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Is It OK to Take Ibuprofen Every Day?

You might be thinking, If I don’t need a prescription to buy it, it must be safe to casually take it. For the most part, taking ibuprofen to ease pain is totally harmless and effective. However, a drug’s a drug, and if you’re taking ibuprofen on the daily, you might start to notice some unfortunate side effects.

First off, what is ibuprofen, exactly? “Ibuprofen is a nonsteroidal anti-inflammatory (NSAID). NSAIDs are frequently used for the treatment of inflammatory and painful conditions and are considered to be one of the most commonly used classes of medications worldwide,” Harrison Linder, MD, from the Center for Interventional Pain Medicine at Mercy Medical Center in Baltimore, tells POPSUGAR.

“The current recommendation for ibuprofen is to limit daily use to no more than 30 days.”

It’s a handy medicine to stash in your purse, as long as it’s used properly in the recommended time span and dosage amount. “The current recommendation for ibuprofen is to limit daily use to no more than 30 days. Dosing can range from 400 milligrams to 800 milligrams up to four times a day with a daily maximum of 3200 milligrams per day,” says Dr. Linder.

However, if you exceed that amount or keep taking it well into your second (or third) month, the negative effects begin to outweigh the desired benefits of decreased discomfort and pain, he says.

You might be surprised, but it’s actually pretty common for some people to rely on ibuprofen as a way to make it through the day. “Very often, individuals involved in large amounts of physical activity, either athletes or people with physically demanding occupations, will rely on ibuprofen or other NSAIDs as a way to limit daily aches and pains and allow continued function,” says Dr. Linder.

Unfortunately, while you might feel that instant hit of relief and make it through a final set of burpees, you could be putting your body at risk down the road. Here’s all the info you need to know about ibuprofen, along with the common physical side effects you could experience if you take too much of it.

Many people take dangerously high amounts of ibuprofen

By Lisa Rapaport, Reuters Health

(Reuters Health) – Many adults who use ibuprofen and other so-called nonsteroidal anti-inflammatory (NSAID) drugs take too much, increasing their risk of serious side effects like internal bleeding and heart attacks, a U.S. study suggests.

About 15 percent of adults taking ibuprofen (Motrin, Advil) or other NSAIDs like aspirin, naproxen (Aleve), celecoxib (Celebrex), meloxicam (Mobic) and diclofenac (Voltaren) exceeded the maximum recommended daily dose for these drugs, the study found.

“NSAIDs are among the most commonly used medicines in the U.S. and worldwide,” said lead study author Dr. David Kaufman of Boston University.

“These drugs can have serious side effects, including gastrointestinal bleeding and heart attacks, and are often taken without medical oversight because many products are available over-the-counter,” Kaufman said by email. “The attitude that users can choose their own dose regardless of label directions, along with poor knowledge of dosing limits, is associated with exceeding the daily limit.”

For the study, 1,326 people who reported taking ibuprofen in the previous month completed online medication diaries every day for one week.

All of the participants took ibuprofen during the diary week, and 87 percent of them only used over-the-counter, or nonprescription, versions, researchers report in Pharmacoepidemiology & Drug Safety.

Overall, 55 percent of participants took ibuprofen at least three days during the week, and 16 percent took it every day.

In addition to ibuprofen, 37 percent of the participants reported taking at least one other NSAID during the week, most often aspirin or naproxen. Less than half of them recognized that all of the products they were taking were NSAIDs.

One limitation of the study is that researchers only focused on recent and current ibuprofen users, which may not reflect what doses might be typical for sporadic or new users, the authors note.

Even so, the findings highlight a potential downside of making NSAIDs widely available without a prescription, said Dr. Gunnar Gislason, director of research for the Danish Heart Foundation in Cophenhagen.

“I believe that the message sent to the consumer when these drugs are widely available in convenience stores and gas stations is that these drugs are safe and you can use them safely for pain relief – thus no need for reading the label,” Gislason, who wasn’t involved in the study, said by email.

Even when people do read the label, they may still ignore it.

“If the recommended dosage does not give sufficient pain relief, it is easier to take more pills than seeking professional advice from a healthcare person or doctor,” Gislason added.

While doctors may prescribe NSAIDs for some muscle and joint disorders and certain other health problems, these drugs aren’t appropriate for many of the reasons that patients may buy them at the drugstore, said Dr. Liffert Vogt of the Academic Medical Center at the University of Amsterdam in the Netherlands.

“In my opinion NSAIDs should not be available as an over-the-counter drug, because of all their deleterious effects,” Vogt, who wasn’t involved in the study, said by email.

“For occasional use, acetaminophen (again in the right dose) is a much safer option and very efficacious as a pain killer,” Vogt added. “But we know that many people use NSAIDs for indications other than pain, such as flu, allergies, fever – and there is no medical base that indicates that NSAIDs or acetaminophen are of any use under these circumstances.”

SOURCE: bit.ly/2sgT6hr Pharmacoepidemiology & Drug Safety, online January 26, 2018.

Ibuprofen: Dosage, Side Effects & Other Facts

Ibuprofen is a non-steroidal anti-inflammatory drug (NSAID) available both over-the-counter and, in greater strength, by prescription. It aims to relieve pain in a variety of cases, including fevers, headaches, toothaches, menstrual cramps, joint pain and backaches. It is sometimes prescribed to relieve the symptoms of osteoarthritis or rheumatoid arthritis, such as stiffness, tenderness and swelling, though it cannot cure arthritis. Ibuprofen works by blocking the body’s enzymes that make chemicals that signal pain.

“It’s an anti-inflammatory drug typically prescribed for the treatment of pain and [it’s] also effective for fever,” said Dr. Aaron Clark, a family medicine physician at The Ohio State University Wexner Medical Center in Columbus, Ohio.

Ibuprofen is commonly marketed as Advil, Motrin or Midol.

Dosage

Nonprescription ibuprofen is available in the following forms: tablet, chewable tablet, liquid and drops of concentrated liquid. Adults and children over 12 can take ibuprofen every four to six hours as needed, though they should not take more than six pills in one day unless directed by a doctor.

Children and infants can usually take ibuprofen every six to eight hours but should not have more than four doses in 24 hours unless directed by a doctor. If you are unsure about how much ibuprofen to give a child, consult a doctor who will determine the dosage based on the child’s weight.

“With children there’s quite a bit of variation,” Clark said. From birth to age 2, the dosage is dependent on the child’s weight. “Their livers are more immature and are less able to metabolize medicine as older children can.”

Prescription ibuprofen should come with a doctor’s instructions. It is usually taken three or four times a day for arthritis symptoms or four to six hours as needed when prescribed for pain.

It is best to take ibuprofen with food or milk to prevent stomach upset. If a dose is missed, it should be taken as soon as the patient remembers, unless it is close to the time to take the next dose. In that case, do not double up on doses — simply skip the missed one.

When taking multiple medicines with ibuprofen, be careful that the other medicines do not contain ibuprofen or other NSAIDs. Ibuprofen can be present in other medicines, including nighttime sleep aids, nonprescription cough and cold medicines, and combining them can cause patients to exceed the recommended dosage. The U.S. National Institutes of Health (NIH) notes that this is especially dangerous for children.

Tell the doctor if you are taking aspirin, lithium, water pills, steroids, blood thinner or blood pressure medicine in addition to ibuprofen.

People who should not take ibuprofen

Women in the later stages of pregnancy should not take ibuprofen. Patients with bleeding disorders, stomach ulcers, liver disease, advanced kidney disease, or who are about to or have just had coronary artery bypass graft surgery should not take ibuprofen.

In 2015, the U.S. Food and Drug Administration (FDA) updated drug labels for NSAIDs, including ibuprofen, to strengthen a warning that the drugs may increase the risk of heart attack or stroke. This risk may be higher for people who take the drugs for a long time, or at higher doses. The warning says that people should not take NSAIDS, including ibuprofen, if they have had a recent heart attack, unless directed by a doctor.

A 2017 study also found that NSAIDs, including ibuprofen, may increase the risk of cardiac arrest, which is when the heart suddenly stops beating. The study, which analyzed information from more than 28,000 people in Denmark, found that use of ibuprofen was linked with a 31 percent increase in the risk of cardiac arrest.

People considering taking ibuprofen should also tell their doctor if they or anyone in their family has ever had heart disease, a heart attack, or stroke; or if they smoke or have ever had high cholesterol, high blood pressure or diabetes, the FDA says.

Side effects and risks

Some people may suffer allergic reactions or asthma after taking ibuprofen, aspirin or other NSAIDs. Reaction symptoms may include:

  • Itching
  • Hives
  • Swelling of face or hands
  • Swelling or tingling in mouth or throat
  • Chest tightness
  • Breathing trouble

If such reactions occur, do not take ibuprofen again.

Ibuprofen and other NSAIDs may cause bleeding, holes or ulcers in the stomach or intestines. The risk is higher for people who have taken NSAIDs for a long time, are elderly, in poor health, those who drink more than three alcoholic beverages a day while taking ibuprofen, or those who have had a stomach ulcer in the past.

There are some less-serious side effects associated with ibuprofen use, including:

  • Constipation, diarrhea, or upset stoma
  • Dizziness or headache
  • Mild nausea, vomiting, gas, stomach pain or heartburn
  • Mild rashor itching skin
  • Ringing in ears

The NIH recommends talking to a doctor about these less-serious side effects if they persist.

However, the NIH recommends calling a doctor immediately in the case of the following side effects:

  • chest pain
  • shortness of breath
  • weakness in one part or side of the body
  • slurred speech.
  • unexplained weight gain
  • swelling of the abdomen, feet, ankles, or lower legs
  • fever
  • allergic reaction
  • hoarseness
  • excessive tiredness
  • pain in the upper right part of the stomach
  • nausea
  • loss of appetite
  • yellowing of the skin or eyes
  • flu-like symptoms
  • pale skin
  • fast heartbeat
  • cloudy, discolored or bloody urine
  • back pain
  • difficult or painful urination
  • blurred vision, changes in color vision or other vision problems
  • red or painful eyes
  • stiff neck
  • headache
  • confusion
  • aggression

Ibuprofen vs.

aspirin

According to Columbia University Health, ibuprofen “appears to be slightly stronger” than aspirin when treating soft tissue injuries, dental pain and menstrual cramps. Aspirin is as effective as ibuprofen for headaches, migraines and fever reduction. Aspirin is sometimes recommended to reduce the risk of heart attack or stroke.

Though both ibuprofen and aspirin can irritate the stomach, ibuprofen is less of an irritant. Both drugs also cause an antiplatelet effect, which reduces the function of platelets, cells that help blood clot. This effect is much stronger in aspirin than in ibuprofen, which can be a benefit of aspirin depending on the patient’s needs. The antiplatelet effect can reduce the risk of heart attack.

Ibuprofen vs. acetaminophen

Acetaminophen is commonly branded as Tylenol or Excedrin.  According to the Cleveland Clinic, it is not as effective for fevers, menstrual cramps or pains caused by inflammation, such as backaches and dental pains, as ibuprofen is. It is, however, considered better for treating headaches and arthritis. It is less likely to cause stomach irritation.

Ibuprofen for cats and dogs

If a pet is in pain, its owners should not give it ibuprofen, said Greg Nelson, a veterinarian with Central Veterinary Associates, in Valley Stream, New York.

“A lot of people assume that it’s a good idea, and it most certainly is not,” Nelson said. “In cats, there has never been success with the use of ibuprofen, and with dogs, they have a very narrow therapeutic range.”

Dangers for animals from ibuprofen include stomach ulceration, kidney failure and neurological damage, according to a 2004 report in the journal Veterinary Medicine.

For pain relief for pets, owners should speak with a veterinarian, who can prescribe a pet-friendly anti-inflammatory drugs such as meloxicam or carprophen.

This article was updated on Jan. 5, 2015 by Live Science Senior Writer Laura Geggel, and again on Oct. 4, 2018 by Live Science Senior Writer, Rachael Rettner.   

Ibuprofen | Health Navigator NZ

Ibuprofen is used to treat pain and inflammation. Find out how to take it safely and possible side effects.


Note: the information on this page is about ibuprofen for adults. For information about use for children, see ibuprofen for children.


 



Type of medicine Also called

  • Analgesics (pain killer)
  • Antipyretic (to control fever)
  • Anti-inflammatory (reduces pain and swelling)
  • Non-steroidal anti-inflammatory drug (NSAID)  

  • Brufen®
  • Ibugesic®
  • I-Profen®
  • Nurofen®
  • Advil®
  • Medix®

Ibuprofen is also contained in some other combination medications such as:

  • Nurofen Plus®
  • Maxigesic®
  • Nuromol®
  • Brufen extra®
  • Nurofen Cold and Flu®

What is ibuprofen?

Ibuprofen is in a group of medicines known as non-steroidal anti-inflammatory drugs (NSAIDs).

It is used to treat different types of pain such as headache, migraine, dental pain, back pain or muscle pain, and pain from injury – read more about pain.

It also helps to ease redness and swelling, and to treat fever.

Different brands and strengths

Ibuprofen is available in different brands and strengths. The lower strength (200 mg) tablets can be bought from a supermarket or over-the-counter from a pharmacy.  The higher strength tablets (400 mg, 600 mg, 800 mg) tablets are only available on prescription from your doctor.

Dose

  • The dose of ibuprofen will be different for different people depending on your condition.
  • Usually, you may need to take ibuprofen for a short time only, while you have pain or swelling.
  • The usual dose for adults is 200 mg to 400 mg 3 or 4 times daily if needed.
  • Do not take more than 1200 mg per day without checking with your doctor.
  • Use the lowest dose that works for you and stop as soon as you can.
  • The dose will be different to this if you have been prescribed a tablet which releases ibuprofen slowly; this is called a modified-released tablet.
  • Always follow the directions on the package or pharmacy label. If you are unsure about how much to take, check with your pharmacist.

How to take ibuprofen

  • Timing: Take ibuprofen with food or immediately after food, to prevent stomach upset. Take ibuprofen with a full glass of water. Swallow the tablets whole. Do not crush or chew them.
  • Limit or avoid alcohol while you are taking ibuprofen. Alcohol can increase the risk of side effects like stomach upset. 
  • Missed dose: If you forget to take a dose, take it when you next need pain relief and then continue as before. Do not take two doses together to make up for a missed dose.

Take care with ibuprofen

For most people taking ibuprofen is safe. However, extra care is needed if you have high blood pressure, high cholesterol, diabetes, stomach ulcers or kidney problems or if you smoke. It can also be harmful if you take it when you are dehydrated or have been sick with nausea or vomiting. Discuss with your doctor whether taking ibuprofen is suitable for you. 

NSAIDs (except low-dose aspirin) increase the chance of a heart attack or stroke, which can lead to death. These serious side effects can occur even in the first weeks of using an NSAID and the risk may increase the longer you are taking them. The risk appears greater at higher doses (such as ibuprofen 2400 mg per day) so use the lowest effective amount for the shortest possible time. Some other medicines contain NSAIDs, including those used for colds, flu, so always read the labels and avoid taking multiple medicines that contain NSAIDs. Also see Ibuprofen patient information guide  SafeRx, Waitematā DHB, 2013.

