Combining NSAIDS and Tylenol for pain

Tylenol (generic Acetaminophen) is commonly used as an adjunct for pain relief in patients with various forms of musculoskeletal pain.  While acetaminophen is not an anti-inflammatory agent (like NSAIDS, including Celebrex), it does act on pain pathways.  It is important for patients to inform their physicians of breakthrough pain that is requiring the use of any over-the-counter agents as there may need to be increased monitoring for certain possible side effects (increased liver function tests, etc). 

It is also important to remember that combining different NSAIDS is not recommended, including over-the-counter agents such as ibuprofen (Advil, Motrin, etc) or naproxen (Alleve) with prescription NSAIDS (Celebrex, diclofenac, and many others).