Aspirin and Ibuprofen: Can You Take Them Together?

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Ibuprofen and aspirin. Is it safe to mix these medicines?

Aspirin and ibuprofen, can you take them together? This is a common question for not only heart patients but the typical parent and overall healthy adults, as well. The answer is predominately found buried within the text and jargon of overeducated publications and journals that graduating college students would need use of both a word and medical dictionary to decipher. That’s where I come in. The answer, predictably, is yes and no. It depends.

If you are a heart patient, the answer becomes critical and the odds are that you have been given a good medication protocol by your doctor to follow. If you are not under a doctor’s care then ambiguity can hail from the mountaintop.

Two verified scientific sources have identified the interactions, or lack thereof, between aspirin and ibuprofen. The Food and Drug Administration (FDA) states,

  •  “Ibuprofen can interfere with the anti-platelet effect of low dose aspirin (81 mg per day), potentially rendering aspirin less effective when used for cardioprotection and stroke prevention. Healthcare professionals should advise consumers and patients regarding the appropriate concomitant use of ibuprofen and aspirin. It has been demonstrated in published and unpublished human ex vivo studies, that ibuprofen interferes with the antiplatelet activity of low dose aspirin (81 mg, immediate release) when they are ingested concurrently.”  FDA

What this means is if you take aspirin at the same time as ibuprofen that the medical reasoning behind the recommendation of taking aspirin is essentially nullified. So don’t do it. The studies are in regard to the baby aspirin 81mg. However, here is where it can get confusing. The FDA also states, “With occasional use of ibuprofen, there is likely to be minimal risk from any attenuation of the antiplatelet effect of low dose aspirin, because of the long-lasting effect of aspirin on platelets.” * In other words, if you only take ibuprofen sometimes then the odds are that the aspirin’s effects will likely continue without issue; so don’t worry about it. You should always consult with your doctor whenever “mixing” medications regardless of if they are over the counter or not! This is where doctors are heavily trained in pharmaceuticals and are the expert at making medication recommendations and not you. Notice that the scientific bodies almost always leave themselves with an out of sorts with non-committal statements such as the one above “likely”. “Will likely continue without issue,” they say. If a negative interaction occurs then the lawyers will say, “My client stated clearly that it would likely continue without issue but did not confirm that it would certainly continue without issue, your honor.” Covering one’s derriere in our day and age is painfully obvious.

The New England Journal of Medicine (NEJM) states, “A pharmacodynamic interaction that potentially interferes with the antiplatelet effect of aspirin is related to the two-step mechanism of COX-1 inactivation.6 Concomitant administration of reversible COX-1 inhibitors, such as ibuprofen48 and naproxen,49 may prevent the irreversible acetylation of platelet COX-1 by low-dose aspirin. This is due to competition between these drugs and aspirin for a common docking site within the COX-1 channel (arginine 120); aspirin binds this site with weak affinity before the acetylation of serine 529.6 This pharmacodynamic interaction does not occur with coxibs or traditional nonsteroidal antiinflammatory drugs (NSAIDs) such as diclofenac that have some degree of COX-2 selectivity.48 Whether this interaction attenuates or abrogates the cardioprotective benefit of low-dose aspirin is uncertain.50,51” N Engl J Med 2005; 353:2373-2383

It is again mentioned that aspirin and ibuprofen have competing agendas in the human body when ingested together. Therefore, consuming both aspirin and ibuprofen may be in conflict with the desired results by each medicine. Science says there is a conflict, yet simultaneously science states that the true end result of this conflict between the medicines is “uncertain,” as stated by the NEJM.

Aspirin and ibuprofen are both kings in their domain. Science says there might be a lessoning or stoppage of the effects desired by aspirin if both are taken either simultaneously or within up to 8 hours of each other depending on a variety of factors. In short, who knows? You must make a rational decision sprinkled with common sense to find your own answer.

Common sense tells me that if you are an otherwise healthy individual, or if you have been directed to take the small 81mg baby aspirin then in all likelihood if you take an ibuprofen from time to time that it will not affect your platelet benefit from your baby aspirin consumption as those effects are long lasting and not easily thwarted. It also tells me that there is a not so great interaction between the medications and if I have a choice I will refrain from combining these two substances as a matter of common sense, too. Here is some of the science; now it is time to choose for the most important person in your life with you 24 hours per day 7 days per week: You! May you be blessed and continue on in good health in life.

© Dwayne Ivey – March 1, 2011


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