Paracetamol (acetaminophen) and warfarin interaction: unraveling the pivotal role of the vitamin K cycle
Elaine M. Hylek
Boston University School of Medicine, Department of Medicine, Section of General Internal Medicine and the Clinical Epidemiology Unit, Boston, Massachusetts, USA
Summary Analgesia poses a clinical challenge for patients takinganticoagulants. Nonsteroidal anti-inflammatory drugsimpair platelet function and also interfere withprostaglandin’s protective effect on the gastric mucosa. As aresult, these medications increase the risk of gastrointestinalhemorrhage (1). In clinical practice, patients are advised toavoid or limit use of these agents because of the added risk ofbleeding. Paracetamol (acetaminophen) is the antipyretic andanalgesic of choice for patients on anticoagulant therapybecause it lacks these adverse effects on platelets and prostaglandin.Paracetamol is readily available and widely used. . . .