Should You Mix Aspirin and Ibuprofen?
Aspirin
is used by many people at risk to help prevent heart attacks and
stroke, but ibuprofen may interfere with its heart protection
properties.
Can I Take Aspirin and Ibuprofen Together?
By Michael Bihari, MD * Reviewed by Emmy Ludwig, MDUpdated August 10, 2017
By Michael Bihari, MD * Reviewed by Emmy Ludwig, MDUpdated August 10, 2017
Your doctor has most likely told you to take a daily aspirin to help reduce your risk of a heart attack or a stroke. Aspirin
works by interfering with your blood’s ability to form dangerous clots,
thus helping to prevent heart attacks and strokes. However, taking
aspirin is not without risk. Aspirin can cause stomach upset and
bleeding—including nose bleeds, stomach, and intestinal bleeding, and
even bleeding in the brain. So taking daily aspirin is recommended only
when the likely benefits greatly outweigh the likely risks in a
particular individual.
Daily aspirin is often recommended for people who have had a heart
attack or a stroke, who have coronary artery disease, or whose risk of
developing cardiovascular disease within the next several years is
judged to be high. However, the decision to take daily aspirin must be
individualized, and always must be discussed with your doctor. It’s
important to learn more about whether taking a daily aspirin is right for you.
Aspirin and Ibuprofen Don’t Mix
According to the U.S. Food and Drug Administration (FDA), ibuprofen
can interfere with the anti-clotting effect of low-dose aspirin (81 mg
per day), potentially making the aspirin less effective when it is used
to help protect your heart and help prevent a stroke.
The FDA recommends that you consider the following:
- If you use ibuprofen occasionally, there is only a minimal risk that the ibuprofen will interfere with the effect of low-dose aspirin.
If you need only a single dose of ibuprofen, take it 8 hours before or 30 minutes after taking a regular (not enteric-coated) low-dose aspirin.
- If you need to take ibuprofen more often, talk to your doctor about medication alternatives. Your doctor may recommend a painkiller that does not interfere with the effect of low-dose aspirin.
Ibuprofen belongs to a class of medications known as NSAIDs
(non-steroidal anti-inflammatory drugs). You should not take another
NSAID (such as medications containing naproxen) without talking to your
doctor, since some other NSAIDs may have the potential to interfere with
the protective effect of low-dose aspirin.
Ibuprofen and Different Types of Aspirin
The FDA recommendations are only for regular (also called
immediate-release) low-dose aspirin (81 mg). Ibuprofen’s ability to
interfere with the anti-clotting effects of enteric-coated aspirin or
larger doses of aspirin (such as an adult aspirin - 325 mg) is not known.
Bottom Line: To be on the safe side and prevent an unwanted drug
interaction, you should always talk to your doctor or pharmacist before
taking any over-the-counter (OTC) pain medications if you are using
aspirin in any form.
Ibuprofen and Acetaminophen
Unlike aspirin and ibuprofen, which should not be mixed, ibuprofen
(such as Motrin) and acetaminophen (such as Tylenol) can be mixed.
In
fact, results from one small study published in the British Journal of
Anaesthesia suggest that when ibuprofen and acetaminophen are taken together
(in the form of a mixed formulation called Maxigesic) by participants
who had just undergone oral surgery, this combination results in
superior pain relief.
- Borazan NH, Furst DE. Nonsteroidal Anti-Inflammatory Drugs, Disease-Modifying Antirheumatic Drugs, Nonopioid Analgesics, & Drugs Used in Gout. In: Katzung BG, Trevor AJ. eds. Basic & Clinical Pharmacology, 13e. New York, NY: McGraw-Hill; 2015.
- Merry AF, Gibbs RD, Edwards J, et al. Combined acetaminophen and ibuprofen for pain relief after oral surgery in adults: a randomized controlled trial. British Journal of Anaesthesia, 2010 Jan; 104 (1): 80-88.
FDA Cautions on Mixing Ibuprofen and Aspirin
by Mark Bloom, Editor-in-Chief, MedPage Today * September 08, 2006- There may be a pharmacodynamic interaction between ibuprofen and aspirin when they are dosed concomitantly. This interaction may interfere with the antiplatelet activity of the aspirin, as measured by TXB2 levels and platelet activation.
- The clinical implication of this interaction is unclear, but may be important since the cardioprotective effect of aspirin, when used for secondary prevention of myocardial infarction, could be minimized or negated.
- A negative clinical impact on aspirin's cardioprotection is unlikely from an occasional dose of ibuprofen because the effect of aspirin taken daily is long-lasting.
