Mixing Tylenol (Acetaminophen) and Prednisone: What You Should Know

Prednisone is a corticosteroid used to decrease inflammation in different diseases, including arthritis, severe allergic reactions, and multiple sclerosis. It works by lowering the activity of the immune system.

Tylenol (acetaminophen) is a pain reliever commonly used to manage mild to moderate pain from headaches, muscle aches, menstrual periods, colds and sore throats, toothaches, backaches, and reactions to vaccinations.

No interaction has been found between the two medications so far. However, you should always consult your healthcare provider before starting a new medication.

This article details whether it is safe to take prednisone with acetaminophen, and includes medications that do not interact with either drug.

What Is Prednisone?

Prednisone is a synthetic corticosteroid. It is different from hydrocortisone or cortisone. It lowers the activity of your immune system, which can help with conditions like rheumatoid arthritis, where the immune system attacks healthy joint tissues and causes inflammation.

As such, prednisone is used in the treatment of different types of autoimmune diseases, which occur when the immune system attacks healthy cells.

This medication is also used to treat a number of other conditions:

• Blood disorders: Autoimmune hemolytic anemia, congenital hypoplastic anemia, leukemia, and lymphoma
• Skin diseases: Atopic dermatitis (eczema), severe psoriasis
• Endocrine disorders: Addison’s disease and congenital hyperplasia
• Eye-related allergic reactions: Conjunctivitis (pink eye), keratitis (cornea inflammation), and optic neuritis (inflammation damaging the optic nerve)
• Rheumatic disorders: Gout, multiple sclerosis, rheumatoid arthritis, and systemic lupus erythematosus
• Allergic reactions: Seasonal allergies, bronchial asthma, and drug hypersensitivity reactions
• Respiratory diseases: Asthma, berylliosis (metal poisoning caused by inhalation), chronic obstructive pulmonary disease, and Loeffler’s syndrome that’s not manageable by other means
• Gastrointestinal diseases: Crohn’s disease, inflammatory bowel disease, and ulcerative colitis
• Miscellaneous disorders: Trichinosis (roundworm infection) and tuberculous meningitis

Corticosteroid Warnings

Since corticosteroids lower the function of your immune system, taking them can increase your susceptibility to infection. If you are taking this medication, you should avoid being near people who are sick or have infections, and you should not receive live vaccines, such as the smallpox vaccine.

Corticosteroids can also mask signs of infection and increase the risk of developing severe and even fatal responses to infections such as chicken pox and measles in non-immune children and adults. People with tuberculosis who are taking corticosteroids require additional monitoring due to the drug’s potential in reactivating the disease.

Taking average or large doses of prednisone can increase your blood pressure and cause salt and water retention, so dietary salt restriction may be necessary. Prednisone also results in increased excretion of potassium and calcium. Therefore, if you are on this medication, you should have those levels monitored by your healthcare provider. Your provider may recommend a supplement to keep these levels balanced.

Stopping corticosteroids abruptly can lead to withdrawal symptoms.

What Is Tylenol? 

Tylenol is a brand of acetaminophen. As a pain reliever, it works by blocking your brain from releasing pain signals or increasing your brain’s pain threshold. As a fever reducer, it works by acting on your brain’s heat-regulating center (hypothalamus). 

 Conditions treated by Tylenol include:

• Backache
• Common cold
• Headache
• Muscle ache
• Premenstrual and menstrual cramps
• Toothache
• Fever

Acetaminophen Warnings

Taking too much acetaminophen can cause severe liver damage. Adults can take between 325 mg and 650 mg of acetaminophen every four to six hours. Do not exceed 3,000 mg of acetaminophen in a 24-hour period.

Do not mix this drug with other medications containing acetaminophen. If you have liver disease or are taking the blood-thinning drug warfarin, consult your healthcare provider before taking Tylenol. If you are pregnant or breastfeeding, ask a healthcare professional about the risks before use.

Severe skin reactions (reddening, rashes, and blistering) can occur in people who are allergic to acetaminophen. If this happens, stop taking Tylenol and seek medical help immediately. 

Is it Safe to Take Prednisone With Tylenol? 

Generally speaking, it’s safe to take prednisone with Tylenol because no known drug interactions or drug and food interactions have been found.

Prednisone must be taken exactly as prescribed by your healthcare provider. Never stop or reduce your prednisone dosage unless your provider directs you to. If you have questions about your dosage, give your provider a call.

Medications That Don't Interact Well With Tylenol

Never take more than one medication containing acetaminophen, as this can lead to liver damage. Acetaminophen is the active ingredient in over 450 over-the-counter and prescription medications, which is why it is essential to check medication labels for acetaminophen and ask your healthcare provider if you are uncertain.

Common prescription and OTC drugs that contain acetaminophen include:

• Endocet
• Percocet
• Tramacet
• Benylin
• Contac
• DayQuil and NyQuil
• Excedrin
• Midol
• Sudafed

Acetaminophen may interact with other drugs by making them more or less potent, or by increasing the risk of bleeding, organ damage, or other serious complications.

Do not use acetaminophen if you have taken a monoamine oxidase inhibitor (MAOI) within the past 14 days. This includes drugs that contain isocarboxazid, linezolid, phenelzine, rasagiline, selegiline, and tranylcypromine.

Also, if you are taking blood-thinning (anticoagulant) medications such as warfarin, ask your healthcare provider before using acetaminophen. Serious interactions between warfarin and acetaminophen are known to occur.

Medications That Don't Interact Well With Prednisone

Prednisone is known to cause adverse reactions when combined with a variety of prescription and over-the-counter drugs, including:

• ACE inhibitors, including benazepril, lisinopril, enalapril, or captopril
• Amphotericin B, an antifungal medication
• Antidiabetic drugs, such as metformin or dapagliflozin
• Antihypertensives, including ramipril, valsartan, and aliskiren
• Carbamazepine, a drug used to treat seizures and nerve pain
• Cobicistat and ritonavir, antiviral drugs used to treat HIV infection
• Estrogens, used to treat menopausal syndrome, breast cancer, and more
• Inhaled Beta-2 adrenergic agonists, including albuterol, bitolterol, formoterol
• Ketoconazole and itraconazole, antifungals used to treat yeast infection
• NSAIDs, including ibuprofen, naproxen, aspirin, and diclofenac
• Phenobarbital, used to treat seizures, insomnia, and more
• Rifampin, an antibiotic used to treat tuberculosis
• Warfarin, an anticoagulant used to prevent blood clots
• Cyclosporine, used to prevent organ rejection after transplantation
• Vaccinations, which prednisone can render less effective

Summary

Tylenol and prednisone can be taken together so long as dosage and other safety guidelines for each are followed. Talk to your healthcare provider before starting, adjusting, or stopping any medication, and always mention any drug allergies or medical conditions.

Also, tell your healthcare provider about all the medications and supplements you are taking so they know whether prednisone and Tylenol are safe for you to use. If you are having an adverse reaction to either or both medications, seek help from a medical professional immediately.