Aspirin (for Cardioprotection)/Selected NSAIDs Interactions
This information is generalized and not intended as specific medical advice. Consult your healthcare professional before taking or discontinuing any drug or commencing any course of treatment.
Moderate. These medicines may cause some risk when taken together. Contact your healthcare professional (e.g. doctor or pharmacist) for more information.
How the interaction occurs:
Some non-steroidal anti-inflammatory agents (NSAIDs) may interfere with the ability of aspirin to protect the heart if they are taken before your daily aspirin.
What might happen:
The aspirin may not work as well.
What you should do about this interaction:
Let your healthcare professionals (e.g. doctor or pharmacist) know that you are using these products together. Your doctor may want to change your medicine. Taking ibuprofen 8 hours before or 30 minutes after the aspirin may help avoid the problem. Take other NSAIDs at least two hours after your aspirin. If you have questions about how to take your medicines, ask your pharmacist.Your healthcare professionals may already be aware of this interaction and may be monitoring you for it. Do not start, stop, or change the dosage of any medicine before checking with them first.
- 1.US Food and Drug Administration Center for Drug Evaluations and Research - FDA Science Paper. Concomitant Use of Ibuprofen and Aspirin Potential for Attenuation of the Anti-Platelet Effect of Aspirin. available at: http://www.fda.gov/downloads/Drugs/DrugSafety/PostmarketDrugSafetyInformat ionforPatientsandProviders/UCM161282.pdf September 8, 2006.
- 2.Cheema AA. Should people on aspirin avoid Ibuprofen? A review of the literature. Cardiol Rev 2004 May-Jun;12(3):174-6.
- 3.Catella-Lawson F, Reilly MP, Kapoor SC, Cucchiara AJ, DeMarco S, Tournier B, Vyas SN, FitzGerald GA. Cyclooxygenase inhibitors and the antiplatelet effects of aspirin. N Engl J Med 2001 Dec 20;345(25):1809-17.
- 4.Cryer B, Berlin RG, Cooper SA, Hsu C, Wason S. Double-blind, randomized, parallel, placebo-controlled study of ibuprofen effects on thromboxane B2 concentrations in aspirin-treated healthy adult volunteers. Clin Ther 2005 Feb;27(2):185-91.
- 5.Curtis JP, Wang Y, Portnay EL, Masoudi FA, Havranek EP, Krumholz HM. Aspirin, ibuprofen, and mortality after myocardial infarction: retrospective cohort study. BMJ 2003 Dec 6;327(7427):1322-3.
- 6.Patel TN, Goldberg KC. Use of aspirin and ibuprofen compared with aspirin alone and the risk of myocardial infarction. Arch Intern Med 2004 Apr 26; 164(8):852-6.
- 7.MacDonald TM, Wei L. Effect of ibuprofen on cardioprotective effect of aspirin. Lancet 2003 Feb 15;361(9357):573-4.
- 8.Kurth T, Glynn RJ, Walker AM, Chan KA, Buring JE, Hennekens CH, Gaziano JM. Inhibition of clinical benefits of aspirin on first myocardial infarction by nonsteroidal antiinflammatory drugs. Circulation 2003 Sep 9; 108(10):1191-5.
- 9.Kimmel SE, Berlin JA, Reilly M, Jaskowiak J, Kishel L, Chittams J, Strom BL. The effects of nonselective non-aspirin non-steroidal anti-inflammatory medications on the risk of nonfatal myocardial infarction and their interaction with aspirin. J Am Coll Cardiol 2004 Mar 17;43(6):985-90.
- 10.Saxena A, Balaramnavar VM, Hohlfeld T, Saxena AK. Drug/drug interaction of common NSAIDs with antiplatelet effect of aspirin in human platelets. Eur J Pharmacol 2013 Dec 5;721(1-3):215-24.
- 11.Meek IL, Vonkeman HE, Kasemier J, Movig KL, van de Laar MA. Interference of NSAIDs with the thrombocyte inhibitory effect of aspirin: a placebo-controlled, ex vivo, serial placebo-controlled serial crossover study. Eur J Clin Pharmacol 2013 Mar;69(3):365-71.
- 12.Anzellotti P, Capone ML, Jeyam A, Tacconelli S, Bruno A, Tontodonati P, Di Francesco L, Grossi L, Renda G, Merciaro G, Di Gregorio P, Price TS, Garcia Rodriguez LA, Patrignani P. Low-dose naproxen interferes with the antiplatelet effects of aspirin in healthy subjects: recommendations to minimize the functional consequences. Arthritis Rheum 2011 Mar; 63(3):850-9.
- 13.Gladding PA, Webster MW, Farrell HB, Zeng IS, Park R, Ruijne N. The antiplatelet effect of six non-steroidal anti-inflammatory drugs and their pharmacodynamic interaction with aspirin in healthy volunteers. Am J Cardiol 2008 Apr 1;101(7):1060-3.
- 14.Capone ML, Sciulli MG, Tacconelli S, Grana M, Ricciotti E, Renda G, Di Gregorio P, Merciaro G, Patrignani P. Pharmacodynamic interaction of naproxen with low-dose aspirin in healthy subjects. J Am Coll Cardiol 2005 Apr 19;45(8):1295-301.
- 15.Russo NW, Petrucci G, Rocca B. Aspirin, stroke and drug-drug interactions. Vascul Pharmacol 2016 Dec;87:14-22.
- 16.Naprosyn (naproxen) US prescribing information. Atnahs Pharma July, 2019. 17.Caldolor (ibuprofen) US prescribing information. Cumberland Pharmaceuticals Inc. July, 2019.
- 17.Gurbel PA, Bliden KP, Zhu J, Troullos E, Centofanti R, Jarvis S, Venkataraman P, Tantry US. Thromboxane inhibition during concurrent therapy with low-dose aspirin and over-the-counter naproxen sodium. J Thromb Thrombolysis 2018 Jan;45(1):18-26.
CONDITIONS OF USE: The information in this database is intended to supplement, not substitute for, the expertise and judgment of healthcare professionals. The information is not intended to cover all possible uses, directions, precautions, drug interactions or adverse effects, nor should it be construed to indicate that use of a particular drug is safe, appropriate or effective for you or anyone else. A healthcare professional should be consulted before taking any drug, changing any diet or commencing or discontinuing any course of treatment.