Maxigesic Drug Interactions

Paracetamol: The following interactions have been noted: anticoagulant drugs (e.g. warfarin): dosage may require reduction if paracetamol and anticoagulants are taken for a prolonged period of time.
antiepileptic medications: the likelihood of toxicity may be increased by the concomitant use of enzyme inducing agents.
paracetamol absorption is increased by substances that increase gastric emptying, e.g. metoclopramide.
paracetamol absorption is decreased by substances that decrease gastric emptying e.g. propantheline, antidepressants with anticholinergic properties, and narcotic analgesics.
paracetamol may increase chloramphenicol plasma concentrations.
hepatotoxic drugs or drugs that induce liver microsomal enzymes such as alcohol and anticonvulsant agents: the risk of paracetamol toxicity may be increased in patients receiving these drugs.
probenecid: may affect paracetamol excretion and plasma concentrations.
cholestyramine: reduces the absorption of paracetamol if given within 1 hour of paracetamol.
isoniazid alone or combined with other drugs for tuberculosis: in patients receiving these drugs severe hepatotoxicity at therapeutic doses or moderate overdoses of paracetamol has been reported.
zidovudine and co-trimoxazole: severe hepatotoxicity has occurred after use of paracetamol in a patients taking these drugs.
Ibuprofen: The following interactions have been noted: anticoagulants, including warfarin: ibuprofen interferes with the stability of INR and may increase risk of severe bleeding and sometimes fatal haemorrhage, especially from the gastrointestinal tract. Ibuprofen should only be used in patients taking warfarin if absolutely necessary and they must be closely monitored.
lithium: ibuprofen may decrease renal clearance and increase plasma concentration of lithium.
ACE inhibitors, beta-blockers and diuretics: ibuprofen may reduce the anti-hypertensive effect of these drugs and may cause natriuresis and hyperkalemia in patients under these treatments.
methotrexate: ibuprofen reduces methotrexate clearance.
cardiac glycosides: ibuprofen may increase the plasma levels of these drugs.
corticosteroids: the risk of ibuprofen-induced gastrointestinal bleeding may be increased with concomitant use of oral corticosteroids.
zidovudine: ibuprofen may prolong bleeding time in patients treated with this drug.
probenecid, antidiabetic medicine and phenytoin: these medicines may interact with ibuprofen.