Precautions – before taking ibuprofen

  • Do you have high blood pressure or problems with your heart?
  • Do you have any problems with the way your kidneys or liver works?
  • Have you had stomach ulcers?
  • Are you pregnant, planning a pregnancy or breast-feeding?
  • Do you have any breathing problems?

If so, it’s important that you tell your doctor before you start taking ibuprofen. Sometimes a medicine isn’t suitable for a person with certain conditions or taking other medicines, or it can only be used with extra care.

Possible side effects






Side effects What should I do?

  • Heartburn
  • Indigestion
  • Stomach discomfort

  • Take ibuprofen with food
  • Talk to your doctor if it is painful.

  • Serious stomach problems such as really bad stomach pain, blood in the stool, black or dark colour in your stool, cough or vomit up blood, or dark coloured vomit

  • Tell your doctor immediately or ring HealthLine on 0800 611 116

  • Signs of allergic reaction such as skin rashes, itching, swelling of the face, lips, mouth or have problems breathing, like a tight chest or shortness of breath

  • Tell your doctor immediately or ring HealthLine on 0800 611 116

  • Chest pain
  • Shortness of breath or trouble breathing
  • Weakness in one part or side of the body
  • Slurred speech

  • Tell your doctor immediately or ring HealthLine on 0800 611 116

Interactions

Ibuprofen interacts with some medicines, especially those used for high blood pressure, so check with your doctor or pharmacist before you start taking it.

Do not take other NSAIDs such as diclofenac or naproxen or COX-2s such as celecoxib while taking ibuprofen. This can increase your risk of side effects.

Taking NSAIDs together with medicines called ACE inhibitors or ARBs and diuretics (water pills) can be harmful to your kidneys. This is called the ‘triple whammy’. If you are taking ACE inhibitors or ARBs and diuretics, tell your doctor or pharmacist before starting ibuprofen. 

  • Examples of ACE inhibitors are captopril, cilazapril, enalapril, lisinopril, perindopril and quinapril.
  • Examples of ARBs are valsartan, candesartan and losartan.
  • Examples of diuretics are furosemide, bumetanide, bendroflumethiazide, chlortalidone, indapamide and metolazone.  

Read more: The triple whammy SafeRx

Learn more

The following links provide further information about ibuprofen. Be aware that websites from other countries may have information that differs from New Zealand recommendations.

Ibuprofen (Māori) New Zealand Formulary Patient Information
Ibuprofen for pain and inflammation Patient info, UK

References

  1. Ibuprofen and cardiovascular safety Medsafe Safety Information, 17 June 2015
  2. Ibuprofen New Zealand Formulary

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Can You Take Ibuprofen When Breastfeeding?

Whether it is a headache, a pain in the neck, swelling or fever, ibuprofen is the medicine you reach out for. It is an over-the-counter (OTC) drug widely used because of its ability to subdue high body temperatures and provide relief from pain. But is it safe to use when you are breastfeeding? Can ibuprofen get into the breast milk and affect the baby’s health?

Keep reading this MomJunction article for information about ibuprofen while breastfeeding, the right dosages and precautions to take.

What Is Ibuprofen?

Ibuprofen is a nonsteroidal anti-inflammatory drug (NSAID) that helps reduce pain, inflammation, and fever (1). The medicine is sold under popular brand names Advil and Motrin. It is also prescribed for conditions such as arthritis and severe menstrual pain.

Ibuprofen mostly has non-prescription usage and can be purchased over the counter for treating a range of issues from reducing respiratory inflammation during cold, alleviating a headache, and providing relief from a toothache.

The extensive uses of ibuprofen and easy availability make it one of the ‘essential medicines’ for pain relief according to the World Health Organization (2). So the chances are that you could take this medicine at least once during your lactation period. That brings us to the important question.

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[ Read: Painkillers While Breastfeeding ]

Is It Safe To Have Ibuprofen While Breastfeeding?

Yes. It is safe to take ibuprofen when you are breastfeeding, provided you don’t have asthma or stomach ulcer (3). The medicine is on the American Academy of Pediatrics’ list of drugs suitable for breastfeeding moms and has no known adverse effects on the baby’s health (4).

Ibuprofen is often the preferred NSAID as it is highly protein-bound and is not easily transferred into breast milk (5). Ibuprofen is the only nonsteroidal anti-inflammatory drug that is safe for use among children and is also given to infants above the age of six months (6) (7).

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Concentration Of Ibuprofen Transferred To The Breast Milk

A study revealed that four doses as high as 400mg each of ibuprofen in a day (1600 mg/day) led to less than 1mg of the drug to pass into the breast milk (8). The amount is highly insignificant considering the ingested dosage. But in some cases, even small quantities of medicine in the breast milk could become a concern.

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Does Ibuprofen Have Any Side Effects On Breastfeeding Babies?

Ibuprofen is unlikely to have any side-effects on a baby, as the medicine passes into milk in negligible quantities (9). Research states that ibuprofen’s strong affinity towards blood plasma proteins reduces its ability to bind with milk proteins, minimizing the chances of it passing to the baby. It is 99% protein bound and remains in your blood, with just an insignificant amount diffusing into the breast milk (10).

If any, the general side effects of ibuprofen are similar to what can occur when the baby is administered ibuprofen directly (11).

Common side effects include

  • Nausea
  • Drowsiness
  • Headache
  • Heartburn
  • Diarrhea
  • Bloated abdomen

Severe side effects could be

  • Vomiting
  • High blood pressure
  • Fever
  • Severe stomach pain
  • Development of rashes on the body
  • Drowsiness and extreme lethargy
  • Blood in the urine
  • Difficulty in breathing

The severe side effects are rare and likely to show in case of an overdose. The American Academy of Family Physicians states that adverse side effects mostly occur due to prolonged maternal use of ibuprofen (12). Make sure you only have the medicine in prescribed doses.

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[ Read: Sleeping Pills While Breastfeeding ]

How Much Of Ibuprofen Is Safe For A Breastfeeding Mother?

The maximum dosage of ibuprofen depends on whether you buy an over-the-counter version or one prescribed by the doctor.

Over-the-counter ibuprofen: If you have over-the-counter ibuprofen, then the dosage is likely to be 200mg per tablet. You can have a maximum of two 200mg tablets every 4-6 hours. If you have two pills at a time, then let there be a gap of six hours. The maximum limit of ibuprofen for adults is 1200 mg in 24 hours, which is no more than six 200 mg tablets in a day (13).

Also, check the label for the maximum drug dosage suggested by the drug manufacturer. Limiting the dosage to 1200mg a day is likely to release less than 1mg of ibuprofen into the breast milk, which will not harm the baby (8).

Prescription ibuprofen: Doctor-prescribed tablets are likely to contain 200mg to 800mg of ibuprofen. The dosage frequency entirely depends on the doctor’s suggestion. The maximum limit of prescription ibuprofen is 3200 mg per day, which is a maximum of four 800 mg tablets in a day (14).

Doctors usually do not prescribe high doses of ibuprofen for lactating mothers and may stick to a maximum of 1600-2400mg per day. You may also be prescribed a slow-release version of ibuprofen to be taken once or twice a day, with a 10-12 hours gap between two doses (15).

Overdosing is highly unlikely if you take prescribed ibuprofen. Avoid using OTC ibuprofen, but if you have to take it, stick to the suggested limit. Consult the doctor for alternatives, if the drug doesn’t provide relief as expected.

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When Should A Breastfeeding Mother Avoid Ibuprofen?

Avoid taking ibuprofen without a doctor’s consent if (16):

  • You or your baby is taking another NSAID or other medicines such as acetaminophen (paracetamol). These medicines have similar effects as ibuprofen and should not be taken together to avoid overdosing.
  • You or your baby have heart or kidney problems. Ibuprofen can be taxing to the kidneys and also may cause high blood pressure, which affects the heart.
  • You or your baby have a stomach ulcer, which could exacerbate due to ibuprofen use.
  • You or your baby have asthma or any other allergic condition.
  • The baby has acid reflux or gastroesophageal disease (GERD). Heartburn is one of the side effects of ibuprofen and babies with GERD could be more sensitive to maternal ibuprofen usage.
  • Your baby has a history of allergic reactions to maternal medication and food consumption.

Taking precautions when using medications can help minimize related risks.

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[ Read: Amoxicillin While Breastfeeding ]

Tips For Ibuprofen Usage While Breastfeeding

  • Avoid mixing too many medicines, since ibuprofen could be a part of other medications as well. For example, ibuprofen is present in certain medications for a headache and cold. So taking them both together could mean exceeding the suggested daily limit of ibuprofen dosage.
  • Do not take ibuprofen for more than ten days, unless the doctor may prescribe it for any specific reason.
  • Do not take more than what is needed to feel better. If you start feeling better after a couple of doses, then stop taking it any more. Use of alternative methods, such as hot water compress, pain relief balms etc, along with the medicine to feel better and reduce the dependency on the drug.
  • In the case of side effects either in yourself or the baby, then stop usage and visit the doctor.

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Ibuprofen is one of the safest medicines you can have when you are lactating. But as you would with any other medication during lactation, stick to the recommended dosages to avoiding any adverse effects on the baby. Consult a doctor if you not sure how to administer over-the-counter ibuprofen or have doubts. Staying within the limit and being watchful for any side effects on your little one is critical for safe ibuprofen usage when breastfeeding.

Recommended Articles:

Advil, Motrin (ibuprofen) dosing, indications, interactions, adverse effects, and more

  • acebutolol

    Monitor Closely (2)ibuprofen decreases effects of acebutolol by pharmacodynamic antagonism. Use Caution/Monitor. Long term (>1 wk) NSAID use. NSAIDs decrease prostaglandin synthesis.

    acebutolol and ibuprofen both increase serum potassium. Use Caution/Monitor.

  • aceclofenac

    Monitor Closely (2)aceclofenac and ibuprofen both increase anticoagulation. Use Caution/Monitor.

    aceclofenac and ibuprofen both increase serum potassium. Use Caution/Monitor.Minor (1)aceclofenac will increase the level or effect of ibuprofen by acidic (anionic) drug competition for renal tubular clearance. Minor/Significance Unknown.

  • acemetacin

    Monitor Closely (2)acemetacin and ibuprofen both increase anticoagulation. Use Caution/Monitor.

    acemetacin and ibuprofen both increase serum potassium. Use Caution/Monitor.Minor (1)acemetacin will increase the level or effect of ibuprofen by acidic (anionic) drug competition for renal tubular clearance. Minor/Significance Unknown.

  • acyclovir

    Minor (1)ibuprofen will increase the level or effect of acyclovir by acidic (anionic) drug competition for renal tubular clearance. Minor/Significance Unknown.

  • adefovir

    Minor (1)ibuprofen increases levels of adefovir by enhancing GI absorption. Applies only to oral form of both agents. Minor/Significance Unknown.

  • agrimony

    Monitor Closely (1)ibuprofen and agrimony both increase anticoagulation. Use Caution/Monitor.

  • albuterol

    Monitor Closely (1)ibuprofen increases and albuterol decreases serum potassium. Effect of interaction is not clear, use caution. Use Caution/Monitor.

  • alendronate

    Minor (1)ibuprofen, alendronate.
    Either increases toxicity of the other by pharmacodynamic synergism. Minor/Significance Unknown. Increased risk of GI ulceration.

  • alfalfa

    Monitor Closely (1)ibuprofen and alfalfa both increase anticoagulation. Use Caution/Monitor.

  • alfuzosin

    Monitor Closely (1)ibuprofen decreases effects of alfuzosin by pharmacodynamic antagonism. Use Caution/Monitor. NSAIDs decrease prostaglandin synthesis.

  • aliskiren

    Monitor Closely (1)ibuprofen will decrease the level or effect of aliskiren by Other (see comment). Use Caution/Monitor. In patients who are elderly, volume-depleted (including those on diuretic therapy), or with compromised renal function, coadministration of NSAIDs with drugs that affect RAAS may increase the risk of renal impairment (including acute renal failure) and cause loss of antihypertensive effect. Monitor renal function periodically.

  • alteplase

    Monitor Closely (1)ibuprofen and alteplase both increase anticoagulation. Use Caution/Monitor. Potential for increased risk of bleeding, caution is advised.

  • American ginseng

    Monitor Closely (1)ibuprofen and American ginseng both increase anticoagulation. Use Caution/Monitor.

  • amikacin

    Monitor Closely (1)ibuprofen increases levels of amikacin by decreasing renal clearance. Use Caution/Monitor. Interaction mainly occurs in preterm infants.

  • amiloride

    Monitor Closely (1)amiloride and ibuprofen both increase serum potassium. Modify Therapy/Monitor Closely.

  • aminohippurate sodium

    Minor (1)ibuprofen will increase the level or effect of aminohippurate sodium by acidic (anionic) drug competition for renal tubular clearance. Minor/Significance Unknown.

  • aminolevulinic acid oral

    Serious – Use Alternative (1)aminolevulinic acid oral, ibuprofen.
    Either increases toxicity of the other by pharmacodynamic synergism. Avoid or Use Alternate Drug. Avoid administering other phototoxic drugs with aminolevulinic acid oral for 24 hr during perioperative period.

  • aminolevulinic acid topical

    Serious – Use Alternative (1)ibuprofen, aminolevulinic acid topical.
    Either increases toxicity of the other by pharmacodynamic synergism. Avoid or Use Alternate Drug. Each drug may increase the photosensitizing effect of the other.

  • amiodarone

    Minor (1)amiodarone will increase the level or effect of ibuprofen by affecting hepatic enzyme CYP2C9/10 metabolism. Minor/Significance Unknown.

  • amobarbital

    Minor (1)amobarbital will decrease the level or effect of ibuprofen by affecting hepatic enzyme CYP2C9/10 metabolism. Minor/Significance Unknown.

  • anamu

    Minor (1)ibuprofen and anamu both increase anticoagulation. Minor/Significance Unknown.

  • antithrombin alfa

    Monitor Closely (1)antithrombin alfa and ibuprofen both increase anticoagulation. Modify Therapy/Monitor Closely.

  • antithrombin III

    Monitor Closely (1)antithrombin III and ibuprofen both increase anticoagulation. Modify Therapy/Monitor Closely.

  • apixaban

    Serious – Use Alternative (1)ibuprofen and apixaban both increase anticoagulation. Avoid or Use Alternate Drug.

  • arformoterol

    Monitor Closely (1)ibuprofen increases and arformoterol decreases serum potassium. Effect of interaction is not clear, use caution. Use Caution/Monitor.

  • argatroban

    Monitor Closely (1)argatroban and ibuprofen both increase anticoagulation. Modify Therapy/Monitor Closely.

  • asenapine

    Monitor Closely (1)ibuprofen decreases effects of asenapine by pharmacodynamic antagonism. Use Caution/Monitor. NSAIDs decrease prostaglandin synthesis.

