Drug & supplement interaction

Fasting + Acetaminophen, Ibuprofen

Acetaminophen, Ibuprofen brand name: Combogesic.

Moderate Interaction
Medically reviewed by · Updated September 2026
The bottom line Moderate

Fasting has a moderate interaction with Acetaminophen, Ibuprofen. Fasting may increase the risk of bleeding if used with anticoagulant or antiplatelet drugs.

Read the full interaction report
SeverityModerate
LikelihoodPossible
EvidenceD
What do Severity, Likelihood & Evidence mean?
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Interaction report

Fasting and Acetaminophen, Ibuprofen

Here is the interaction we found between these two, with the evidence behind it.

Moderate

ANTICOAGULANT/ANTIPLATELET DRUGS

Why this applies to Acetaminophen, Ibuprofen

Acetaminophen, Ibuprofen falls under ANTICOAGULANT/ANTIPLATELET DRUGS — the group Fasting interacts with.

Fasting may increase the risk of bleeding if used with anticoagulant or antiplatelet drugs.
Fasting has been found to increase the international normalized ratio (INR) in patients stabilized on warfarin. Closely monitor patients who are fasting while taking anticoagulant or antiplatelet drugs. Dose adjustment may be necessary.
Severity Moderate Likelihood Possible Evidence D

Interaction has been documented in animal or in lab research, or the interaction has been documented in humans but is limited to case reports or conflicting clinical research exists.

Dr. Brian Staiger, PharmD, BCPS
Dr. Brian Staiger explains PharmD, Clinical Pharmacist

Here's the honest picture: Combogesic combines acetaminophen with ibuprofen, and the ibuprofen part has mild blood-thinning, antiplatelet activity. The note we have suggests that fasting may slightly raise bleeding risk when paired with drugs that affect clotting. Most of that signal comes from anecdotal reports and from people on warfarin (not ibuprofen specifically), so the evidence here is weak.

Still, ibuprofen on its own can irritate the stomach lining, and an empty stomach during fasting may make that worse, leading to stomach upset, heartburn, or in some cases bleeding. Watch for things like black stools, easy bruising, or unusual stomach pain. Please don't change anything on your own. Just check with your pharmacist or doctor before combining regular fasting with Combogesic.

Contact Dr. Brian directly if you have additional questions on this interaction
References
  1. Wilhelmi de Toledo F, Grundler F, Bergouignan A, Drinda S, Michalsen A. Safety, health improvement and well-being during a 4 to 21-day fasting period in an observational study including 1422 subjects. PLoS One. 2019;14(1):e0209353. PubMed
  2. Katada Y, Nakagawa S, Nishimura A, et al. Effects of fasting on warfarin sensitivity index in patients undergoing cardiovascular surgery. Eur J Clin Pharmacol. 2019;75(4):561-568. PubMed
  3. Lai YF, Cheen MHH, Lim SH, et al. The effects of fasting in Muslim patients taking warfarin. J Thromb Haemost. 2014;12(3):349-54. PubMed

What These Ratings Mean

Every interaction above is graded three ways — here’s the key to each label.

Severity how clinically significant the interaction is
Major

Clinically significant. Avoid the combination, or use only under close professional supervision.

Moderate

Usually worth avoiding or managing — may need monitoring, a dose change, or timing apart.

Minor

Generally not serious. Be aware of it and mention it to your pharmacist.

Likelihood how strong the evidence is that the interaction actually happens in people
  • LikelyWell-controlled human studies have demonstrated the likely existence of this interaction.
  • ProbableInteraction has not been documented in well-controlled studies, however, the interaction has been demonstrated in some small human studies or in controlled animal studies in conjunction with multiple case reports.
  • PossibleInteraction has been documented in animal or in lab research, or the interaction has been documented in humans but is limited to case reports or conflicting clinical research exists.
  • UnlikelyInteraction has been demonstrated in animal or in lab research but has been shown not to occur in humans.
Evidence the quality of the studies behind the rating (graded A–D)
  • AHigh-quality meta-analysis (quantitative systematic review).
  • BCase-control study.
  • CConsensus.
  • DAnecdotal evidence.

These ratings are for information only. Never start, stop, or otherwise change your therapy before speaking with your provider.

Keep it in perspective

Fasting Also Interacts With Other Medications

Fasting has 2 major, 205 moderate known drug interactions in our database — the Acetaminophen, Ibuprofen one above is one of them. If you take anything else, check it against the full list below.

Major 2 Moderate 205 No known interaction 2,623 (incl. Acetaminophen, Ibuprofen)
Taking anything else?

Check Another of Your Medications Against Fasting

Covers the 2,830 medications we’ve checked against Fasting. Pick one to open its full report.

