Medication Interaction Alert

September 11, 2006

INTERACTING MEDICATIONS: IBUPROFEN AND ASPIRIN

Brand Names	Advil, Motrin for ibuprofen, various brands for aspirin
Dosage Forms	Tablet for both, rectal suppository for aspirin, oral suspension available for ibuprofen
Manufacturer	Multiple manufacturers
Strength	Multiple strengths, low-dose aspirin in 81mg and 325mg strengths

Description: When taken together, ibuprofen can decrease the antiplatelet effect of aspirin and potentially decrease the cardioprotection and stroke prevention activity of aspirin.

Mechanism of interaction: Aspirin and ibuprofen target the same site in the platelet, however, ibuprofen's anti-platelet (anti-clotting) effect is short-lived while aspirin's is permanent. If taken together, ibuprofen can bind to this site and then releases but at the same time prevent aspirin from binding. The net result is aspirin is unable to provide the intended anti-platelet activity and provide its cardio and stroke protective effect.

Recommendations: If taking once daily low dose immediate-release aspirin for cardioprotection, avoid taking ibuprofen at the same time. If ibuprofen needs to be taken, wait at least 30 minutes after aspirin is taken or take aspirin 8 hours after an ibuprofen dose is taken. If an enteric coated or extended-release aspirin preparations is taken, do not use ibuprofen in the same 24-hour period.

Further Implications: Other over the counter non-steroidal anti-inflammatory agents (NSAIDs) such as naproxen (Aleve) may also have the same interaction with aspirin and should be used with the same caution.

Alternative Agents: When pain control is needed, consider using acetaminophen (Tylenol) or a prescription agent that does not contain an NSAID to avoid the anti-platelet interaction with aspirin.