  • aspirin

    Monitor Closely (2)aspirin and ibuprofen both increase anticoagulation. Use Caution/Monitor.

    aspirin and ibuprofen both increase serum potassium. Use Caution/Monitor.Serious – Use Alternative (2)ibuprofen increases toxicity of aspirin by anticoagulation. Avoid or Use Alternate Drug. increases risk of bleeding.

    ibuprofen decreases effects of aspirin by Other (see comment). Avoid or Use Alternate Drug.
    Comment: Ibuprofen decreases the antiplatelet effects of low-dose aspirin by blocking the active site of platelet cyclooxygenase. Administer ibuprofen 8 h before aspirin or at least 2-4 h after aspirin. The effect of other NSAIDs on aspirin is not established.Minor (1)aspirin will increase the level or effect of ibuprofen by acidic (anionic) drug competition for renal tubular clearance. Minor/Significance Unknown.

  • aspirin rectal

    Monitor Closely (2)aspirin rectal and ibuprofen both increase anticoagulation. Use Caution/Monitor.

    aspirin rectal and ibuprofen both increase serum potassium. Use Caution/Monitor.Serious – Use Alternative (1)ibuprofen decreases effects of aspirin rectal by Other (see comment). Avoid or Use Alternate Drug.
    Comment: Ibuprofen decreases the antiplatelet effects of aspirin by blocking the active site of platelet cyclooxygenase. The effect of other NSAIDs on aspirin is not established.Minor (1)aspirin rectal will increase the level or effect of ibuprofen by acidic (anionic) drug competition for renal tubular clearance. Minor/Significance Unknown.

  • aspirin/citric acid/sodium bicarbonate

    Monitor Closely (2)aspirin/citric acid/sodium bicarbonate and ibuprofen both increase anticoagulation. Use Caution/Monitor.

    aspirin/citric acid/sodium bicarbonate and ibuprofen both increase serum potassium. Use Caution/Monitor.Serious – Use Alternative (1)ibuprofen decreases effects of aspirin/citric acid/sodium bicarbonate by Other (see comment). Avoid or Use Alternate Drug.
    Comment: Ibuprofen decreases the antiplatelet effects of aspirin by blocking the active site of platelet cyclooxygenase. The effect of other NSAIDs on aspirin is not established. Minor (1)aspirin/citric acid/sodium bicarbonate will increase the level or effect of ibuprofen by acidic (anionic) drug competition for renal tubular clearance. Minor/Significance Unknown.

  • atenolol

    Monitor Closely (2)ibuprofen decreases effects of atenolol by pharmacodynamic antagonism. Use Caution/Monitor. Long term (>1 wk) NSAID use. NSAIDs decrease prostaglandin synthesis.

    atenolol and ibuprofen both increase serum potassium. Use Caution/Monitor.

  • azficel-T

    Monitor Closely (1)azficel-T, ibuprofen. Other (see comment). Use Caution/Monitor.
    Comment: Patients taking NSAIDS may experience increased bruising or bleeding at biopsy and/or injection sites. Concomitant use of NSAIDs is not recommended.

  • azilsartan

    Monitor Closely (2)ibuprofen, azilsartan.
    Either increases toxicity of the other by Other (see comment). Use Caution/Monitor.
    Comment: May result in renal function deterioration, particularly in elderly or volume depleted individuals.

    ibuprofen decreases effects of azilsartan by pharmacodynamic antagonism. Modify Therapy/Monitor Closely. NSAIDs decrease synthesis of vasodilating renal prostaglandins, and thus affect fluid homeostasis and may diminish antihypertensive effect.

  • balsalazide

    Minor (1)ibuprofen will increase the level or effect of balsalazide by acidic (anionic) drug competition for renal tubular clearance. Minor/Significance Unknown.

  • bemiparin

    Monitor Closely (1)bemiparin and ibuprofen both increase anticoagulation. Modify Therapy/Monitor Closely.

  • benazepril

    Monitor Closely (1)benazepril, ibuprofen.
    Either increases toxicity of the other by Other (see comment). Use Caution/Monitor.
    Comment: May result in renal function deterioration, particularly in elderly or volume depleted individuals.Serious – Use Alternative (1)ibuprofen, benazepril. pharmacodynamic antagonism. Avoid or Use Alternate Drug. Coadministration may result in a significant decrease in renal function. NSAIDs may diminish the antihypertensive effect of ACE inhibitors. The mechanism of these interactions is likely related to the ability of NSAIDs to reduce the synthesis of vasodilating renal prostaglandins.

  • bendroflumethiazide

    Monitor Closely (1)ibuprofen increases and bendroflumethiazide decreases serum potassium. Effect of interaction is not clear, use caution. Use Caution/Monitor.Minor (1)bendroflumethiazide will increase the level or effect of ibuprofen by acidic (anionic) drug competition for renal tubular clearance. Minor/Significance Unknown.

  • betaxolol

    Monitor Closely (2)ibuprofen decreases effects of betaxolol by pharmacodynamic antagonism. Use Caution/Monitor. Long term (>1 wk) NSAID use. NSAIDs decrease prostaglandin synthesis.

    betaxolol and ibuprofen both increase serum potassium. Use Caution/Monitor.

  • betrixaban

    Monitor Closely (1)ibuprofen, betrixaban.
    Either increases levels of the other by anticoagulation. Use Caution/Monitor.

  • bimatoprost

    Monitor Closely (1)bimatoprost, ibuprofen. unspecified interaction mechanism. Use Caution/Monitor. There are conflicting reports from studies of either increased or decreased IOP when ophthalmic prostaglandins are coadministered with NSAIDs (either systemic or ophthalmic).

  • bisoprolol

    Monitor Closely (2)ibuprofen decreases effects of bisoprolol by pharmacodynamic antagonism. Use Caution/Monitor. Long term (>1 wk) NSAID use. NSAIDs decrease prostaglandin synthesis.

    bisoprolol and ibuprofen both increase serum potassium. Use Caution/Monitor.

  • bivalirudin

    Monitor Closely (1)bivalirudin and ibuprofen both increase anticoagulation. Modify Therapy/Monitor Closely.

  • bosentan

    Minor (1)bosentan will decrease the level or effect of ibuprofen by affecting hepatic enzyme CYP2C9/10 metabolism. Minor/Significance Unknown.

  • budesonide

    Monitor Closely (1)ibuprofen, budesonide.
    Either increases toxicity of the other by pharmacodynamic synergism. Use Caution/Monitor. Increased risk of GI ulceration.

  • bumetanide

    Monitor Closely (2)ibuprofen decreases effects of bumetanide by pharmacodynamic antagonism. Use Caution/Monitor. NSAIDs decrease prostaglandin synthesis.

    ibuprofen increases and bumetanide decreases serum potassium. Effect of interaction is not clear, use caution. Use Caution/Monitor.

  • butabarbital

    Minor (1)butabarbital will decrease the level or effect of ibuprofen by affecting hepatic enzyme CYP2C9/10 metabolism. Minor/Significance Unknown.

  • butalbital

    Minor (1)butalbital will decrease the level or effect of ibuprofen by affecting hepatic enzyme CYP2C9/10 metabolism. Minor/Significance Unknown.

  • candesartan

    Monitor Closely (3)candesartan, ibuprofen.
    Either increases toxicity of the other by Other (see comment). Use Caution/Monitor.
    Comment: May result in renal function deterioration, particularly in elderly or volume depleted individuals.

    ibuprofen decreases effects of candesartan by pharmacodynamic antagonism. Modify Therapy/Monitor Closely. NSAIDs decrease synthesis of vasodilating renal prostaglandins, and thus affect fluid homeostasis and may diminish antihypertensive effect.

    candesartan and ibuprofen both increase serum potassium. Use Caution/Monitor.

  • captopril

    Monitor Closely (1)captopril, ibuprofen.
    Either increases toxicity of the other by Other (see comment). Use Caution/Monitor.
    Comment: May result in renal function deterioration, particularly in elderly or volume depleted individuals.Serious – Use Alternative (1)ibuprofen, captopril. pharmacodynamic antagonism. Avoid or Use Alternate Drug. Coadministration may result in a significant decrease in renal function. NSAIDs may diminish the antihypertensive effect of ACE inhibitors. The mechanism of these interactions is likely related to the ability of NSAIDs to reduce the synthesis of vasodilating renal prostaglandins.

  • carbamazepine

    Monitor Closely (1)ibuprofen will increase the level or effect of carbamazepine by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor. Monitor plasma levels when used concomitantlyMinor (1)carbamazepine will decrease the level or effect of ibuprofen by affecting hepatic enzyme CYP2C9/10 metabolism. Minor/Significance Unknown.

  • carbenoxolone

    Monitor Closely (1)ibuprofen increases and carbenoxolone decreases serum potassium. Effect of interaction is not clear, use caution. Use Caution/Monitor.

  • carvedilol

    Monitor Closely (2)ibuprofen decreases effects of carvedilol by pharmacodynamic antagonism. Use Caution/Monitor. Long term (>1 wk) NSAID use. NSAIDs decrease prostaglandin synthesis.

    carvedilol and ibuprofen both increase serum potassium. Use Caution/Monitor.

  • cefadroxil

    Minor (1)cefadroxil will increase the level or effect of ibuprofen by acidic (anionic) drug competition for renal tubular clearance. Minor/Significance Unknown.

  • cefamandole

    Minor (1)cefamandole will increase the level or effect of ibuprofen by acidic (anionic) drug competition for renal tubular clearance. Minor/Significance Unknown.

  • cefdinir

    Minor (1)cefdinir will increase the level or effect of ibuprofen by acidic (anionic) drug competition for renal tubular clearance. Minor/Significance Unknown.

  • cefpirome

    Minor (1)cefpirome will increase the level or effect of ibuprofen by acidic (anionic) drug competition for renal tubular clearance. Minor/Significance Unknown.

  • ceftibuten

    Minor (1)ceftibuten will increase the level or effect of ibuprofen by acidic (anionic) drug competition for renal tubular clearance. Minor/Significance Unknown.

  • celecoxib

    Monitor Closely (2)celecoxib and ibuprofen both increase anticoagulation. Use Caution/Monitor.

    celecoxib and ibuprofen both increase serum potassium. Use Caution/Monitor.Minor (1)celecoxib will increase the level or effect of ibuprofen by acidic (anionic) drug competition for renal tubular clearance. Minor/Significance Unknown.

  • celiprolol

    Monitor Closely (2)ibuprofen decreases effects of celiprolol by pharmacodynamic antagonism. Use Caution/Monitor. Long term (>1 wk) NSAID use. NSAIDs decrease prostaglandin synthesis.

    celiprolol and ibuprofen both increase serum potassium. Use Caution/Monitor.

  • cephalexin

    Minor (1)cephalexin will increase the level or effect of ibuprofen by acidic (anionic) drug competition for renal tubular clearance. Minor/Significance Unknown.

  • chlorothiazide

    Monitor Closely (1)ibuprofen increases and chlorothiazide decreases serum potassium. Effect of interaction is not clear, use caution. Use Caution/Monitor.Minor (1)chlorothiazide will increase the level or effect of ibuprofen by acidic (anionic) drug competition for renal tubular clearance. Minor/Significance Unknown.

  • chlorpropamide

    Monitor Closely (1)ibuprofen increases effects of chlorpropamide by unknown mechanism. Use Caution/Monitor. Risk of hypoglycemia.Minor (1)ibuprofen will increase the level or effect of chlorpropamide by acidic (anionic) drug competition for renal tubular clearance. Minor/Significance Unknown.

  • chlorthalidone

    Monitor Closely (1)ibuprofen increases and chlorthalidone decreases serum potassium. Effect of interaction is not clear, use caution. Use Caution/Monitor.Minor (1)chlorthalidone will increase the level or effect of ibuprofen by acidic (anionic) drug competition for renal tubular clearance. Minor/Significance Unknown.

  • choline magnesium trisalicylate

    Monitor Closely (2)ibuprofen and choline magnesium trisalicylate both increase anticoagulation. Use Caution/Monitor.

    ibuprofen and choline magnesium trisalicylate both increase serum potassium. Use Caution/Monitor.Minor (1)ibuprofen will increase the level or effect of choline magnesium trisalicylate by acidic (anionic) drug competition for renal tubular clearance. Minor/Significance Unknown.

  • cimetidine

    Minor (1)cimetidine will increase the level or effect of ibuprofen by affecting hepatic enzyme CYP2C9/10 metabolism. Minor/Significance Unknown.

  • cinnamon

    Monitor Closely (1)ibuprofen and cinnamon both increase anticoagulation. Use Caution/Monitor.

  • ciprofloxacin

    Monitor Closely (1)ibuprofen, ciprofloxacin. Other (see comment). Modify Therapy/Monitor Closely.
    Comment: Mechanism: unknown. Increased risk of CNS stimulation and seizures with high doses of fluoroquinolones.

  • citalopram

    Monitor Closely (1)citalopram, ibuprofen.
    Either increases toxicity of the other by pharmacodynamic synergism. Use Caution/Monitor. Increased risk of upper GI bleeding. If possible, avoid concurrent use.

  • clobetasone

    Monitor Closely (1)ibuprofen, clobetasone.
    Either increases toxicity of the other by pharmacodynamic synergism. Use Caution/Monitor. Increased risk of GI ulceration.

  • clomipramine

    Monitor Closely (1)clomipramine, ibuprofen.
    Either increases toxicity of the other by pharmacodynamic synergism. Use Caution/Monitor. Increased risk of upper GI bleeding. Clomipramine inhib. serotonin uptake by platelets.

  • clopidogrel

    Monitor Closely (1)clopidogrel, ibuprofen.
    Either increases effects of the other by pharmacodynamic synergism. Modify Therapy/Monitor Closely. Clopidogrel and NSAIDs both inhibit platelet aggregation.

  • cordyceps

    Monitor Closely (1)ibuprofen and cordyceps both increase anticoagulation. Use Caution/Monitor.

  • cortisone

    Monitor Closely (1)ibuprofen, cortisone.
    Either increases toxicity of the other by pharmacodynamic synergism. Use Caution/Monitor. Increased risk of GI ulceration.

  • creatine

    Minor (1)creatine, ibuprofen. Mechanism: pharmacodynamic synergism. Minor/Significance Unknown. (Theoretical interaction) Combination may have additive nephrotoxic effects.

  • cyclopenthiazide

    Monitor Closely (1)ibuprofen increases and cyclopenthiazide decreases serum potassium. Effect of interaction is not clear, use caution. Use Caution/Monitor.Minor (1)cyclopenthiazide will increase the level or effect of ibuprofen by acidic (anionic) drug competition for renal tubular clearance. Minor/Significance Unknown.

  • cyclosporine

    Monitor Closely (1)ibuprofen, cyclosporine.
    Either increases toxicity of the other by nephrotoxicity and/or ototoxicity. Use Caution/Monitor. NSAIDs decrease prostaglandin synthesis, increasing the risk of nephrotoxicity.

