Ibuprofen

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Ibuprofen

Dos & Don'ts

Ibuprofen

Ibuprofen is a member of the nonsteroidal anti-inflammatory drug (NSAIDs) family. NSAIDs reduce inflammation (swelling), pain, and temperature. Ibuprofen is used to treat mild to moderate pain, fever, osteoarthritis, rheumatoid arthritis, primary dysmenorrhea, and other conditions. Ibuprofen is available in prescription and nonprescription strengths.

Do…
  • Take copper too, to prevent potential side effects Copper taken in with ibuprofen may enhance the NSAID’s anti-inflammatory effects and reduce ulcerogenic effects at the same time.
  • Add some special licorice Preliminary evidence suggests that a specific form of deglycyrrhizinated licorice (DGL) might support and stimulate the stomach’s natural protective mechanisms and protect it against damage caused by aspirin and possibly other NSAIDs.
  • Ask your doctor if you should replenish iron while taking ibuprofen Iron is sometimes needed by people taking NSAIDs as it may lead to iron deficiency.
Don't…
  • Take ibuprofen if taking lithium

    Taking lithium with NSAIDs often increases blood levels of lithium, so they should not be taken together.

  • Take white willow products with NSAIDS White willow taken with ibuprofen may reduce ibuprofen levels in the blood.

Interaction

Summary of Interactions with Vitamins, Herbs, & Foods

dnicon_Beneficial May Be Beneficial: Depletion or interference—This medication may deplete these substances from the body or interfere with how they work; extra intake may help replenish them.

Iron
dnicon_Beneficial May Be Beneficial: Side effect reduction and/or prevention—These substances may help reduce the likelihood and/or severity of a potential side effect caused by the medication.

Licorice
dnicon_Beneficial May Be Beneficial: Supportive interaction—These substances may help this medication work better.

none

dnicon_Avoid Avoid: Reduces drug effectiveness—When taking this medication, avoid these substances as they may decrease the medication's absorption and/or activity in the body.

none

dnicon_Avoid Avoid: Adverse interaction—When taking this medication, avoid these substances, as the combination may cause undesirable or dangerous interactions.

Sodium*

White Willow*
dnicon_Check Check: Explanation needed—When taking this medication, read the article details and discuss them with your doctor or pharmacist before taking these substances.

Potassium

Copper*

An asterisk (*) next to an item in the summary indicates that the interaction is supported only by weak, fragmentary, and/or contradictory scientific evidence.

Interactions Details

Interactions with Vitamins

Copper

Supplementation may enhance the anti-inflammatory effects of NSAIDs while reducing their ulcerogenic effects. One study found that when various anti-inflammatory drugs were chelated with copper, the anti-inflammatory activity was increased.1 Animal models of inflammation have found that the copper chelate of aspirin was active at one-eighth the effective amount of aspirin. These copper complexes are less toxic than the parent compounds as well.

Iron

NSAIDs cause gastrointestinal (GI) irritation, bleeding, and iron loss.2 Iron supplements can cause GI irritation.3 However, iron supplementation is sometimes needed in people taking NSAIDs if those drugs have caused enough blood loss to lead to iron deficiency. If both iron and ibuprofen are prescribed, they should be taken with food to reduce GI irritation and bleeding risk.

Lithium

Lithium is a mineral that may be present in some supplements and is also used in large amounts to treat mood disorders such as manic-depression (bipolar disorder). Most NSAIDs inhibit the excretion of lithium from the body, resulting in higher blood levels of the mineral, though sulindac may have an opposite effect.4 Since major changes in lithium blood levels can produce unwanted side effects or interfere with its efficacy, NSAIDs should be used with caution, and only under medical supervision, in people taking lithium supplements.

Potassium

Ibuprofen has caused kidney dysfunction and increased blood potassium levels, especially in older people.5 People taking ibuprofen should not supplement potassium without consulting with their doctor.

