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Acetaminophen - Interactions and Warnings

The mechanisms of sleep disruption after NSAID administration may relate to direct and indirect consequences of inhibiting prostaglandin synthesis, including decreases in prostaglandin D2, suppression of nighttime melatonin levels, and changes in body temperature.
- Physiol Behav. 1994 Jun;55(6):1063-6. -- Nonsteroidal anti-inflammatory drugs affect normal sleep patterns in humans. -- Murphy PJ, Badia P, Myers BL, Boecker MR, Wright KP Jr.

Incidences of hepatotoxicity and nephrotoxicity may be augmented by acetaminophen when concomitantly used with the potentially hepatotoxic herbs echinacea and kava, and with herbs containing salicylate such as willow and meadowsweet.
- J Clin Pharm Ther. 2002 Dec;27(6):391-401. -- Herbal medication: potential for adverse interactions with analgesic drugs. -- Abebe W.

Overdosage of acetaminophen causes fatal hepatic failure and acute renal failure.
- Fukuoka Igaku Zasshi 1997 Nov;88(11):352-7 -- The risk factors of death from the acetaminophen poisoning with antipyretic-analgesic drugs in Japan. -- Washio M, Inoue N.

Oral administration of 3 g of ascorbic acid 1.5 hr after an oral dose of 1 g of acetaminophen caused a rapid and pronounced decrease in the excretion rate of acetaminophen sulfate in five healthy adult volunteers. There was a statistically significant increase in the fractions of the dose of acetaminophen excreted as such as as acetaminophen glucuronide but a decrease in the fraction excreted as acetaminophen sulfate. Ascorbic acid, which itself is metabolized in part to the sulfate, inhibits the conjugation of acetaminophen with sulfate by competing for available sulfate in the body.
- J Pharm Sci 1976 Aug;65(8):1218-21 -- Drug biotransformation interactions in man VI: acetaminophen and ascorbic acid. -- Houston JB, Levy G.

Acetaminophen may interfere with home blood-glucose-measurement systems.
- Am J Hosp Pharm 1985 Oct;42(10):2202-7 -- In vitro drug interference with home blood-glucose-measurement systems. -- Rice GK, Galt KA.

last update: November 2008

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