  • dabigatran

    Monitor Closely (1)dabigatran and ibuprofen both increase anticoagulation. Use Caution/Monitor. Caution is advised, both drugs have the potential to cause bleeding. Concomitant use may increase risk of bleeding.

  • dalteparin

    Monitor Closely (1)dalteparin and ibuprofen both increase anticoagulation. Modify Therapy/Monitor Closely.

  • danshen

    Minor (1)ibuprofen and danshen both increase anticoagulation. Minor/Significance Unknown.

  • deferasirox

    Monitor Closely (1)deferasirox, ibuprofen. Other (see comment). Use Caution/Monitor.
    Comment: Combination may increase GI bleeding, ulceration and irritation. Use with caution.

  • defibrotide

    Monitor Closely (1)defibrotide increases effects of ibuprofen by P-glycoprotein (MDR1) efflux transporter. Use Caution/Monitor. Defibrotide may enhance effects of platelet inhibitors.

  • deflazacort

    Monitor Closely (1)ibuprofen, deflazacort.
    Either increases toxicity of the other by pharmacodynamic synergism. Use Caution/Monitor. Increased risk of GI ulceration.

  • devil’s claw

    Minor (1)ibuprofen and devil’s claw both increase anticoagulation. Minor/Significance Unknown.

  • dexamethasone

    Monitor Closely (1)ibuprofen, dexamethasone.
    Either increases toxicity of the other by pharmacodynamic synergism. Use Caution/Monitor. Increased risk of GI ulceration.

  • dichlorphenamide

    Monitor Closely (1)dichlorphenamide, ibuprofen.
    Either increases toxicity of the other by pharmacodynamic synergism. Modify Therapy/Monitor Closely. Both drugs can cause metabolic acidosis.

  • diclofenac

    Monitor Closely (2)diclofenac and ibuprofen both increase anticoagulation. Use Caution/Monitor.

    diclofenac and ibuprofen both increase serum potassium. Use Caution/Monitor.Minor (1)diclofenac will increase the level or effect of ibuprofen by acidic (anionic) drug competition for renal tubular clearance. Minor/Significance Unknown.

  • diclofenac topical

    Minor (1)diclofenac topical, ibuprofen.
    Either increases effects of the other by pharmacodynamic synergism. Minor/Significance Unknown. Although low, there is systemic exposure to diclofenac topical; theoretically, concomitant administration with systemic NSAIDS or aspirin may result in increased NSAID adverse effects.

  • diflunisal

    Monitor Closely (2)diflunisal and ibuprofen both increase anticoagulation. Use Caution/Monitor.

    diflunisal and ibuprofen both increase serum potassium. Use Caution/Monitor.Minor (1)diflunisal will increase the level or effect of ibuprofen by acidic (anionic) drug competition for renal tubular clearance. Minor/Significance Unknown.

  • digoxin

    Monitor Closely (1)ibuprofen and digoxin both increase serum potassium. Use Caution/Monitor.Minor (1)ibuprofen increases levels of digoxin by decreasing renal clearance. Minor/Significance Unknown.

  • disulfiram

    Minor (1)disulfiram will increase the level or effect of ibuprofen by affecting hepatic enzyme CYP2C9/10 metabolism. Minor/Significance Unknown.

  • dobutamine

    Monitor Closely (1)ibuprofen increases and dobutamine decreases serum potassium. Effect of interaction is not clear, use caution. Use Caution/Monitor.

  • dong quai

    Monitor Closely (1)ibuprofen and dong quai both increase anticoagulation. Use Caution/Monitor.

  • dopexamine

    Monitor Closely (1)ibuprofen increases and dopexamine decreases serum potassium. Effect of interaction is not clear, use caution. Use Caution/Monitor.

  • doxazosin

    Monitor Closely (1)ibuprofen decreases effects of doxazosin by pharmacodynamic antagonism. Use Caution/Monitor. NSAIDs decrease prostaglandin synthesis.

  • dronabinol

    Monitor Closely (1)ibuprofen will increase the level or effect of dronabinol by affecting hepatic enzyme CYP2C9/10 metabolism. Use Caution/Monitor. Dronabinol is a CYP2C9 substrate.

  • drospirenone

    Monitor Closely (1)drospirenone and ibuprofen both increase serum potassium. Modify Therapy/Monitor Closely.

  • duloxetine

    Monitor Closely (1)duloxetine, ibuprofen.
    Either increases toxicity of the other by pharmacodynamic synergism. Use Caution/Monitor. Increased risk of upper GI bleeding. SSRIs inhib. serotonin uptake by platelets.

  • edoxaban

    Monitor Closely (1)edoxaban, ibuprofen.
    Either increases toxicity of the other by anticoagulation. Modify Therapy/Monitor Closely. Both drugs have the potential to cause bleeding, monitor closely. Promptly evaluate any signs or symptoms of blood loss.

  • efavirenz

    Monitor Closely (1)efavirenz will increase the level or effect of ibuprofen by affecting hepatic enzyme CYP2C9/10 metabolism. Use Caution/Monitor.

  • eltrombopag

    Monitor Closely (1)eltrombopag increases levels of ibuprofen by decreasing metabolism. Use Caution/Monitor. UGT inhibition; significance of interaction unclear.

  • eluxadoline

    Monitor Closely (1)ibuprofen increases levels of eluxadoline by affecting hepatic enzyme CYP2C9/10 metabolism. Use Caution/Monitor. As a precautionary measure due to incomplete information on the metabolism of eluxadoline, use caution when coadministered with strong CYP2C9/10 inhibitors.

  • elvitegravir/cobicistat/emtricitabine/tenofovir DF

    Monitor Closely (1)elvitegravir/cobicistat/emtricitabine/tenofovir DF, ibuprofen.
    Either increases toxicity of the other by decreasing renal clearance. Modify Therapy/Monitor Closely. Toxicity may result from coadministration of emtricitabine and tenofovir with other drugs that are also primarily excreted by glomerular filtration and/or active tubular secretion including high-dose or multiple-dose NSAIDs; alternatives to NSAIDs should be considered.

  • emtricitabine

    Monitor Closely (1)emtricitabine, ibuprofen.
    Either increases levels of the other by decreasing renal clearance. Modify Therapy/Monitor Closely. Toxicity may result from coadministration of emtricitabine with other drugs that are also primarily excreted by glomerular filtration and/or active tubular secretion including high-dose or multiple-dose NSAIDs; alternatives to NSAIDs should be considered.

  • enalapril

    Monitor Closely (1)enalapril, ibuprofen.
    Either increases toxicity of the other by Other (see comment). Use Caution/Monitor.
    Comment: May result in renal function deterioration, particularly in elderly or volume depleted individuals.Serious – Use Alternative (1)ibuprofen, enalapril. pharmacodynamic antagonism. Avoid or Use Alternate Drug. Coadministration may result in a significant decrease in renal function. NSAIDs may diminish the antihypertensive effect of ACE inhibitors. The mechanism of these interactions is likely related to the ability of NSAIDs to reduce the synthesis of vasodilating renal prostaglandins.

  • enoxaparin

    Monitor Closely (1)enoxaparin and ibuprofen both increase anticoagulation. Modify Therapy/Monitor Closely.

  • ephedrine

    Monitor Closely (1)ibuprofen increases and ephedrine decreases serum potassium. Effect of interaction is not clear, use caution. Use Caution/Monitor.

  • epinephrine

    Monitor Closely (1)ibuprofen increases and epinephrine decreases serum potassium. Effect of interaction is not clear, use caution. Use Caution/Monitor.

  • epinephrine racemic

    Monitor Closely (1)ibuprofen increases and epinephrine racemic decreases serum potassium. Effect of interaction is not clear, use caution. Use Caution/Monitor.

  • eplerenone

    Minor (1)ibuprofen decreases effects of eplerenone by pharmacodynamic antagonism. Minor/Significance Unknown. NSAIDs decrease prostaglandin synthesis.

  • epoprostenol

    Monitor Closely (1)ibuprofen and epoprostenol both increase anticoagulation. Use Caution/Monitor.

  • eprosartan

    Monitor Closely (3)ibuprofen decreases effects of eprosartan by pharmacodynamic antagonism. Modify Therapy/Monitor Closely. NSAIDs decrease synthesis of vasodilating renal prostaglandins, and thus affect fluid homeostasis and may diminish antihypertensive effect.

    eprosartan and ibuprofen both increase serum potassium. Use Caution/Monitor.

    eprosartan, ibuprofen.
    Either increases toxicity of the other by Other (see comment). Use Caution/Monitor.
    Comment: May result in renal function deterioration, particularly in elderly or volume depleted individuals.

  • erdafitinib

    Serious – Use Alternative (1)ibuprofen will increase the level or effect of erdafitinib by affecting hepatic enzyme CYP2C9/10 metabolism. Avoid or Use Alternate Drug. If unable to avoid coadministration with strong CYP2C9 inhibitors, monitor closely for adverse reactions and consider decreasing dose accordingly. If strong CYP2C9 inhibitor is discontinued, consider increasing erdafitinib dose in the absence of any drug-related toxicities.

  • escitalopram

    Monitor Closely (1)escitalopram, ibuprofen.
    Either increases toxicity of the other by pharmacodynamic synergism. Use Caution/Monitor. Increased risk of upper GI bleeding. SSRIs inhib. serotonin uptake by platelets.

  • esmolol

    Monitor Closely (2)ibuprofen decreases effects of esmolol by pharmacodynamic antagonism. Use Caution/Monitor. Long term (>1 wk) NSAID use. NSAIDs decrease prostaglandin synthesis.

    esmolol and ibuprofen both increase serum potassium. Use Caution/Monitor.

  • ethacrynic acid

    Monitor Closely (1)ibuprofen increases and ethacrynic acid decreases serum potassium. Effect of interaction is not clear, use caution. Use Caution/Monitor.

  • etodolac

    Monitor Closely (2)etodolac and ibuprofen both increase anticoagulation. Use Caution/Monitor.

    etodolac and ibuprofen both increase serum potassium. Use Caution/Monitor.Minor (1)etodolac will increase the level or effect of ibuprofen by acidic (anionic) drug competition for renal tubular clearance. Minor/Significance Unknown.

  • etravirine

    Minor (1)etravirine will increase the level or effect of ibuprofen by affecting hepatic enzyme CYP2C9/10 metabolism. Minor/Significance Unknown.

  • felbamate

    Minor (1)felbamate will increase the level or effect of ibuprofen by affecting hepatic enzyme CYP2C9/10 metabolism. Minor/Significance Unknown.

  • fennel

    Monitor Closely (1)ibuprofen and fennel both increase anticoagulation. Use Caution/Monitor.

  • fenoprofen

    Monitor Closely (2)fenoprofen and ibuprofen both increase anticoagulation. Use Caution/Monitor.

    fenoprofen and ibuprofen both increase serum potassium. Use Caution/Monitor.Minor (1)fenoprofen will increase the level or effect of ibuprofen by acidic (anionic) drug competition for renal tubular clearance. Minor/Significance Unknown.

  • feverfew

    Monitor Closely (1)ibuprofen and feverfew both increase anticoagulation. Use Caution/Monitor.Minor (1)ibuprofen decreases effects of feverfew by pharmacodynamic antagonism. Minor/Significance Unknown.

  • fish oil triglycerides

    Monitor Closely (1)fish oil triglycerides will increase the level or effect of ibuprofen by anticoagulation. Use Caution/Monitor. Prolonged bleeding reported in patients taking antiplatelet agents or anticoagulants and oral omega-3 fatty acids. Periodically monitor bleeding time in patients receiving fish oil triglycerides and concomitant antiplatelet agents or anticoagulants.

  • flucloxacillin

    Monitor Closely (2)flucloxacillin, ibuprofen.
    Either increases levels of the other by plasma protein binding competition. Use Caution/Monitor.

    flucloxacillin, ibuprofen.
    Either increases levels of the other by decreasing renal clearance. Use Caution/Monitor.

  • fluconazole

    Minor (1)fluconazole will increase the level or effect of ibuprofen by affecting hepatic enzyme CYP2C9/10 metabolism. Minor/Significance Unknown.

  • fludrocortisone

    Monitor Closely (1)ibuprofen, fludrocortisone.
    Either increases toxicity of the other by pharmacodynamic synergism. Use Caution/Monitor. Increased risk of GI ulceration.

  • fluoxetine

    Monitor Closely (2)fluoxetine will increase the level or effect of ibuprofen by affecting hepatic enzyme CYP2C9/10 metabolism. Use Caution/Monitor.

    fluoxetine, ibuprofen.
    Either increases toxicity of the other by pharmacodynamic synergism. Use Caution/Monitor. Increased risk of upper GI bleeding. SSRIs inhib. serotonin uptake by platelets.

  • flurbiprofen

    Monitor Closely (2)flurbiprofen and ibuprofen both increase anticoagulation. Use Caution/Monitor.

    flurbiprofen and ibuprofen both increase serum potassium. Use Caution/Monitor.Minor (1)flurbiprofen will increase the level or effect of ibuprofen by acidic (anionic) drug competition for renal tubular clearance. Minor/Significance Unknown.

  • fluvoxamine

    Monitor Closely (1)fluvoxamine, ibuprofen.
    Either increases toxicity of the other by pharmacodynamic synergism. Use Caution/Monitor. Increased risk of upper GI bleeding; SSRIs inhib. srotonin uptake by platelets.

  • fondaparinux

    Monitor Closely (1)fondaparinux and ibuprofen both increase anticoagulation. Modify Therapy/Monitor Closely.

  • formoterol

    Monitor Closely (1)ibuprofen increases and formoterol decreases serum potassium. Effect of interaction is not clear, use caution. Use Caution/Monitor.

  • forskolin

    Monitor Closely (1)ibuprofen and forskolin both increase anticoagulation. Use Caution/Monitor.

  • fosinopril

    Monitor Closely (1)fosinopril, ibuprofen.
    Either increases toxicity of the other by Other (see comment). Use Caution/Monitor.
    Comment: May result in renal function deterioration, particularly in elderly or volume depleted individuals.Serious – Use Alternative (1)ibuprofen, fosinopril. pharmacodynamic antagonism. Avoid or Use Alternate Drug. Coadministration may result in a significant decrease in renal function. NSAIDs may diminish the antihypertensive effect of ACE inhibitors. The mechanism of these interactions is likely related to the ability of NSAIDs to reduce the synthesis of vasodilating renal prostaglandins.

  • furosemide

    Monitor Closely (1)ibuprofen increases and furosemide decreases serum potassium. Effect of interaction is not clear, use caution. Use Caution/Monitor.Minor (1)ibuprofen decreases effects of furosemide by pharmacodynamic antagonism. Minor/Significance Unknown. NSAIDs decrease prostaglandin synthesis.

  • ganciclovir

    Minor (1)ibuprofen will increase the level or effect of ganciclovir by acidic (anionic) drug competition for renal tubular clearance. Minor/Significance Unknown.

  • garlic

    Monitor Closely (1)ibuprofen and garlic both increase anticoagulation. Use Caution/Monitor.

