By Fiona Callingham

Copyright manchestereveningnews

The NHS has cautioned that people taking certain medications should exercise care when using painkillers, as combining them could be risky. The health service has recommended consulting your GP before taking paracetamol or ibuprofen if you’re affected. Millions of people depend on over-the-counter painkillers for common health issues. Paracetamol is one such medication frequently utilised for headaches, back pain and colds, amongst other conditions. Ibuprofen is likewise extensively accessible across the UK, employed for various aches and pains, including back pain, period pain, toothache and addressing symptoms of colds, flu or even COVID-19 . While these tablets are typically safe to consume provided you adhere to the guidance on the packaging, they do carry particular warnings. On its website , the NHS clarifies that specific other medications should not be consumed alongside paracetamol and ibuprofen. The NHS states that paracetamol is “not suitable” for everyone. This includes people who routinely take warfarin, a medication to prevent blood clots. If this situation applies to you, you should seek advice from your doctor before taking paracetamol, the health authority states. The NHS adds: “Paracetamol can increase the risk of bleeding if you take it [warfarin] regularly.” Nevertheless, it remains safe to take low-dose paracetamol with warfarin. The NHS continues: “It’s safe to take paracetamol while you’re on warfarin. But take the lowest dose that controls your pain. “Taking more than four 500mg tablets over 24 hours for longer than a few days may make your blood clot more slowly. This puts you at risk of bleeding.” It’s also potentially hazardous to take the painkiller alongside other medications containing paracetamol, such as co-codamol or certain cold and flu treatments, due to the overdose risk. However, ibuprofen, aspirin and codeine are alternative painkillers that don’t contain paracetamol and can be safely combined with it. The NHS advises consulting your GP before using paracetamol if you’re taking medication for epilepsy or tuberculosis (TB) as this may also pose risks. The NHS website cautions: “Ibuprofen does not mix well with some medicines.” The health service has warned people against taking ibuprofen at the same time as other nonsteroidal anti-inflammatory drugs (NSAIDs). These include aspirin, diclofenac, celecoxib and naproxen, and mixing them could heighten the risk of adverse effects such as stomach bleeding or kidney complications. “NSAIDs are also used in medicines you can buy from pharmacies, such as cough and cold remedies,” the NHS explains. “Before taking any other medicines, check the label to see if they contain aspirin, ibuprofen or other NSAIDs.” For safety reasons, you should also inform your doctor if you’re using any of the following medicines before starting any form of ibuprofen: You should also avoid combining ibuprofen with gingko biloba supplements as it can “increase the chance of bleeding”. The NHS has further warned that you should seek urgent medical help or ring 111 if you have been taking ibuprofen and experience