Everything else you take

See Every Supplement That Interacts With Acetaminophen, Ibuprofen

This page covers Fasting only. If you take other supplements — a multivitamin, a sleep aid, something for joints — the Acetaminophen, Ibuprofen page lists 342 supplements it has a documented interaction with, worst first, each one explained.

The most serious there right now: Activated Charcoal (major), Asarabacca (major), Beer (major), Danshen (major) and Piracetam (major).

By severity: 7 major · 290 moderate · 45 minor.

From our pharmacist’s overview on the Acetaminophen, Ibuprofen page

“Combogesic pairs acetaminophen with ibuprofen, so it inherits the vulnerabilities of both drugs, and its supplement list deserves real attention before you add anything to it. Of the 342 ingredients on file, 7 carry a major rating, and those are the ones to understand first.”

Reviewed by 2 · Jul 18, 2026

Open the Acetaminophen, Ibuprofen interaction page

How much people look this up

Where Fasting and Acetaminophen, Ibuprofen Sit Against Everything Else

Out of every supplement and medication people look up on HelloPharmacist, here is where these two land this week — and which way each has been moving.

Supplement Fasting
Steady interest

#1,226 of 1,452 supplements looked up here in the last 7 days

29 days ago today
Medication Acetaminophen, Ibuprofen
Top 25%

#398 of 2,830 medications looked up here in the last 7 days

29 days ago today

Position among everything looked up on this site, not a measure of how commonly either one is used or how important it is. A supplement can climb this list because of a news story. It counts every request to the page, automated ones included, and nothing here identifies anyone.

Eating pattern

About Fasting

What is Fasting?

  • Weight loss
  • Blood sugar control
  • Heart health
  • Religious or spiritual practice
  • General wellness and longevity

Fasting means voluntarily going without food (and sometimes drink) for set periods. Some research suggests it may help with weight loss and blood sugar in certain people, but results vary and quality of evidence is mixed. It is not safe for everyone, so check with your doctor or pharmacist before starting—especially if you take medication or have a health condition.

Read the full Fasting monograph & all interactions
Keep checking

Other Drugs & Fasting

Browse every other medication we’ve checked against Fasting — both the ones with a known interaction and the ones without. Select any drug for the full detail.

2Major
205Moderate
0Minor
2,622No known interaction
2 Major 205 Moderate 2,622 No interaction
Major

2 interactions

Moderate

205 interactions

Showing 60 of 205 moderate interactions — see all 205 on the Fasting page.

No interaction 2,622 drugs checked — show the list

We also checked Fasting against these medications and found no known interaction in our sources. Open any page to confirm.

Showing the 60 most looked-up of 2,622 medications checked with no known interaction — see the full Fasting list.

See the full Fasting interactions page
See every supplement checked against Acetaminophen, Ibuprofen, ranked by severity
Sources

Sources & How We Checked

Interaction details are evidence-graded and sourced from the Natural Medicines database. The medication overview comes from MedlinePlus.

Content is written and reviewed by licensed HelloPharmacist pharmacists. See our data sources and editorial standards for how this information is built and checked.

Parts of this content are provided by the Therapeutic Research Center, LLC.

DISCLAIMER: Currently this does not check for drug-drug interactions. This is not an all-inclusive comprehensive list of potential interactions and is for informational purposes only. Not all interactions are known or well-reported in the scientific literature, and new interactions are continually being reported. Input is needed from a qualified healthcare provider including a pharmacist before starting any therapy. Application of clinical judgment is necessary.

© 2021 Therapeutic Research Center, LLC

Keep exploring
Fasting monograph › Uses, safety, and every drug interaction in one place Acetaminophen, Ibuprofen supplement interactions › Every supplement checked against Acetaminophen, Ibuprofen, ranked by severity Supplement interaction checker › Check any supplement or product against your medications Browse medications A–Z › Every drug we've checked against herbs & supplements Ask a pharmacist › Free, personal answer from our licensed team
Pharmacist Counseling Corner

Following Fasting While Taking Acetaminophen, Ibuprofen: Common Questions

Can you follow Fasting while taking Acetaminophen, Ibuprofen?
There is a moderate interaction, so it may be acceptable with monitoring or timing changes — but check with your pharmacist first. Read the full details on this page and confirm with your pharmacist before combining them.
How serious is the Fasting and Acetaminophen, Ibuprofen interaction?
We rate it Moderate. This combination may require monitoring, a dose adjustment, or separating the times you take each one. Consult your pharmacist before using them together.

Written and reviewed by the HelloPharmacist editorial staff. Our editorial policy

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This information is for education only and is not a substitute for professional medical advice. Always check with your pharmacist or doctor before starting, stopping, or combining supplements and medications.