  • gemifloxacin

    Monitor Closely (1)gemifloxacin, ibuprofen. Other (see comment). Modify Therapy/Monitor Closely.
    Comment: Increased risk of CNS stimulation and seizures with high doses of fluoroquinolones.

  • gentamicin

    Monitor Closely (1)ibuprofen increases and gentamicin decreases serum potassium. Effect of interaction is not clear, use caution. Use Caution/Monitor.Minor (1)ibuprofen increases levels of gentamicin by decreasing renal clearance. Minor/Significance Unknown. Interaction mainly occurs in preterm infants.

  • ginger

    Monitor Closely (1)ibuprofen and ginger both increase anticoagulation. Use Caution/Monitor.

  • ginkgo biloba

    Monitor Closely (1)ibuprofen and ginkgo biloba both increase anticoagulation. Use Caution/Monitor.

  • glimepiride

    Monitor Closely (1)ibuprofen increases effects of glimepiride by unknown mechanism. Use Caution/Monitor. Risk of hypoglycemia.

  • glipizide

    Monitor Closely (1)ibuprofen increases effects of glipizide by unknown mechanism. Use Caution/Monitor. Risk of hypoglycemia.

  • glyburide

    Monitor Closely (2)ibuprofen increases effects of glyburide by unknown mechanism. Use Caution/Monitor. Risk of hypoglycemia.

    ibuprofen increases levels of glyburide by affecting hepatic enzyme CYP2C9/10 metabolism. Use Caution/Monitor. Strong CYP2C9 inhibitors may decrease glyburide metabolism.

  • green tea

    Monitor Closely (1)green tea, ibuprofen. Other (see comment). Use Caution/Monitor.
    Comment: Combination may increase risk of bleeding.

  • heparin

    Monitor Closely (1)heparin and ibuprofen both increase anticoagulation. Modify Therapy/Monitor Closely.

  • horse chestnut seed

    Monitor Closely (1)ibuprofen and horse chestnut seed both increase anticoagulation. Use Caution/Monitor.

  • hydralazine

    Monitor Closely (1)ibuprofen decreases effects of hydralazine by pharmacodynamic antagonism. Use Caution/Monitor. NSAIDs decrease prostaglandin synthesis.

  • hydrochlorothiazide

    Monitor Closely (1)ibuprofen increases and hydrochlorothiazide decreases serum potassium. Effect of interaction is not clear, use caution. Use Caution/Monitor.Minor (1)hydrochlorothiazide will increase the level or effect of ibuprofen by acidic (anionic) drug competition for renal tubular clearance. Minor/Significance Unknown.

  • hydrocortisone

    Monitor Closely (1)ibuprofen, hydrocortisone.
    Either increases toxicity of the other by pharmacodynamic synergism. Use Caution/Monitor. Increased risk of GI ulceration.

  • ibrutinib

    Monitor Closely (1)ibrutinib will increase the level or effect of ibuprofen by anticoagulation. Use Caution/Monitor. Ibrutinib may increase the risk of hemorrhage in patients receiving antiplatelet or anticoagulant therapies and monitor for signs of bleeding.

  • imatinib

    Monitor Closely (2)imatinib will increase the level or effect of ibuprofen by affecting hepatic enzyme CYP2C9/10 metabolism. Use Caution/Monitor.

    imatinib, ibuprofen.
    Either increases toxicity of the other by Other (see comment). Modify Therapy/Monitor Closely.
    Comment: Imatinib may cause thrombocytopenia; bleeding risk increased when imatinib is coadministered with anticoagulants, NSAIDs, platelet inhibitors, and thrombolytic agents.

  • imidapril

    Minor (1)ibuprofen decreases effects of imidapril by pharmacodynamic antagonism. Minor/Significance Unknown. NSAIDs decrease prostaglandin synthesis.

  • indapamide

    Monitor Closely (1)ibuprofen increases and indapamide decreases serum potassium. Effect of interaction is not clear, use caution. Use Caution/Monitor.Minor (1)indapamide will increase the level or effect of ibuprofen by acidic (anionic) drug competition for renal tubular clearance. Minor/Significance Unknown.

  • indomethacin

    Monitor Closely (2)ibuprofen and indomethacin both increase anticoagulation. Use Caution/Monitor.

    ibuprofen and indomethacin both increase serum potassium. Use Caution/Monitor.Minor (1)ibuprofen will increase the level or effect of indomethacin by acidic (anionic) drug competition for renal tubular clearance. Minor/Significance Unknown.

  • irbesartan

    Monitor Closely (3)irbesartan, ibuprofen.
    Either increases toxicity of the other by Other (see comment). Use Caution/Monitor.
    Comment: May result in renal function deterioration, particularly in elderly or volume depleted individuals.

    irbesartan and ibuprofen both increase serum potassium. Use Caution/Monitor.

    ibuprofen decreases effects of irbesartan by pharmacodynamic antagonism. Use Caution/Monitor. Antihypertensive effect of angiotensin receptor blockers may be attenuated by NSAIDs; monitor renal function and blood pressure periodically.

  • isoproterenol

    Monitor Closely (1)ibuprofen increases and isoproterenol decreases serum potassium. Effect of interaction is not clear, use caution. Use Caution/Monitor.

  • ketoconazole

    Minor (1)ketoconazole will increase the level or effect of ibuprofen by affecting hepatic enzyme CYP2C9/10 metabolism. Minor/Significance Unknown.

  • ketoprofen

    Monitor Closely (2)ibuprofen and ketoprofen both increase anticoagulation. Use Caution/Monitor.

    ibuprofen and ketoprofen both increase serum potassium. Use Caution/Monitor.Minor (1)ibuprofen will increase the level or effect of ketoprofen by acidic (anionic) drug competition for renal tubular clearance. Minor/Significance Unknown.

  • ketorolac

    Monitor Closely (2)ibuprofen and ketorolac both increase anticoagulation. Use Caution/Monitor.

    ibuprofen and ketorolac both increase serum potassium. Use Caution/Monitor.Serious – Use Alternative (1)ibuprofen, ketorolac.
    Either increases toxicity of the other by pharmacodynamic synergism. Contraindicated.Minor (1)ibuprofen will increase the level or effect of ketorolac by acidic (anionic) drug competition for renal tubular clearance. Minor/Significance Unknown.

  • ketorolac intranasal

    Monitor Closely (2)ibuprofen and ketorolac intranasal both increase anticoagulation. Use Caution/Monitor.

    ibuprofen and ketorolac intranasal both increase serum potassium. Use Caution/Monitor.Serious – Use Alternative (1)ibuprofen, ketorolac intranasal.
    Either increases toxicity of the other by pharmacodynamic synergism. Contraindicated.Minor (1)ibuprofen will increase the level or effect of ketorolac intranasal by acidic (anionic) drug competition for renal tubular clearance. Minor/Significance Unknown.

  • labetalol

    Monitor Closely (2)labetalol and ibuprofen both increase serum potassium. Use Caution/Monitor.

    ibuprofen decreases effects of labetalol by pharmacodynamic antagonism. Use Caution/Monitor. NSAIDs diminish antihypertensive effects of beta-blockers.

  • lacosamide

    Monitor Closely (1)ibuprofen increases levels of lacosamide by affecting hepatic enzyme CYP2C9/10 metabolism. Modify Therapy/Monitor Closely. Consider decreasing lacosamide dose when coadministered with strong CYP2C9 inhibitors.

  • latanoprost

    Monitor Closely (1)latanoprost, ibuprofen. unspecified interaction mechanism. Use Caution/Monitor. There are conflicting reports from studies of either increased or decreased IOP when ophthalmic prostaglandins are coadministered with NSAIDs (either systemic or ophthalmic).

  • latanoprostene bunod ophthalmic

    Monitor Closely (1)latanoprostene bunod ophthalmic, ibuprofen. unspecified interaction mechanism. Use Caution/Monitor. There are conflicting reports from studies of either increased or decreased IOP when ophthalmic prostaglandins are coadministered with NSAIDs (either systemic or ophthalmic).

  • leflunomide

    Minor (1)leflunomide will increase the level or effect of ibuprofen by affecting hepatic enzyme CYP2C9/10 metabolism. Minor/Significance Unknown.

  • lesinurad

    Monitor Closely (1)ibuprofen will increase the level or effect of lesinurad by affecting hepatic enzyme CYP2C9/10 metabolism. Modify Therapy/Monitor Closely.

  • levalbuterol

    Monitor Closely (1)ibuprofen increases and levalbuterol decreases serum potassium. Effect of interaction is not clear, use caution. Use Caution/Monitor.

  • levofloxacin

    Monitor Closely (1)levofloxacin, ibuprofen. Other (see comment). Modify Therapy/Monitor Closely.
    Comment: Risk of CNS stimulation/seizure. Mechanism: Displacement of GABA from receptors in brain.

  • levomilnacipran

    Monitor Closely (1)levomilnacipran, ibuprofen.
    Either increases toxicity of the other by pharmacodynamic synergism. Use Caution/Monitor. SNRIs may further impair platelet activity in patients taking antiplatelet or anticoagulant drugs.

  • lisinopril

    Monitor Closely (1)lisinopril, ibuprofen.
    Either increases toxicity of the other by Other (see comment). Use Caution/Monitor.
    Comment: May result in renal function deterioration, particularly in elderly or volume depleted individuals.Serious – Use Alternative (1)ibuprofen, lisinopril. pharmacodynamic antagonism. Avoid or Use Alternate Drug. Coadministration may result in a significant decrease in renal function. NSAIDs may diminish the antihypertensive effect of ACE inhibitors. The mechanism of these interactions is likely related to the ability of NSAIDs to reduce the synthesis of vasodilating renal prostaglandins.

  • lithium

    Monitor Closely (1)ibuprofen increases levels of lithium by decreasing renal clearance. Use Caution/Monitor.

  • lornoxicam

    Monitor Closely (2)ibuprofen and lornoxicam both increase anticoagulation. Use Caution/Monitor.

    ibuprofen and lornoxicam both increase serum potassium. Use Caution/Monitor.Minor (1)ibuprofen will increase the level or effect of lornoxicam by acidic (anionic) drug competition for renal tubular clearance. Minor/Significance Unknown.

  • losartan

    Monitor Closely (3)losartan, ibuprofen.
    Either increases toxicity of the other by Other (see comment). Use Caution/Monitor.
    Comment: May result in renal function deterioration, particularly in elderly or volume depleted individuals.

    ibuprofen decreases effects of losartan by pharmacodynamic antagonism. Modify Therapy/Monitor Closely. NSAIDs decrease synthesis of vasodilating renal prostaglandins, and thus affect fluid homeostasis and may diminish antihypertensive effect.

    losartan and ibuprofen both increase serum potassium. Use Caution/Monitor.

  • lumacaftor/ivacaftor

    Monitor Closely (1)lumacaftor/ivacaftor will decrease the level or effect of ibuprofen by affecting hepatic enzyme CYP2C9/10 metabolism. Use Caution/Monitor. Ibuprofen it a substrate of CYP2C9. Lumacaftor has the potential to induce CYP2C9 substrates.

  • meclofenamate

    Monitor Closely (2)meclofenamate and ibuprofen both increase anticoagulation. Use Caution/Monitor.

    meclofenamate and ibuprofen both increase serum potassium. Use Caution/Monitor.Minor (1)meclofenamate will increase the level or effect of ibuprofen by acidic (anionic) drug competition for renal tubular clearance. Minor/Significance Unknown.

  • mefenamic acid

    Monitor Closely (2)ibuprofen and mefenamic acid both increase anticoagulation. Use Caution/Monitor.

    ibuprofen and mefenamic acid both increase serum potassium. Use Caution/Monitor.Minor (1)ibuprofen will increase the level or effect of mefenamic acid by acidic (anionic) drug competition for renal tubular clearance. Minor/Significance Unknown.

  • melatonin

    Monitor Closely (1)melatonin increases effects of ibuprofen by anticoagulation. Use Caution/Monitor. Melatonin may decrease prothrombin time.

  • meloxicam

    Monitor Closely (2)ibuprofen and meloxicam both increase anticoagulation. Use Caution/Monitor.

    ibuprofen and meloxicam both increase serum potassium. Use Caution/Monitor.Minor (1)ibuprofen will increase the level or effect of meloxicam by acidic (anionic) drug competition for renal tubular clearance. Minor/Significance Unknown.

  • mesalamine

    Monitor Closely (1)mesalamine, ibuprofen.
    Either increases toxicity of the other by pharmacodynamic synergism. Use Caution/Monitor. Additive nephrotoxicity.Minor (1)ibuprofen will increase the level or effect of mesalamine by acidic (anionic) drug competition for renal tubular clearance. Minor/Significance Unknown.

  • metaproterenol

    Monitor Closely (1)ibuprofen increases and metaproterenol decreases serum potassium. Effect of interaction is not clear, use caution. Use Caution/Monitor.

  • methotrexate

    Serious – Use Alternative (1)ibuprofen increases levels of methotrexate by decreasing renal clearance. Avoid or Use Alternate Drug. Concomitant administration of NSAIDs with high dose methotrexate has been reported to elevate and prolong serum methotrexate levels, resulting in deaths from severe hematologic and GI toxicity. NSAIDs may reduce tubular secretion of methotrexate and enhance toxicity. .

  • methyclothiazide

    Monitor Closely (1)ibuprofen increases and methyclothiazide decreases serum potassium. Effect of interaction is not clear, use caution. Use Caution/Monitor. .Minor (1)methyclothiazide will increase the level or effect of ibuprofen by acidic (anionic) drug competition for renal tubular clearance. Minor/Significance Unknown.

  • methyl aminolevulinate

    Serious – Use Alternative (1)ibuprofen, methyl aminolevulinate.
    Either increases toxicity of the other by pharmacodynamic synergism. Avoid or Use Alternate Drug. Each drug may increase the photosensitizing effect of the other.

  • methylprednisolone

    Monitor Closely (1)ibuprofen, methylprednisolone.
    Either increases toxicity of the other by pharmacodynamic synergism. Use Caution/Monitor. Increased risk of GI ulceration.

  • metolazone

    Monitor Closely (1)ibuprofen increases and metolazone decreases serum potassium. Effect of interaction is not clear, use caution. Use Caution/Monitor.Minor (1)metolazone will increase the level or effect of ibuprofen by acidic (anionic) drug competition for renal tubular clearance. Minor/Significance Unknown.

  • metoprolol

    Monitor Closely (2)ibuprofen decreases effects of metoprolol by pharmacodynamic antagonism. Use Caution/Monitor. Long term (>1 wk) NSAID use. NSAIDs decrease prostaglandin synthesis.

    metoprolol and ibuprofen both increase serum potassium. Use Caution/Monitor.

  • metronidazole

    Minor (1)metronidazole will increase the level or effect of ibuprofen by affecting hepatic enzyme CYP2C9/10 metabolism. Minor/Significance Unknown.

  • miconazole vaginal

    Minor (1)miconazole vaginal will increase the level or effect of ibuprofen by affecting hepatic enzyme CYP2C9/10 metabolism. Minor/Significance Unknown.

