Drug & supplement interaction

Onion + Acetaminophen, Ibuprofen

Acetaminophen, Ibuprofen brand name: Combogesic.

Moderate Interaction
The bottom line Moderate

Acetaminophen, Ibuprofen falls into 2 drug categories that Onion can interact with; the most serious is rated moderate. Theoretically, concomitant use of anticoagulant or antiplatelet drugs with onion might increase the risk of bleeding.

Read the full interaction report
SeverityModerate
LikelihoodPossible
Interactions2
EvidenceD
What do Severity, Likelihood & Evidence mean?
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Interaction report

Onion and Acetaminophen, Ibuprofen

These two interact in 2 distinct ways. Each one is explained separately below.

Why Are There 2 Interactions?

Onion interacts with whole categories of medication. Acetaminophen, Ibuprofen falls into 2 of those categories, so it can interact with Onion in 2 different ways. We’ve listed each one below — your overall risk is driven by the most serious of them (Moderate).

Moderate

ANTICOAGULANT/ANTIPLATELET DRUGS

1 of 2

Why this applies to Acetaminophen, Ibuprofen

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

Theoretically, concomitant use of anticoagulant or antiplatelet drugs with onion might increase the risk of bleeding.
In vitro research shows that onion inhibits platelet aggregation.
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 connection worth knowing: lab studies suggest onion's compounds can make platelets (the tiny cells that help your blood clot) a little less sticky. The ibuprofen half of Combogesic already has a mild blood-thinning effect of its own, plus it can irritate the stomach lining. Stack these together and, in theory, you could bruise a bit more easily or be slower to stop bleeding from a cut.

I want to keep this in perspective, though. This is a theoretical concern based mostly on test-tube research, and onion eaten as food is very unlikely to cause a problem. Concentrated onion supplements are the bigger question mark. If you take Combogesic regularly, use other blood thinners, or notice unusual bruising or bleeding, check in with your pharmacist or doctor.

References
  1. Brinker F. Herb Contraindications and Drug Interactions. 2nd ed. Sandy, OR: Eclectic Medical Publications, 1998.
  2. Hubbard, G. P., Wolffram, S., de Vos, R., Bovy, A., Gibbins, J. M., and Lovegrove, J. A. Ingestion of onion soup high in quercetin inhibits platelet aggregation and essential components of the collagen-stimulated platelet activation pathway in man: a pil
Moderate

CYTOCHROME P450 2E1 (CYP2E1) SUBSTRATES

2 of 2

Acetaminophen, Ibuprofen also falls under CYTOCHROME P450 2E1 (CYP2E1) SUBSTRATES.

Theoretically, taking onion might increase the levels and clinical effects of drugs metabolized by CYP2E1.
Animal research shows that taking onion powder inhibits CYP2E1. However, this interaction has not been reported in humans.
Severity Moderate Likelihood Possible Evidence B

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 short version about Combogesic (the acetaminophen plus ibuprofen combo) and onion. One of the liver enzymes that helps process acetaminophen is called CYP2E1. Animal studies suggest onion compounds (like the sulfur compounds and quercetin) may slow that enzyme down a bit. In theory, that could mean a little more acetaminophen hanging around. Importantly, this has not actually been seen in people, and it's the acetaminophen part, not really the ibuprofen, that this enzyme touches.

For practical purposes, eating onion with your food is not something I'd worry about here. The bigger picture with acetaminophen is simply not going over the daily limit. If you're thinking about concentrated onion supplements, just run it by your pharmacist first.

References
  1. Teyssier, C., Amiot, M. J., Mondy, N., Auger, J., Kahane, R., and Siess, M. H. Effect of onion consumption by rats on hepatic drug-metabolizing enzymes. Food Chem.Toxicol. 2001;39(10):981-987. 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

Onion Also Interacts With Other Medications

Onion has 274 moderate known drug interactions in our database — the Acetaminophen, Ibuprofen one above is among them. If you take anything else, check it against the full list below.

Taking anything else?

Check Another of Your Medications Against Onion

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

Everything else you take

See Every Supplement That Interacts With Acetaminophen, Ibuprofen

This page covers Onion 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

One more smart check

Taking Onion as Part of a Dietary Supplement Product? Check It for Interactions

We hold 1,061 real supplement products containing Onion, each one broken down to its full ingredient list — and combination products often carry several ingredients besides Onion. Your product may carry other ingredients that interact with Acetaminophen, Ibuprofen too, on top of Onion — and those would not show on this page. Find your product and we’ll check every ingredient on its label:

How much people look this up

Where Onion 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 Onion
Top 25%

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

29 days ago today
Medication Acetaminophen, Ibuprofen
Top 25%

#405 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.

Supplement

About Onion

What is Onion?

Onion
  • Colds and respiratory symptoms
  • Heart and cholesterol health
  • Blood sugar support
  • Antimicrobial and wound care
  • Scar appearance (topical gels)

Onion is a common food with a long history in traditional medicine, and it contains antioxidants like quercetin and sulfur compounds. Eating onion as part of a balanced diet is safe for most people, but high-dose supplements have only limited human evidence for any specific health condition. Talk with your pharmacist or doctor before using concentrated onion products for a medical reason.

Read the full Onion monograph & all interactions
Keep checking

Other Drugs & Onion

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

0Major
274Moderate
0Minor
2,555No known interaction
Moderate

274 interactions

Showing 60 of 274 moderate interactions — see all 274 on the Onion page.

No interaction 2,555 drugs checked — show the list
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

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Pharmacist Counseling Corner

Taking Onion and Acetaminophen, Ibuprofen Together: Common Questions

Can you take Onion with 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.
Why are there 2 interactions listed for Onion and Acetaminophen, Ibuprofen?
Acetaminophen, Ibuprofen belongs to more than one drug category, and Onion interacts with each of those categories a little differently. We list every one so nothing is missed — your overall risk is driven by the most serious of them.
How serious is the Onion 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.