7 Facts About Acetaminophen and Your Heart

Doctor William C Lloyd Healthgrades Medical Reviewer
Medically Reviewed By William C. Lloyd III, MD, FACS
Written By Nancy LeBrun on September 15, 2022
  • OTC Products
    Some over-the-counter painkillers are safer for your heart than others.
    If you’re one of the tens of millions of people in the United States who are on heart medication or low-dose aspirin therapy to reduce your risk of a heart attack, here are some facts you should know about over-the-counter pain relievers and heart health.
  • Pain Killer Pills or Tablets
    1. Acetaminophen does not increase your chance of a heart attack.
    Acetaminophen does not make you more likely to have a heart attack, even if you have had one in the past. This is not the case for some other pain relievers like ibuprofen and naproxen, (also known as NSAIDs), which can increase your risk, particularly if you have a history of cardiovascular disease. It’s always best to check with your doctor before taking any over-the-counter pain medicine if you are taking pills for your heart, but acetaminophen has been shown to be a safer choice.
  • Pills in hand
    2. You can take acetaminophen and low-dose aspirin together safely.
    If your doctor has advised you to take low-dose aspirin for your heart, you can still take acetaminophen for aches and pains. Taken as directed, it will not cause side effects or harmful interactions with your aspirin. So if you have an everyday complaint like a headache, toothache or fever, acetaminophen is a good OTC choice. If you have pain from inflammation, acetaminophen will not help, but you can try ice, heat or other non-drug treatments.
  • close up of hand holding pill
    3. Take only the recommended dose of acetaminophen.
    Though acetaminophen is safe for your heart, it’s important to be careful not to use too much, because high doses can affect your liver. You should not take more than 4,000 milligrams of acetaminophen within a 24-hour period, which is about six to eight tablets, depending on the strength of the pill. Because cold medicines and other OTC medicines may also contain acetaminophen, read the labels carefully to make sure you are not taking too much by accident. Whatever pain reliever you choose, it’s always best to take the least amount you need for the shortest period of time.
  • Pill Organizer
    4. You can take acetaminophen on a regular basis.
    If you have recurring or ongoing pain that is not due to inflammation, you can use acetaminophen for longer periods of time than NSAIDS, which are only recommended for short-term use— no longer than ten days—unless you are being monitored by a healthcare provider. However, you should not drink a lot of alcohol while you are taking acetaminophen, because it can increase the risk for liver damage.
  • Senior man using laptop
    5. Acetaminophen won’t interfere with your aspirin therapy.
    Unlike some NSAIDs, acetaminophen does not lower the effectiveness of low-dose aspirin, because it works in a different way to reduce pain and fever. Ibuprofen, an NSAID, can prevent aspirin from linking to a particular enzyme in your body, which is how it protects your heart. If your doctor has said that you can take ibuprofen— for example if your pain is from inflammation— don’t take it during the 8 hours before you take aspirin or for a half hour after you take it.
  • Senior Man Talking with Doctor
    6. Some early studies show that acetaminophen may protect the heart.
    Though the jury is still out, there have been studies that show acetaminophen may help the heart when taken as directed. In animals, it has been shown to slow the heartbeat and make it more regular and strong. However, experts are still investigating the potential beneficial effects of acetaminophen on the heart, so it’s important that you don’t take it for this reason without talking to your doctor.
  • woman reading pill bottle
    7. Acetaminophen is the only OTC pain reliever without a “black box” warning about increased risk of heart attack.
    The FDA requires the makers of non-aspirin NSAIDs to print warnings about heart health on the labels. In 2015, it strengthened those warnings, stating that, “patients treated with NSAIDs following a first heart attack were more likely to die in the first year after the heart attack compared to patients who were not treated with NSAIDs.” It did not require a similar warning for acetaminophen. OTC painkillers can be safe and make you feel much better in a short amount of time, but be sure to talk to your doctor about the best choice for you.
7 Facts About Acetaminophen and Your Heart
  1. Painkillers pose problems for people with heart disease. Harvard Health Publications. http://www.health.harvard.edu/blog/painkillers-pose-problems-for-people-with-heart-disease-201107193120
  2. Can Patients With Cardiovascular Disease Take Nonsteroidal Anti-inflammatory Drugs?Circulation. American Heart Association. http://circ.ahajournals.org/content/117/17/e322.full
  3. Acetaminophen: Beyond Pain and Fever-Relieving. US National Library of Medicine, National Institutes of Health. http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3213427/
  4. Painkiler Choices with Kidney or Heart Problems. Choosing Wisely, ABIM Foundation. http://www.choosingwisely.org/patient-resources/painkiller-with-kidney-or-heart-problems/
  5. Pain relief that’s safe for your heart. Harvard Health Publications. http://www.health.harvard.edu/heart-health/pain-relief-thats-safe-for-your-heart-
  6. Over-the-counter pain relievers. Medline Plus, National Institutes of Health. https://www.nlm.nih.gov/medlineplus/ency/article/002123.htm
  7. NSAIDs and cardiovascular risk explained, according to studies from the Perelman School of Medicine. Penn Medicine. http://www.uphs.upenn.edu/news/news_releases/2012/05/risk/
  8. FDA strengthens warning that non-aspirin nonsteroidal anti-inflammatory drugs (NSAIDs) can cause heart attacks or strokes. U.S. Food and Drug Administration. http://www.fda.gov/Drugs/DrugSafety/ucm451800.htm
  9. Medications and supplements that can raise your blood pressure. Mayo Clinic. http://www.mayoclinic.org/diseases-conditions/high-blood-pressure/in-depth/blood-pressure/art-200452...
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Last Review Date: 2022 Sep 15
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