  • milnacipran

    Monitor Closely (1)milnacipran, ibuprofen.
    Either increases toxicity of the other by pharmacodynamic synergism. Use Caution/Monitor. Increased risk of upper GI bleeding. SSRIs inhib. serotonin uptake by platelets.

  • mipomersen

    Monitor Closely (1)mipomersen, ibuprofen.
    Either increases toxicity of the other by Other (see comment). Use Caution/Monitor.
    Comment: Both drugs have potential to increase hepatic enzymes; monitor LFTs.

  • mistletoe

    Monitor Closely (1)ibuprofen increases and mistletoe decreases anticoagulation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

  • moexipril

    Monitor Closely (1)moexipril, ibuprofen.
    Either increases toxicity of the other by Other (see comment). Use Caution/Monitor.
    Comment: May result in renal function deterioration, particularly in elderly or volume depleted individuals.Serious – Use Alternative (1)ibuprofen, moexipril. pharmacodynamic antagonism. Avoid or Use Alternate Drug. Coadministration may result in a significant decrease in renal function. NSAIDs may diminish the antihypertensive effect of ACE inhibitors. The mechanism of these interactions is likely related to the ability of NSAIDs to reduce the synthesis of vasodilating renal prostaglandins.

  • moxifloxacin

    Monitor Closely (1)moxifloxacin, ibuprofen. Other (see comment). Modify Therapy/Monitor Closely.
    Comment: Increased risk of CNS stimulation and seizures with high doses of fluoroquinolones.

  • moxisylyte

    Monitor Closely (1)ibuprofen decreases effects of moxisylyte by pharmacodynamic antagonism. Use Caution/Monitor. NSAIDs decrease prostaglandin synthesis.

  • mycophenolate

    Monitor Closely (1)ibuprofen will increase the level or effect of mycophenolate by acidic (anionic) drug competition for renal tubular clearance. Use Caution/Monitor.

  • nabumetone

    Monitor Closely (2)ibuprofen and nabumetone both increase anticoagulation. Use Caution/Monitor.

    ibuprofen and nabumetone both increase serum potassium. Use Caution/Monitor.Minor (1)ibuprofen will increase the level or effect of nabumetone by acidic (anionic) drug competition for renal tubular clearance. Minor/Significance Unknown.

  • nadolol

    Monitor Closely (2)ibuprofen decreases effects of nadolol by pharmacodynamic antagonism. Use Caution/Monitor. Long term (>1 wk) NSAID use. NSAIDs decrease prostaglandin synthesis.

    nadolol and ibuprofen both increase serum potassium. Use Caution/Monitor.

  • naproxen

    Serious – Use Alternative (3)ibuprofen will increase the level or effect of naproxen by acidic (anionic) drug competition for renal tubular clearance. Avoid or Use Alternate Drug. Therapeutic duplication

    ibuprofen and naproxen both increase anticoagulation. Avoid or Use Alternate Drug. Therapeutic duplication

    ibuprofen and naproxen both increase serum potassium. Avoid or Use Alternate Drug. Therapeutic duplication

  • nateglinide

    Minor (1)nateglinide will increase the level or effect of ibuprofen by affecting hepatic enzyme CYP2C9/10 metabolism. Minor/Significance Unknown.

  • nebivolol

    Monitor Closely (2)ibuprofen decreases effects of nebivolol by pharmacodynamic antagonism. Use Caution/Monitor. Long term (>1 wk) NSAID use. NSAIDs decrease prostaglandin synthesis.

    nebivolol and ibuprofen both increase serum potassium. Use Caution/Monitor.

  • nefazodone

    Monitor Closely (1)nefazodone, ibuprofen.
    Either increases toxicity of the other by pharmacodynamic synergism. Use Caution/Monitor. Increased risk of upper GI bleeding. SSRIs inhib. serotonin uptake by platelets.

  • neomycin PO

    Minor (1)ibuprofen increases levels of neomycin PO by decreasing renal clearance. Minor/Significance Unknown. Interaction mainly occurs in preterm infants.

  • nettle

    Monitor Closely (1)ibuprofen increases and nettle decreases anticoagulation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

  • nilotinib

    Minor (1)nilotinib will increase the level or effect of ibuprofen by affecting hepatic enzyme CYP2C9/10 metabolism. Minor/Significance Unknown.

  • noni juice

    Minor (1)ibuprofen and noni juice both increase serum potassium. Minor/Significance Unknown.

  • norepinephrine

    Monitor Closely (1)ibuprofen increases and norepinephrine decreases serum potassium. Effect of interaction is not clear, use caution. Use Caution/Monitor.

  • ofloxacin

    Minor (1)ofloxacin, ibuprofen. Other (see comment). Minor/Significance Unknown.
    Comment: Risk of CNS stimulation/seizure. Mechanism: Displacement of GABA from receptors in brain.

  • olmesartan

    Monitor Closely (3)olmesartan, ibuprofen.
    Either increases toxicity of the other by Other (see comment). Use Caution/Monitor.
    Comment: May result in renal function deterioration, particularly in elderly or volume depleted individuals.

    ibuprofen decreases effects of olmesartan by pharmacodynamic antagonism. Modify Therapy/Monitor Closely. NSAIDs decrease synthesis of vasodilating renal prostaglandins, and thus affect fluid homeostasis and may diminish antihypertensive effect.

    olmesartan and ibuprofen both increase serum potassium. Use Caution/Monitor.

  • ospemifene

    Monitor Closely (2)ibuprofen increases levels of ospemifene by affecting hepatic enzyme CYP2C9/10 metabolism. Use Caution/Monitor.

    ibuprofen, ospemifene.
    Either increases levels of the other by plasma protein binding competition. Modify Therapy/Monitor Closely.

  • oxaprozin

    Serious – Use Alternative (3)ibuprofen and oxaprozin both increase anticoagulation. Avoid or Use Alternate Drug. Therapeutic duplication

    ibuprofen will increase the level or effect of oxaprozin by acidic (anionic) drug competition for renal tubular clearance. Avoid or Use Alternate Drug. Therapeutic duplication

    ibuprofen and oxaprozin both increase serum potassium. Avoid or Use Alternate Drug. Therapeutic duplication

  • panax ginseng

    Monitor Closely (1)ibuprofen and panax ginseng both increase anticoagulation. Use Caution/Monitor.

  • parecoxib

    Monitor Closely (2)ibuprofen and parecoxib both increase anticoagulation. Use Caution/Monitor.

    ibuprofen and parecoxib both increase serum potassium. Use Caution/Monitor.Minor (1)ibuprofen will increase the level or effect of parecoxib by acidic (anionic) drug competition for renal tubular clearance. Minor/Significance Unknown.

  • paromomycin

    Minor (1)ibuprofen increases levels of paromomycin by decreasing renal clearance. Minor/Significance Unknown. Interaction mainly occurs in preterm infants.

  • paroxetine

    Monitor Closely (1)paroxetine, ibuprofen.
    Either increases toxicity of the other by pharmacodynamic synergism. Use Caution/Monitor. Increased risk of upper GI bleeding. SSRIs inhib. serotonin uptake by platelets.

  • pau d’arco

    Monitor Closely (1)ibuprofen and pau d’arco both increase anticoagulation. Use Caution/Monitor.

  • pegaspargase

    Monitor Closely (1)pegaspargase increases effects of ibuprofen by pharmacodynamic synergism. Use Caution/Monitor. Increased risk of bleeding events.

  • peginterferon alfa 2b

    Monitor Closely (1)peginterferon alfa 2b decreases levels of ibuprofen by affecting hepatic enzyme CYP2C9/10 metabolism. Use Caution/Monitor. When patients are administered peginterferon alpha-2b with CYP2C9 substrates, the therapeutic effect of these drugs may be altered.

  • pemetrexed

    Serious – Use Alternative (1)ibuprofen increases levels of pemetrexed by unspecified interaction mechanism. Avoid or Use Alternate Drug. Especially in pts. w/mild moderate renal insufficiency. D/C NSAIDs 2 5 d before and 2 d after pemetrexed administration.

  • penbutolol

    Monitor Closely (2)ibuprofen decreases effects of penbutolol by pharmacodynamic antagonism. Use Caution/Monitor. Long term (>1 wk) NSAID use. NSAIDs decrease prostaglandin synthesis.

    penbutolol and ibuprofen both increase serum potassium. Use Caution/Monitor.

  • pentobarbital

    Minor (1)pentobarbital will decrease the level or effect of ibuprofen by affecting hepatic enzyme CYP2C9/10 metabolism. Minor/Significance Unknown.

  • perindopril

    Monitor Closely (1)perindopril, ibuprofen.
    Either increases toxicity of the other by Other (see comment). Use Caution/Monitor.
    Comment: May result in renal function deterioration, particularly in elderly or volume depleted individuals.Serious – Use Alternative (1)ibuprofen, perindopril. pharmacodynamic antagonism. Avoid or Use Alternate Drug. Coadministration may result in a significant decrease in renal function. NSAIDs may diminish the antihypertensive effect of ACE inhibitors. The mechanism of these interactions is likely related to the ability of NSAIDs to reduce the synthesis of vasodilating renal prostaglandins.

  • pexidartinib

    Serious – Use Alternative (1)ibuprofen and pexidartinib both increase Other (see comment). Avoid or Use Alternate Drug. Pexidartinib can cause hepatotoxicity. Avoid coadministration of pexidartinib with other products know to cause hepatoxicity.

  • phenindione

    Monitor Closely (1)phenindione and ibuprofen both increase anticoagulation. Modify Therapy/Monitor Closely.

  • phenobarbital

    Minor (1)phenobarbital will decrease the level or effect of ibuprofen by affecting hepatic enzyme CYP2C9/10 metabolism. Minor/Significance Unknown.

  • phenoxybenzamine

    Monitor Closely (1)ibuprofen decreases effects of phenoxybenzamine by pharmacodynamic antagonism. Use Caution/Monitor. NSAIDs decrease prostaglandin synthesis.

  • phentolamine

    Monitor Closely (1)ibuprofen decreases effects of phentolamine by pharmacodynamic antagonism. Use Caution/Monitor. NSAIDs decrease prostaglandin synthesis.

  • phytoestrogens

    Monitor Closely (1)ibuprofen and phytoestrogens both increase anticoagulation. Use Caution/Monitor.

  • pindolol

    Monitor Closely (2)ibuprofen decreases effects of pindolol by pharmacodynamic antagonism. Use Caution/Monitor. Long term (>1 wk) NSAID use. NSAIDs decrease prostaglandin synthesis.

    pindolol and ibuprofen both increase serum potassium. Use Caution/Monitor.

  • pirbuterol

    Monitor Closely (1)ibuprofen increases and pirbuterol decreases serum potassium. Effect of interaction is not clear, use caution. Use Caution/Monitor.

  • piroxicam

    Monitor Closely (2)ibuprofen and piroxicam both increase anticoagulation. Use Caution/Monitor.

    ibuprofen and piroxicam both increase serum potassium. Use Caution/Monitor.Minor (1)ibuprofen will increase the level or effect of piroxicam by acidic (anionic) drug competition for renal tubular clearance. Minor/Significance Unknown.

  • pivmecillinam

    Monitor Closely (2)pivmecillinam, ibuprofen.
    Either increases levels of the other by plasma protein binding competition. Use Caution/Monitor.

    pivmecillinam, ibuprofen.
    Either increases levels of the other by decreasing renal clearance. Use Caution/Monitor.

  • potassium acid phosphate

    Monitor Closely (1)ibuprofen and potassium acid phosphate both increase serum potassium. Modify Therapy/Monitor Closely.

  • potassium chloride

    Monitor Closely (1)ibuprofen and potassium chloride both increase serum potassium. Modify Therapy/Monitor Closely.

  • potassium citrate

    Monitor Closely (1)ibuprofen and potassium citrate both increase serum potassium. Modify Therapy/Monitor Closely.

  • potassium iodide

    Monitor Closely (1)potassium iodide and ibuprofen both increase serum potassium. Use Caution/Monitor.

  • pralatrexate

    Monitor Closely (1)ibuprofen increases levels of pralatrexate by decreasing renal clearance. Use Caution/Monitor. NSAIDs may delay pralatrexate clearance, increasing drug exposure. Adjust the pralatrexate dose as needed.

  • prasugrel

    Monitor Closely (1)ibuprofen, prasugrel.
    Either increases effects of the other by anticoagulation. Use Caution/Monitor. Chronic use of NSAIDs with prasugrel may increase bleeding risk.

  • prazosin

    Monitor Closely (1)ibuprofen decreases effects of prazosin by pharmacodynamic antagonism. Use Caution/Monitor. NSAIDs decrease prostaglandin synthesis.

  • prednisolone

    Monitor Closely (1)ibuprofen, prednisolone.
    Either increases toxicity of the other by pharmacodynamic synergism. Use Caution/Monitor. Increased risk of GI ulceration.

  • prednisone

    Monitor Closely (1)ibuprofen, prednisone.
    Either increases toxicity of the other by pharmacodynamic synergism. Use Caution/Monitor. Increased risk of GI ulceration.

  • pretomanid

    Serious – Use Alternative (1)ibuprofen, pretomanid.
    Either increases toxicity of the other by Other (see comment). Avoid or Use Alternate Drug.
    Comment: Pretomanid regimen associated with hepatotoxicity. Avoid alcohol and hepatotoxic agents, including herbal supplements and drugs other than bedaquiline and linezolid.

  • primidone

    Minor (1)primidone will decrease the level or effect of ibuprofen by affecting hepatic enzyme CYP2C9/10 metabolism. Minor/Significance Unknown.

  • probenecid

    Monitor Closely (1)ibuprofen will increase the level or effect of probenecid by acidic (anionic) drug competition for renal tubular clearance. Use Caution/Monitor.

  • propranolol

    Monitor Closely (2)ibuprofen decreases effects of propranolol by pharmacodynamic antagonism. Use Caution/Monitor. Long term (>1 wk) NSAID use. NSAIDs decrease prostaglandin synthesis.

    propranolol and ibuprofen both increase serum potassium. Use Caution/Monitor.

  • protamine

    Monitor Closely (1)protamine and ibuprofen both increase anticoagulation. Modify Therapy/Monitor Closely.

  • quinapril

    Monitor Closely (1)quinapril, ibuprofen.
    Either increases toxicity of the other by Other (see comment). Use Caution/Monitor.
    Comment: May result in renal function deterioration, particularly in elderly or volume depleted individuals.Serious – Use Alternative (1)ibuprofen, quinapril. pharmacodynamic antagonism. Avoid or Use Alternate Drug. Coadministration may result in a significant decrease in renal function. NSAIDs may diminish the antihypertensive effect of ACE inhibitors. The mechanism of these interactions is likely related to the ability of NSAIDs to reduce the synthesis of vasodilating renal prostaglandins.

