Paracetamol Use in Patients Taking Anticoagulants

Clinical Practice Guidelines

• The American College of Cardiology recommends using paracetamol as the preferred analgesic option for mild to moderate pain in anticoagulated patients, at the lowest effective dose (preferably ≤2g daily) 1
• For patients requiring higher doses (>2g daily) or prolonged therapy, the American College of Cardiology suggests considering additional INR monitoring within 5-7 days of initiating paracetamol 1
• For perioperative management, the American College of Cardiology recommends following established guidelines for temporarily discontinuing anticoagulants before procedures based on thrombotic risk, and using paracetamol for pain management without additional concerns beyond standard anticoagulation bridging protocols 1
• The British Society of Gastroenterology guidelines suggest following established protocols for temporarily discontinuing anticoagulants before procedures based on thrombotic risk 2, 3