MinorAntiplatelet agents (low dose) / NSAIDs (analgesic dose)×Anilides. Analgesics and antipyretics
Updated · Methodology
Mechanism
Paracetamol does not inhibit platelet cyclooxygenase, so it neither competes with acetylsalicylic acid for the binding site nor interferes with cardioprotection, unlike ibuprofen. The paracetamol label proposes it as the alternative to salicylates in anticoagulated patients, with one condition: chronic use above 2 g a day can potentiate acenocoumarol and warfarin.
Symptoms
No symptoms attributable to the pair. With analgesic doses of aspirin the gastrointestinal risk, gum bleeding and bruising remain; at 100 mg the profile is the usual cardioprotective one. If an oral anticoagulant is also on board with chronic paracetamol, INR may rise.
Management
Paracetamol is the analgesic of choice for patients on 100 mg aspirin for cardioprotection: no dose spacing is needed. On oral anticoagulants keep sustained use below 2 g a day, or check INR if more is required.
Check the full regimen, not just this pair
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Sources
- AEMPS: Ficha técnica Paracetamol Abamed 1 g comprimidos EFG (2020)– AEMPS, CIMA, nº registro 77758, secciones 4.2 y 4.5
- AEMPS: Ficha técnica Ácido acetilsalicílico Cinfa 100 mg comprimidos gastrorresistentes EFG (2024)– AEMPS, CIMA, nº registro 74266, sección 4.5