  • ramipril

    Monitor Closely (1)ramipril, ibuprofen.
    Either increases toxicity of the other by Other (see comment). Use Caution/Monitor.
    Comment: May result in renal function deterioration, particularly in elderly or volume depleted individuals.Serious – Use Alternative (1)ibuprofen, ramipril. pharmacodynamic antagonism. Avoid or Use Alternate Drug. Coadministration may result in a significant decrease in renal function. NSAIDs may diminish the antihypertensive effect of ACE inhibitors. The mechanism of these interactions is likely related to the ability of NSAIDs to reduce the synthesis of vasodilating renal prostaglandins.

  • reishi

    Monitor Closely (1)ibuprofen and reishi both increase anticoagulation. Use Caution/Monitor.

  • reteplase

    Monitor Closely (1)ibuprofen and reteplase both increase anticoagulation. Use Caution/Monitor. Potential for increased risk of bleeding, caution is advised.

  • rifampin

    Minor (1)rifampin will decrease the level or effect of ibuprofen by affecting hepatic enzyme CYP2C9/10 metabolism. Minor/Significance Unknown.

  • rifapentine

    Minor (1)rifapentine will decrease the level or effect of ibuprofen by affecting hepatic enzyme CYP2C9/10 metabolism. Minor/Significance Unknown.

  • rivaroxaban

    Monitor Closely (1)rivaroxaban, ibuprofen. Other (see comment). Use Caution/Monitor.
    Comment: NSAIDs are known to increase bleeding. Bleeding risk may be increased when NSAIDs are used concomitantly with rivaroxaban. Monitor for signs/symptoms of blood loss.

  • rivastigmine

    Monitor Closely (1)rivastigmine increases toxicity of ibuprofen by pharmacodynamic synergism. Use Caution/Monitor. Monitor patients for symptoms of active or occult gastrointestinal bleeding.

  • rose hips

    Minor (1)rose hips will increase the level or effect of ibuprofen by acidic (anionic) drug competition for renal tubular clearance. Minor/Significance Unknown.

  • sacubitril/valsartan

    Monitor Closely (3)sacubitril/valsartan, ibuprofen.
    Either increases toxicity of the other by Other (see comment). Use Caution/Monitor.
    Comment: May result in renal function deterioration, particularly in elderly or volume depleted individuals.

    ibuprofen decreases effects of sacubitril/valsartan by pharmacodynamic antagonism. Modify Therapy/Monitor Closely. NSAIDs decrease synthesis of vasodilating renal prostaglandins, and thus affect fluid homeostasis and may diminish antihypertensive effect.

    sacubitril/valsartan and ibuprofen both increase serum potassium. Use Caution/Monitor.

  • salicylates (non-asa)

    Monitor Closely (2)ibuprofen and salicylates (non-asa) both increase anticoagulation. Use Caution/Monitor.

    ibuprofen and salicylates (non-asa) both increase serum potassium. Use Caution/Monitor.Minor (1)ibuprofen will increase the level or effect of salicylates (non-asa) by acidic (anionic) drug competition for renal tubular clearance. Minor/Significance Unknown.

  • salmeterol

    Monitor Closely (1)ibuprofen increases and salmeterol decreases serum potassium. Effect of interaction is not clear, use caution. Use Caution/Monitor.

  • salsalate

    Monitor Closely (2)ibuprofen and salsalate both increase anticoagulation. Use Caution/Monitor.

    ibuprofen and salsalate both increase serum potassium. Use Caution/Monitor.Minor (1)ibuprofen will increase the level or effect of salsalate by acidic (anionic) drug competition for renal tubular clearance. Minor/Significance Unknown.

  • saw palmetto

    Monitor Closely (1)saw palmetto increases toxicity of ibuprofen by unspecified interaction mechanism. Use Caution/Monitor. May increase risk of bleeding.

  • secobarbital

    Minor (1)secobarbital will decrease the level or effect of ibuprofen by affecting hepatic enzyme CYP2C9/10 metabolism. Minor/Significance Unknown.

  • sertraline

    Monitor Closely (1)sertraline, ibuprofen.
    Either increases toxicity of the other by pharmacodynamic synergism. Use Caution/Monitor. Increased risk of upper GI bleeding. SSRIs inhib. serotonin uptake by platelets.

  • Siberian ginseng

    Monitor Closely (1)ibuprofen and Siberian ginseng both increase anticoagulation. Use Caution/Monitor.

  • silodosin

    Monitor Closely (1)ibuprofen decreases effects of silodosin by pharmacodynamic antagonism. Use Caution/Monitor. NSAIDs decrease prostaglandin synthesis.

  • siponimod

    Serious – Use Alternative (1)ibuprofen will increase the level or effect of siponimod by affecting hepatic enzyme CYP2C9/10 metabolism. Avoid or Use Alternate Drug. Coadministration of siponimod with drugs that cause moderate CYP2C9 AND a moderate or strong CYP3A4 inhibition is not recommended. Caution if siponimod coadministered with moderate CYP2C9 inhibitors alone.

  • sodium picosulfate/magnesium oxide/anhydrous citric acid

    Monitor Closely (1)ibuprofen, sodium picosulfate/magnesium oxide/anhydrous citric acid.
    Either increases toxicity of the other by Other (see comment). Use Caution/Monitor.
    Comment: May be associated with fluid and electrolyte imbalances.

  • sodium sulfate/?magnesium sulfate/potassium chloride

    Monitor Closely (1)sodium sulfate/?magnesium sulfate/potassium chloride increases toxicity of ibuprofen by Other (see comment). Use Caution/Monitor.
    Comment: Coadministration with medications that cause fluid and electrolyte abnormalities may increase the risk of adverse events of seizure, arrhythmias, and renal impairment.

  • sodium sulfate/potassium sulfate/magnesium sulfate

    Monitor Closely (1)sodium sulfate/potassium sulfate/magnesium sulfate increases toxicity of ibuprofen by Other (see comment). Use Caution/Monitor.
    Comment: Coadministration with medications that cause fluid and electrolyte abnormalities may increase the risk of adverse events of seizure, arrhythmias, and renal impairment.

  • sodium sulfate/potassium sulfate/magnesium sulfate/polyethylene glycol

    Monitor Closely (1)ibuprofen, sodium sulfate/potassium sulfate/magnesium sulfate/polyethylene glycol. Other (see comment). Use Caution/Monitor.
    Comment: Caution when bowel preps are used with drugs that cause SIADH or NSAIDs; increased risk for water retention or electrolyte imbalance.

  • sotalol

    Monitor Closely (2)ibuprofen decreases effects of sotalol by pharmacodynamic antagonism. Use Caution/Monitor. Long term (>1 wk) NSAID use. NSAIDs decrease prostaglandin synthesis.

    sotalol and ibuprofen both increase serum potassium. Use Caution/Monitor.

  • spironolactone

    Monitor Closely (1)spironolactone and ibuprofen both increase serum potassium. Modify Therapy/Monitor Closely.

  • streptomycin

    Minor (1)ibuprofen increases levels of streptomycin by decreasing renal clearance. Minor/Significance Unknown. Interaction mainly occurs in preterm infants.

  • succinylcholine

    Monitor Closely (1)ibuprofen and succinylcholine both increase serum potassium. Use Caution/Monitor.

  • sulfamethoxazole

    Minor (1)sulfamethoxazole will increase the level or effect of ibuprofen by affecting hepatic enzyme CYP2C9/10 metabolism. Minor/Significance Unknown.

  • sulfasalazine

    Monitor Closely (2)ibuprofen and sulfasalazine both increase anticoagulation. Use Caution/Monitor.

    ibuprofen and sulfasalazine both increase serum potassium. Use Caution/Monitor.Minor (1)ibuprofen will increase the level or effect of sulfasalazine by acidic (anionic) drug competition for renal tubular clearance. Minor/Significance Unknown.

  • sulindac

    Monitor Closely (2)ibuprofen and sulindac both increase anticoagulation. Use Caution/Monitor.

    ibuprofen and sulindac both increase serum potassium. Use Caution/Monitor.Minor (1)ibuprofen will increase the level or effect of sulindac by acidic (anionic) drug competition for renal tubular clearance. Minor/Significance Unknown.

  • tacrolimus

    Serious – Use Alternative (1)ibuprofen, tacrolimus.
    Either increases toxicity of the other by Other (see comment). Avoid or Use Alternate Drug.
    Comment: Concomitant administration increases risk of nephrotoxicity.

  • tafluprost

    Monitor Closely (1)tafluprost, ibuprofen. unspecified interaction mechanism. Use Caution/Monitor. There are conflicting reports from studies of either increased or decreased IOP when ophthalmic prostaglandins are coadministered with NSAIDs (either systemic or ophthalmic).

  • telmisartan

    Monitor Closely (3)telmisartan, ibuprofen.
    Either increases toxicity of the other by Other (see comment). Use Caution/Monitor.
    Comment: May result in renal function deterioration, particularly in elderly or volume depleted individuals.

    ibuprofen decreases effects of telmisartan by pharmacodynamic antagonism. Modify Therapy/Monitor Closely. NSAIDs decrease synthesis of vasodilating renal prostaglandins, and thus affect fluid homeostasis and may diminish antihypertensive effect.

    telmisartan and ibuprofen both increase serum potassium. Use Caution/Monitor.

  • temocillin

    Monitor Closely (2)temocillin, ibuprofen.
    Either increases levels of the other by plasma protein binding competition. Use Caution/Monitor.

    temocillin, ibuprofen.
    Either increases levels of the other by decreasing renal clearance. Use Caution/Monitor.

  • tenecteplase

    Monitor Closely (1)ibuprofen and tenecteplase both increase anticoagulation. Use Caution/Monitor. Potential for increased risk of bleeding, caution is advised.

  • tenofovir DF

    Monitor Closely (1)tenofovir DF, ibuprofen.
    Either increases levels of the other by decreasing renal clearance. Modify Therapy/Monitor Closely. Toxicity may result from coadministration of tenofovir DF with other drugs that are also primarily excreted by glomerular filtration and/or active tubular secretion including high-dose or multiple-dose NSAIDs; alternatives to NSAIDs should be considered.

  • terazosin

    Monitor Closely (1)ibuprofen decreases effects of terazosin by pharmacodynamic antagonism. Use Caution/Monitor. NSAIDs decrease prostaglandin synthesis.

  • terbinafine

    Monitor Closely (1)ibuprofen will increase the level or effect of terbinafine by affecting hepatic enzyme CYP2C9/10 metabolism. Use Caution/Monitor.

  • terbutaline

    Monitor Closely (1)ibuprofen increases and terbutaline decreases serum potassium. Effect of interaction is not clear, use caution. Use Caution/Monitor.

  • ticagrelor

    Monitor Closely (1)ticagrelor, ibuprofen.
    Either increases effects of the other by anticoagulation. Use Caution/Monitor. Increased risk of bleeding with use of ticagrelor and chronic NSAID use. .

  • ticarcillin

    Monitor Closely (2)ticarcillin, ibuprofen.
    Either increases levels of the other by plasma protein binding competition. Use Caution/Monitor.

    ticarcillin, ibuprofen.
    Either increases levels of the other by decreasing renal clearance. Use Caution/Monitor.

  • ticlopidine

    Monitor Closely (2)ticlopidine will increase the level or effect of ibuprofen by affecting hepatic enzyme CYP2C9/10 metabolism. Use Caution/Monitor.

    ticlopidine increases toxicity of ibuprofen by anticoagulation. Use Caution/Monitor.

  • timolol

    Monitor Closely (2)ibuprofen decreases effects of timolol by pharmacodynamic antagonism. Use Caution/Monitor. Long term (>1 wk) NSAID use. NSAIDs decrease prostaglandin synthesis.

    timolol and ibuprofen both increase serum potassium. Use Caution/Monitor.

  • tobramycin

    Minor (1)ibuprofen increases levels of tobramycin by decreasing renal clearance. Minor/Significance Unknown. Interaction mainly occurs in preterm infants.

  • tobramycin inhaled

    Monitor Closely (1)tobramycin inhaled and ibuprofen both increase nephrotoxicity and/or ototoxicity. Modify Therapy/Monitor Closely. Avoid concurrent or sequential use to decrease risk for ototoxicity

  • tolazamide

    Monitor Closely (1)ibuprofen increases effects of tolazamide by unknown mechanism. Use Caution/Monitor. Risk of hypoglycemia.

  • tolbutamide

    Monitor Closely (1)ibuprofen increases effects of tolbutamide by unknown mechanism. Use Caution/Monitor. Risk of hypoglycemia.

  • tolfenamic acid

    Monitor Closely (2)ibuprofen and tolfenamic acid both increase anticoagulation. Use Caution/Monitor.

    ibuprofen and tolfenamic acid both increase serum potassium. Use Caution/Monitor.Minor (1)ibuprofen will increase the level or effect of tolfenamic acid by acidic (anionic) drug competition for renal tubular clearance. Minor/Significance Unknown.

  • tolmetin

    Monitor Closely (2)ibuprofen and tolmetin both increase anticoagulation. Use Caution/Monitor.

    ibuprofen and tolmetin both increase serum potassium. Use Caution/Monitor.Minor (1)ibuprofen will increase the level or effect of tolmetin by acidic (anionic) drug competition for renal tubular clearance. Minor/Significance Unknown.

  • tolvaptan

    Monitor Closely (1)ibuprofen and tolvaptan both increase serum potassium. Use Caution/Monitor.

  • torsemide

    Monitor Closely (1)ibuprofen increases and torsemide decreases serum potassium. Effect of interaction is not clear, use caution. Use Caution/Monitor.

  • trandolapril

    Monitor Closely (1)trandolapril, ibuprofen.
    Either increases toxicity of the other by Other (see comment). Use Caution/Monitor.
    Comment: May result in renal function deterioration, particularly in elderly or volume depleted individuals.Serious – Use Alternative (1)ibuprofen, trandolapril. pharmacodynamic antagonism. Avoid or Use Alternate Drug. Coadministration may result in a significant decrease in renal function. NSAIDs may diminish the antihypertensive effect of ACE inhibitors. The mechanism of these interactions is likely related to the ability of NSAIDs to reduce the synthesis of vasodilating renal prostaglandins.

  • travoprost ophthalmic

    Monitor Closely (1)travoprost ophthalmic, ibuprofen. unspecified interaction mechanism. Use Caution/Monitor. There are conflicting reports from studies of either increased or decreased IOP when ophthalmic prostaglandins are coadministered with NSAIDs (either systemic or ophthalmic).

  • trazodone

    Monitor Closely (1)trazodone, ibuprofen.
    Either increases toxicity of the other by pharmacodynamic synergism. Use Caution/Monitor. Increased risk of upper GI bleeding. SSRIs inhib. serotonin uptake by platelets.

  • treosulfan

    Minor (1)treosulfan decreases effects of ibuprofen by Mechanism: unspecified interaction mechanism. Minor/Significance Unknown.

  • triamcinolone acetonide injectable suspension

    Monitor Closely (1)ibuprofen, triamcinolone acetonide injectable suspension.
    Either increases toxicity of the other by pharmacodynamic synergism. Use Caution/Monitor. Concomitant use of NSAIDS and corticosteroids increases the risk of gastrointestinal side effects. .