Interactions with Herbs

Licorice  (Glycyrrhiza glabra)

The flavonoids found in the extract of licorice known as DGL (deglycyrrhizinated licorice) are helpful for avoiding the irritating actions NSAIDs have on the stomach and intestines. One study found that 350 mg of chewable DGL taken together with each dose of aspirin reduced gastrointestinal bleeding caused by the aspirin.6 DGL has been shown in controlled human research to be as effective as drug therapy (cimetidine) in healing stomach ulcers.7

White willow bark (Salix alba)

White willow bark contains salicin, which is related to aspirin. Both salicin and aspirin produce anti-inflammatory effects after they have been converted to salicylic acid in the body. The administration of salicylates like aspirin to individuals taking oral NSAIDs may result in reduced blood levels of NSAIDs.8 Though no studies have investigated interactions between white willow bark and NSAIDs, people taking NSAIDs should avoid the herb until more information is available.

Interactions with Foods & Other Compounds

Food

Ibuprofen should be taken with food to prevent gastrointestinal upset.9

Ibuprofen may cause sodium and water retention.10 It is healthful to reduce dietary salt intake by eliminating table salt and heavily salted foods.

Alcohol

Ibuprofen may cause drowsiness, dizziness, or blurred vision.11 Alcohol may intensify these effects and increase the risk of accidental injury. Use of alcohol during ibuprofen therapy increases the risk of stomach irritation and bleeding. People taking ibuprofen should avoid alcohol.

Brands

Common brand names:

Advil, Motrin, PediaCare Fever, Midol Maximum Strength Cramp Formula

References

1. Sorenson JRJ. Copper chelates as possible active forms of the antiarthritic agents. J Medicinal Chem 1976;19:135–48.

2. Bjarnason I, Macpherson AJ. Intestinal toxicity of non-steroidal anti-inflammatory drugs. Pharmacol Ther 1994;62:145–57.

3. Threlkeld DS, ed. Blood Modifiers, Iron-Containing Products. In Facts and Comparisons Drug Information. St. Louis, MO: Facts and Comparisons, Jun 1998, 62–9a.

4. Olin BR, ed. Central Nervous System Drugs, Analgesics and Anti-inflammatory Drugs, Nonsteroidal Anti-inflammatory Agents, In Drug Facts and Comparisons. St. Louis, MO: Facts and Comparisons, 1993, 1172–90.

5. Bailie GR. Acute renal failure. In Applied Therapeutics: The Clinical Use of Drugs, 6th ed. Vancouver, WA: Applied Therapeutics, 1995, 29–33.

6. Rees WDW, Rhodes J, Wright JE, et al. Effect of deglycyrrhizinated liquorice on gastric mucosal damage by aspirin. Scand J Gastroenterol 1979;14:605–7.

7. Morgan AG, McAdam WAF, Pascoo C, Darnborough A. Comparison between cimetidine and Caved-S in the treatment of gastric ulceration, and subsequent maintenance therapy. Gut 1982;23:545–51.

8. Olin BR, ed. Central Nervous System Drugs, Analgesics and Anti-inflammatory Drugs, Nonsteroidal Anti-inflammatory Agents, In Drug Facts and Comparisons. St. Louis, MO: Facts and Comparisons, 1993, 1172–90.

9. Threlkeld DS, ed. Central Nervous System Drugs, Nonsteroidal Anti-Inflammatory Agents. In Facts and Comparisons Drug Information. St. Louis, MO: Facts and Comparisons, Feb 1992, 251j–1l.

10. Threlkeld DS, ed. Central Nervous System Drugs, Nonsteroidal Anti-Inflammatory Agents. In Facts and Comparisons Drug Information. St. Louis, MO: Facts and Comparisons, Mar 1993, 251j–1l.

11. Threlkeld DS, ed. Central Nervous System Drugs, Nonsteroidal Anti-Inflammatory Agents. In Facts and Comparisons Drug Information. St. Louis, MO: Facts and Comparisons, Feb 1992, 251j–1l.

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