If you take hydroxychloroquine (Plaquenil) for lupus (systemic lupus erythematosus, or SLE), you may wonder if it’s safe to use an over-the-counter (OTC) pain reliever for joint pain or fever. The good news? Acetaminophen — the active ingredient in the drug with the brand name Tylenol — is one of the most popular OTC pain relievers, and it’s generally safe to take with hydroxychloroquine, as there aren’t any known drug interactions. No studies or reports have found serious side effects (adverse effects) from combining these medications.

Many members of MyLupusTeam have taken hydroxychloroquine and acetaminophen together without problems. While advice from someone else’s doctor may not apply to you, it may be helpful to hear others’ experiences. “I take Plaquenil and Tylenol for pain when needed. My doctors prescribed it to me,” wrote one. “My pharmacist also let me know that it was OK,” said another member. “I also have prescription Tylenol 500 milligrams and take Plaquenil. I’ve been taking both for the past five years.”

If you have questions about pain relievers, ask your doctor or pharmacist. They can help you find a safe option based on your health conditions and other medications.

What Is Hydroxychloroquine?

Hydroxychloroquine was originally prescribed as an antimalarial drug. Over time, doctors found that it could also be used to treat lupus and rheumatoid arthritis. Hydroxychloroquine can help lower inflammation in your body, such as the ongoing inflammation seen in autoimmune diseases, where the immune system mistakenly attacks healthy tissues. Because of this, hydroxychloroquine can help reduce common symptoms of lupus like joint pain, stiffness, and swelling. Some people find that hydroxychloroquine alone is enough to keep their lupus under control. Others take it with additional medications to treat lupus and avoid lupus flares.

Other Over-the-Counter Pain Medications and Hydroxychloroquine

So, what pain relievers can you take with hydroxychloroquine? Hydroxychloroquine is safe to take with most OTC pain medications. These include nonsteroidal anti-inflammatory drugs (NSAIDs), like ibuprofen (Motrin) and naproxen (Aleve). NSAIDs are usually safe with hydroxychloroquine, but they may raise the risk of heart problems, especially for people with heart disease. If you have any heart issues, talk to your doctor before taking NSAIDs. You can also safely take aspirin with hydroxychloroquine.

Aspirin is not just for pain — it’s sometimes given to people with lupus who have a higher risk of blood clots, like those with antiphospholipid syndrome, an autoimmune condition that causes abnormal blood clotting. If you’re unsure about pain medication, your healthcare provider can help. If your current treatment isn’t working, they may suggest a different option.

Acetaminophen Risks

Acetaminophen is usually safe when taken as directed, but too much can harm the liver. Since it’s found in many medications, including cold and pain relievers, always check labels to avoid taking more than the recommended dose. If you have lupus nephritis or kidney disease, your doctor may recommend acetaminophen over NSAIDs, but it’s still important to get personalized medical advice before taking any new medication.

Find Your Team

On MyLupusTeam, the social network for people with lupus and their loved ones, more than 235,000 members come together to ask questions, give advice, and share their stories with others who understand life with lupus.

Do you take acetaminophen and hydroxychloroquine? Share your experience in the comments below, or start a conversation by posting on your Activities page.