  • triamterene

    Monitor Closely (1)triamterene and ibuprofen both increase serum potassium. Modify Therapy/Monitor Closely.Minor (2)triamterene, ibuprofen. Other (see comment). Minor/Significance Unknown.
    Comment: Risk of acute renal failure. Mechanism: NSAIDs decrease prostaglandin synthesis, which normally protect against nephrotoxicity.

    ibuprofen increases toxicity of triamterene by pharmacodynamic antagonism. Minor/Significance Unknown. NSAIDs decrease prostaglandin synthesis, increasing the risk of nephrotoxicity.

  • valganciclovir

    Minor (1)ibuprofen will increase the level or effect of valganciclovir by acidic (anionic) drug competition for renal tubular clearance. Minor/Significance Unknown.

  • valproic acid

    Minor (1)valproic acid will increase the level or effect of ibuprofen by affecting hepatic enzyme CYP2C9/10 metabolism. Minor/Significance Unknown.

  • valsartan

    Monitor Closely (3)valsartan, ibuprofen.
    Either increases toxicity of the other by Other (see comment). Use Caution/Monitor.
    Comment: May result in renal function deterioration, particularly in elderly or volume depleted individuals.

    ibuprofen decreases effects of valsartan by pharmacodynamic antagonism. Modify Therapy/Monitor Closely. NSAIDs decrease synthesis of vasodilating renal prostaglandins, and thus affect fluid homeostasis and may diminish antihypertensive effect.

    valsartan and ibuprofen both increase serum potassium. Use Caution/Monitor.

  • vancomycin

    Minor (1)ibuprofen increases levels of vancomycin by decreasing renal clearance. Minor/Significance Unknown. Interaction mainly occurs in neonates.

  • venlafaxine

    Monitor Closely (1)venlafaxine, ibuprofen.
    Either increases toxicity of the other by pharmacodynamic synergism. Use Caution/Monitor. Increased risk of upper GI bleeding. SSRIs inhib. serotonin uptake by platelets.

  • vitamin K1 (phytonadione)

    Monitor Closely (1)ibuprofen increases and vitamin K1 (phytonadione) decreases anticoagulation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

  • voclosporin

    Monitor Closely (1)voclosporin, ibuprofen.
    Either increases toxicity of the other by nephrotoxicity and/or ototoxicity. Modify Therapy/Monitor Closely. Coadministration with drugs associated with nephrotoxicity may increase the risk for acute and/or chronic nephrotoxicity.

  • vorapaxar

    Monitor Closely (1)ibuprofen, vorapaxar.
    Either increases effects of the other by pharmacodynamic synergism. Use Caution/Monitor. Additive antiplatelet effect may occur.

  • voriconazole

    Minor (1)voriconazole will increase the level or effect of ibuprofen by affecting hepatic enzyme CYP2C9/10 metabolism. Minor/Significance Unknown.

  • vortioxetine

    Monitor Closely (1)ibuprofen, vortioxetine.
    Either increases effects of the other by anticoagulation. Use Caution/Monitor.

  • warfarin

    Monitor Closely (1)warfarin and ibuprofen both increase anticoagulation. Modify Therapy/Monitor Closely.

  • willow bark

    Minor (1)ibuprofen will increase the level or effect of willow bark by acidic (anionic) drug competition for renal tubular clearance. Minor/Significance Unknown.

  • zafirlukast

    Minor (1)zafirlukast will increase the level or effect of ibuprofen by affecting hepatic enzyme CYP2C9/10 metabolism. Minor/Significance Unknown.

  • zanubrutinib

    Monitor Closely (1)ibuprofen, zanubrutinib.
    Either increases effects of the other by anticoagulation. Modify Therapy/Monitor Closely. Zanubrutinib-induced cytopenias increases risk of hemorrhage. Coadministration of zanubritinib with antiplatelets or anticoagulants may further increase this risk.

  • zotepine

    Monitor Closely (1)ibuprofen decreases effects of zotepine by pharmacodynamic antagonism. Use Caution/Monitor. NSAIDs decrease prostaglandin synthesis.

  • Brufen SR®

    Effective date: November 12, 2015

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    90,000 Compatibility of ibuprofen and alcohol intake: consequences

    Ibuprofen is a popular anti-inflammatory drug with antipyretic and analgesic effects.If you use it according to your doctor’s instructions or instructions, then this medicine is absolutely safe. But how does it interact with alcohol?

    According to the National Health Service (NHS) in the UK, if you drink small amounts of alcohol, it is safe to take ibuprofen. But in the case when the patient takes ibuprofen often, and also drinks more than 1-2 alcoholic beverages per day, then there is a likelihood of side effects of varying severity.In this situation, it is worth thinking not only about the compatibility of alcohol with drugs, but also about the fact that it is probably time to start treating alcoholism, because everyday use is a vivid symptom of addiction.

    What side effects can I encounter?

    • Stomach problems and bleeding

    Ibuprofen tends to irritate the digestive tract, so doctors recommend taking it with meals. Frequent use of this drug or higher dosage increases the risk of stomach ulcers and bleeding in the digestive tract.The fact is, alcohol also has a tendency to irritate the digestive tract. By mixing two substances with similar side effects, you increase the risk of their occurrence.

    • Kidney problems

    The kidneys are the filters of our body that separate and remove all harmful substances, including alcohol breakdown products. Therefore, any use of alcoholic beverages increases the burden on the kidneys, if a person drinks regularly, the likelihood of developing chronic kidney disease doubles.

    To reduce pain and inflammation, ibuprofen stops the production of the enzyme cyclooxygenase in the kidneys, which reduces their efficiency. For healthy people, such exposure is not critical; caution is needed for those who already have reduced kidney function. It is important for such people to consult a doctor before taking alcohol with ibuprofen.

    Both alcohol and ibuprofen can have individual reactions such as drowsiness. The combination of these factors can lead to the fact that a person will not be able to function normally.

    • Risks in the elderly

    The American National Institute of Alcohol Abuse and Alcohol Abuse reports that older adults are at greater risk of complications from drug / alcohol mixing. As we age, the body is less effective at breaking down alcohol, and older people also tend to take a large number of different medications to maintain their health, many of which can interact with alcohol. Therefore, this category of patients needs to be especially careful.Elderly person often drinks alcohol and cannot stop? One of the options for solving the problem is coding for alcoholism.

    Thus, combining a small amount of alcohol with ibuprofen is safe, but if you have any chronic medical conditions, the best solution is to consult your doctor about combining alcohol and ibuprofen.

    90,000 Covid-19 and ibuprofen: myths and truths about drugs against the virus

    Photo author, Getty Images

    Recently, information has been circulating on the network that with symptoms of coronavirus, you should not take ibuprofen, nurofen and other drugs with anti-inflammatory effect.Along with the advice of real doctors, a lot of fake news appeared. What is going on and what information should I trust?

    In a BBC commentary, doctors confirmed that it is not recommended to take ibuprofen if a coronavirus is suspected. However, people taking this drug for other reasons should not stop taking this drug without consulting their doctor.

    What is the essence of the controversy about ibuprofen?

    Ibuprofen belongs to the group of non-steroidal anti-inflammatory drugs.They help bring down fever and relieve symptoms of the flu or other viral infection, but they can also cause side effects, especially in people with asthma, heart problems, and poor blood circulation.

    There have been no studies on the properties of ibuprofen for the symptoms of Covid-19, but the effect of the drug in other respiratory infections has previously been studied. It has been proven that in some cases it can really aggravate the patient’s condition.

    The main conclusion of the experts is that the anti-inflammatory component of ibuprofen can reduce the effectiveness of the human immune system in fighting the virus.

    Recently, a message appeared on the website of the British National Health System (NHS) that, although the harm from ibuprofen in coronavirus has not yet been fully proven, citizens are asked to refrain from using it.

    Previously, the NHS did not share concerns about anti-inflammatory drugs.

    What are the recommendations of experts

    Photo author, Getty Images

    Photo caption,

    Paracetamol is sold out in most pharmacies in the world

    “If you have a fever, take paracetamol.If you are already taking an anti-inflammatory drug for another reason or are not sure what to do, see your doctor, “says French Minister of Health Olivier Veran, a neurologist by training.

    Tom Wingfield, professor and scientific adviser at the Liverpool School of Tropical Medicine, recommends paracetamol, as it has fewer side effects.

    “Nonsteroidal drugs such as ibuprofen, especially when taken for a long time, can irritate the stomach and strain the kidneys.And this is dangerous for patients with a predisposition to diseases of the stomach and kidneys, “- says Tom Wingfield.

    ” At the moment, symptoms such as fever and sore throat are best treated with paracetamol, “says professor of epidemiology at the London School of Hygiene and Tropical Medicine Charlotte Warren-Gash: She calls for early research into the effects of anti-inflammatory drugs on patients with certain pre-existing conditions

    On Thursday, the World Health Organization (WHO) officially recommended people with Covid-19 symptoms to avoid ibuprofen.

    How to recognize a fake

    Photo author, Facebook

    Photo caption,

    In this fake post, the author refers to the research of a laboratory in Vienna, which allegedly proves the destructive effect of a number of drugs in coronavirus

    the Internet, since recently there have been a number of reports that people in serious condition have been admitted to hospitals in different countries, allegedly taking ibuprofen with a fever and cough.

    However, the mentioned hospitals denied this information.

    In one of the reports, for example, it was said that experts from the University of Vienna claim that ibuprofen creates a favorable environment for Covid-19 in the body, which was the reason for such a disastrous situation in Italy.

    As a rule, users publishing such information refer to medical sources, however, doctors claim that such messages are fake.

    Users should be alarmed by links to an abstract doctor, as well as numerous publications of the same message on different accounts.

    It is also dangerous when an official’s post is taken out of context and leads to incorrect conclusions.

    For example, a Twitter post by French Minister of Health Olivier Veran that anti-inflammatory drugs can provoke a more aggressive spread of infection was distributed more than 43 thousand times without mentioning that Veran also urged not to stop taking these drugs without consulting a doctor.

    Physicians around the world urge to believe only information published on the official websites of national health systems, on the WHO website and in well-known scientific journals.

    Ibuprofen – active substance, effect on the body and composition in

    Ibuprofen History Use Interaction

    Ibuprofen today is one of the most popular active ingredients in the group of non-steroidal anti-inflammatory drugs (NSAIDs). The indications for its use are extensive: treatment of almost all inflammatory diseases, pain relief, lowering body temperature with fever. In addition, ibuprofen is widely used in the complex therapy of joint diseases.

    Ibuprofen for inflammation and pain relief: how it works and how to use it

    All processes in our body are regulated by mediators – chemicals involved, among other things, in the transmission of nerve impulses. The sensation of pain is also associated with the release of special pain mediators. Prostaglandins have multiple functions in the body, including regulating pain and inflammation. Prostaglandins are formed from arachidonic acid under the action of an enzyme called cyclooxygenase.Ibuprofen blocks cyclooxygenase, stopping the formation of prostaglandins and, as a result, the development of inflammation.

    How does ibuprofen work on the body? Once in the body, ibuprofen is absorbed into the blood during the first hour (tmax from 35 to 90 minutes), the maximum concentration in the blood when taking tablets and capsules is achieved in 1-2 hours. There are studies proving that ibuprofen has additional anti-inflammatory properties that act at the level of the cell nucleus. Ibuprofen is available in different dosage forms:

    • Tablets;
    • Long-acting capsules;
    • Suspension;
    • Oral drops;
    • Rectal suppositories;
    • Gel and ointment for external use.

    Oral medications are usually prescribed in the lowest effective dose in as short a course as possible (7-14 days) to reduce the risk of potential side effects. External agents cause them much less often, since a very small amount of the drug enters the general bloodstream. Ibuprofen is also used in combination with other substances, such as chondroprotectors, to provide additional anti-inflammatory effects.

    Due to the possible negative effect on the mucous membrane of the gastrointestinal tract with prolonged courses, ibuprofen is usually prescribed in combination with drugs that protect the gastric mucosa, the so-called proton pump inhibitors.

    History of ibuprofen

    Of all the anti-inflammatory drugs for ibuprofen, the remarkable thing is that it was discovered as part of the search for a cure for rheumatoid arthritis (joint disease).

    In the 1950s, steroids – hormonal drugs – were the only way to relieve symptoms and reduce inflammation. Then the young scientist Stuart Adams was set an ambitious goal – to find a new alternative to steroids that could compete with them in effectiveness, but at the same time had a higher safety profile in terms of side effects.

    After ten years of careful research, only a few chemical compounds have been approved for clinical trials by a team led by Stuart Adams. Among them was a substance that we know today as ibuprofen. In 1953, research began on the substance in the UK, and after 16 years it was approved as a prescription drug for reducing pain and inflammation in rheumatoid arthritis. Since the 80s of the last century, ibuprofen has been used to relieve fever and fever, in 1983 it received an over-the-counter status and went into mass sales as an anti-inflammatory, antipyretic and analgesic drug.

    Ibuprofen use for joint pain

    Joint pain in most cases is associated with inflammation. The reasons can be different: infectious, immune arthritis or the most common osteoarthritis or osteoarthritis caused by degenerative changes in cartilage and bone tissue. Regardless of the reasons, the mechanism for the development of arthritis is the same: an inflammatory reaction is triggered with the participation of an enzyme – cyclooxygenase. Therefore, ibuprofen, by blocking this enzyme that provokes pain and inflammation, has been shown to be effective in various types of joint diseases.

    It is able to reduce pain, swelling, restore range of motion. For the treatment of joint diseases, ibuprofen can be administered orally in the form of tablets or topically in the form of an ointment. In the case of local use, the active substance is applied closer to the focus of inflammation, while in smaller quantities it enters the bloodstream. For joint pain, ibuprofen can also be used in combination with other active ingredients as it further reduces inflammation and pain.

    Application features

    Use in pregnant women and during lactation

    During pregnancy, it is advisable to stop taking medications, since any chemical that enters the mother’s body can affect the fetus.

    Application for problems with kidney function

    Ibuprofen should not be taken in case of renal failure if creatinine clearance (CC) is less than 30 ml / min. With a CC of 30-60 ml / min, the drug is prescribed with caution, for health reasons. With renal failure, the blood filtration process is disrupted, that is, the drug cannot be fully excreted from the body, its toxicity increases. Any progressive kidney disease is a possible cause of impaired renal function, therefore, in these conditions, NSAIDs are either abandoned altogether or prescribed under constant control of QC.

    In case of impaired liver function

    The liver metabolizes all substances that enter the body, including drugs. Many of her diseases (cirrhosis, hepatitis) are accompanied by a decrease in organ function. This means that drugs will not be able to undergo adequate “processing” in the liver and will put additional stress on an already weakened organ. Ibuprofen, unlike some other NSAIDs, does not significantly affect liver function. However, with liver pathology in the active stage and with a pronounced decrease in its function, ibuprofen is not prescribed.