According to a study in The Journal of Clinical Pharmacology this past January, ibuprofen may lessen the benefit of daily aspirin therapy. Other pain relievers are preferable for those who need aspirin therapy; however, complete clinical relevance of this effect remains unclear. Those patients who are taking both ibuprofen for pain and aspirin to reduce their chances of a second stroke may not be receiving the full benefit of their stroke prevention efforts
Researchers assessed the combined effect of both drugs on a group comprised of 10 healthy volunteers and 18 others who were using both medications for pain relief and stroke risk reduction. The blood-thinning effect of the aspirin was blunted in the healthy participants, while those who were attempting to prevent a stroke appeared to be resistant to the effects of aspirin until ibuprofen was discontinued. Also, 13 people in the latter group experienced a stroke while taking these two drugs together over a 27-month period. “Those strokes were preventable,” said Francis M. Gengo, PharmD, lead author and associate professor of pharmacy practice and neurology at University at Buffalo in New York.
Several studies suggest that ibuprofen may interfere with the vascular benefits of aspirin; however, it’s unclear how clinically relevant this phenomenon may be. Meanwhile, the US Food and Drug Administration (FDA) issued a statement in September 2006 calling for physicians to be aware of this possible interaction and the authors of this latest piece are calling for increased awareness of the possibility regarding stroke prevention. “This interaction between aspirin and ibuprofen or prescription NSAIDs is one of the best-known but well-kept secrets in stroke medicine,” said Dr. Gengo.
Those physicians who were treating patients at an increased risk for a stroke or myocardial infarction—heart attack—responded that those taking daily aspirin should be cautioned against also taking ibuprofen concurrently and regularly. This study, however, was too small to be conclusive, although it did corroborate findings by others who have investigated the issue. “The only limitation is the very limited sample size, but this fits very well with previously published studies,” said Tobias Kurth, MD, ScD, an epidemiologist at Brigham and Women’s Hospital and assistant professor of medicine at Harvard Medical School in Boston.
Cardiologists were also concerned about the study’s conclusions because, while aspirin does reduce the risk of stroke, it does not eliminate the risk of stroke entirely. The strokes seen during the study may have occurred with or without the use of ibuprofen.
Ibuprofen is in the class of medications called NSAID and is used to reduce fever and to relieve mild pain from headaches, muscle aches, arthritis, menstrual periods, the common cold, toothaches, and backaches. Ibuprofen is in a class of medications called NSAIDs and works by stopping the body’s production of a substance that causes pain, fever, and inflammation. Aspirin is in a group of drugs called salicylates and works by reducing substances in the body that cause pain, fever, and inflammation and is used to treat mild to moderate pain and also reduce fever or inflammation. Aspirin is sometimes used to treat or prevent heart attacks, strokes, and chest pain (angina).
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