Anti-Depressants with painkillers (paracetamol, NSAIDs, aspirin)
Painkillers are among the most commonly co-administered medications with Anti-Depressants (Anti-Depressants), often started without telling the prescriber. Most short-term combinations are safe at the standard 10mg, 20mg, 40mg, 30mg, 60mg dose, but a few specific painkiller-Amitriptyline, Bupropion, Citalopram, Duloxetine, Escitalopram, Fluoxetine, Mirtazapine, Paroxetine, Sertraline, Trazodone, Venlafaxine interactions matter and should not be assumed away.
Common painkillers and Anti-Depressants
Paracetamol (acetaminophen) is generally the safest painkiller to combine with Anti-Depressants, with very few documented interactions. NSAIDs (ibuprofen, naproxen, diclofenac) can interact with cardiovascular medications and amplify renal or gastrointestinal risks of Amitriptyline, Bupropion, Citalopram, Duloxetine, Escitalopram, Fluoxetine, Mirtazapine, Paroxetine, Sertraline, Trazodone, Venlafaxine. Aspirin shares the NSAID profile plus its own bleeding risk. Opioid painkillers add sedative load to many Anti-Depressants agents.
Practical guidance
According to the prescribing information for Amitriptyline, Bupropion, Citalopram, Duloxetine, Escitalopram, Fluoxetine, Mirtazapine, Paroxetine, Sertraline, Trazodone, Venlafaxine, occasional standard-dose painkiller use is rarely a problem with Anti-Depressants at 10mg, 20mg, 40mg, 30mg, 60mg. Regular daily NSAID use, high-dose aspirin therapy, or any opioid combination should be reviewed with the prescriber or pharmacist before being added to a routine that already includes Anti-Depressants.
Frequently asked questions
Is paracetamol safe with Anti-Depressants? ▾
Paracetamol at standard adult doses (≤3g/day for short courses) is generally safe to take with Anti-Depressants at 10mg, 20mg, 40mg, 30mg, 60mg. It is usually the first-line painkiller to combine with chronic medication because of its low interaction profile.
Can I take ibuprofen on Anti-Depressants? ▾
Occasional ibuprofen for short-term pain is usually fine with Anti-Depressants. Daily ibuprofen, NSAIDs in elderly users, or NSAIDs combined with cardiovascular or renal disease deserve a pharmacist review before being routinely added to Amitriptyline, Bupropion, Citalopram, Duloxetine, Escitalopram, Fluoxetine, Mirtazapine, Paroxetine, Sertraline, Trazodone, Venlafaxine.
Medications in Anti-Depressants
More on Anti-Depressants
- With alcoholAnti-Depressants and alcohol — is it safe to drink?
- With foodShould Anti-Depressants be taken with food?
- Side effectsAnti-Depressants side effects: common, rare and warning signs
- For older adultsAnti-Depressants after 60: doses and safety in older adults
- For womenAnti-Depressants for women: indications and considerations
- For menAnti-Depressants for men: indications and considerations
The information on this website is provided for reference and educational purposes only. It does not replace consultation with a qualified healthcare professional.