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Dr. Andrew Rynne
MD
Dr. Andrew Rynne

Family Physician

Exp 50 years

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Can Ibuprofen And Paracetamol Be Taken Together While On Warfarin?

HI, my mother is on wafarin as she came back from hospital 2 weeks ago. she was in hospital for a Valve change and now has the mechanical valve. she has no alligies and has only been give paracetmol for pain releif. As she has bouts of other aches and pains, would it be harmful if she was to take a ibuprofen 400mg with her paracetomol?
Tue, 29 Nov 2016
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General & Family Physician,  's  Response
Hi & Welcome.

I appreciate your concern for your beloved mother who is taking "blood thinner" Warfarin for her prosthetic heart valve to prevent thromboembolism.

Nonsteroidal anti-inflammatory drugs like Ibuprofen reduce the pain or inflammatory swelling by decreasing the prostaglandin synthesis. The lack of prostaglandins prevent the aggregation of platelets responsible for the clot formation and thus bleeding can be an important side effect of such drugs.

So, if taken together with Warfarin Ibuprofen may increase the risk of bruising, bleeding, vomiting of blood, blood in the urine or stools, headache, dizziness or weakness.

It is better to avoid giving her Ibuprofen as long as she takes Warfarin.

For her body aches and pains which are not relieved by Paracetamol alone, an opioid analgesic like Tramadol or Codeine may be added along with Paracetamol after consulting her treating doctor.

Remember, in order to keep her Warfarin at an optimal dose the periodic lab tests such as international normalized ration (INR) and prothrombin time should be maintained in their normal ranges.

Hope these answer your query.
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Can Ibuprofen And Paracetamol Be Taken Together While On Warfarin?

Hi & Welcome. I appreciate your concern for your beloved mother who is taking blood thinner Warfarin for her prosthetic heart valve to prevent thromboembolism. Nonsteroidal anti-inflammatory drugs like Ibuprofen reduce the pain or inflammatory swelling by decreasing the prostaglandin synthesis. The lack of prostaglandins prevent the aggregation of platelets responsible for the clot formation and thus bleeding can be an important side effect of such drugs. So, if taken together with Warfarin Ibuprofen may increase the risk of bruising, bleeding, vomiting of blood, blood in the urine or stools, headache, dizziness or weakness. It is better to avoid giving her Ibuprofen as long as she takes Warfarin. For her body aches and pains which are not relieved by Paracetamol alone, an opioid analgesic like Tramadol or Codeine may be added along with Paracetamol after consulting her treating doctor. Remember, in order to keep her Warfarin at an optimal dose the periodic lab tests such as international normalized ration (INR) and prothrombin time should be maintained in their normal ranges. Hope these answer your query.