaga M, Vial S, Guerra R. Selectivity of silymarin on the increase of the glutathione content in different tissues of the rat. Planta Med 1989;55:420–2.
5. Threlkeld DS, ed. Central Nervous System Drugs, Acetaminophen. In Facts and Comparisons Drug Information. St. Louis, MO: Facts and Comparisons, Mar 1997, 247–f.
6. Campos R, Garrido A, Guerra R, Valenzuela A. Silybin dihemisuccinate protects against glutathione depletion and lipid peroxidation induced by acetaminophen on rat liver. Planta Med 1989;55:417–9.
7. Yamada S, Murawaki Y, Kawasaki H. Preventive effect of gomisin A, a lignan component of schizandra fruits, on acetaminophen-induced hepatotoxicity in rats. Biochem Pharmacol 1993;46:1081–5.
8. Holt GA. Food & Drug Interactions. Chicago: Precept Press, 1998, 2.
9. Threlkeld DS, ed. Central Nervous System Drugs, Acetaminophen. In Facts and Comparisons Drug Information. St. Louis, MO: Facts and Comparisons, Mar 1997, 247–f.
