Ibuprofen drug interactions
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]
List of drug interactions
ACE-Inhibitors
Aspirin
Diuretics
Lithium
Methotrexate
Warfarin-type anticoagulants
H-2 Antagonists
ACE-Inhibitors
Reports suggest that NSAIDs may diminish the antihypertensive effect of ACE-inhibitors. This interaction should be given consideration in patients taking NSAIDs concomitantly with ACE-inhibitors.Return to top
Aspirin
When Ibuprofen tablets are administered with aspirin, its protein binding is reduced, although the clearance of free Ibuprofen tablets is not altered. The clinical significance of this interaction is not known; however, as with other NSAIDs, concomitant administration of Ibuprofen and aspirin is not generally recommended because of the potential for increased adverse effects.Return to top
Diuretics
Clinical studies have shown that Ibuprofen tablets can reduce the natriuretic effect-of furosemide and thiazides in some patients. This response has been attributed to inhibition of renal prostaglandin synthesis. During concomitant therapy with NSAIDs, the patient should be observed closely for signs of renal failure, as well as to assure diuretic efficacy.Return to top
Lithium
Ibuprofen produced an elevation of plasma lithium levels and a reduction in renal lithium clearance in a study of normal volunteers. The mean minimum lithium concentration increased 15% and the renal clearance of lithium was decreased by 19% during this period of concomitant drug administration.This effect has been attributed to inhibition of renal prostaglandin synthesis by Ibuprofen. Thus, when Ibuprofen and lithium are administered concurrently, subjects should be observed carefully for signs of lithium toxicity.Return to top
Methotrexate
NSAIDs have been reported to competitively inhibit methotrexate accumulation. This may indicate that they could enhance the toxicity of methotrexate. Caution should be used when NSAIDs are administered concomitantly with methotrexate.Return to top
Warfarin-type anticoagulants
Several short-term controlled studies failed to show that Ibuprofen tablets significantly affected prothrombin times or a variety of other clotting factors when administered to individuals on coumarin-type anticoagulants. However, because bleeding has been reported when Ibuprofen tablets and other NSAIDs have been administered to patients on coumarin-type anticoagulants, the physician should be cautious when administering Ibuprofen tablets to patients on anticoagulants. The effects of Warfarin and NSAIDs on GI bleeding are synergistic, such that the users of both drugs together have a risk of serious GI bleeding higher than users of either drug alone.Return to top
H-2 Antagonists
In studies with human volunteers, co-administration of cimetidine or ranitidine with Ibuprofen had no substantive effect on Ibuprofen serum concentrations.Return to top
Complete list of drug interactions
Major Interactions
Acetylsalicylic Acid, Acuprin 81, adefovir, anisindione, ardeparin, Arixtra, Arixtra 10 mg/dose, Arixtra 5 mg/dose, Arixtra 7.5 mg/dose, Arthritis Pain, ASA, Ascriptin Enteric, Aspergum Cherry, Aspergum Orginal, Aspir-Low, aspirin, aspirin extended release, Aspirin Lite Coat, Aspirin Litecoat, Aspirin Low Strength, Aspirtab, Bayer Aspirin, Bayer Aspirin Regimen, Bayer Aspirin Sugar Free, Bayer Aspirin with Calcium, Bayer Childrens Aspirin, Bayer Low Strength, Bayer Plus, Bexxar Dosimetric, Bexxar I 131 Dosimetric, Bexxar I 131 Therapeutic, BexxarTherapeutic, Buffered Aspirin, Bufferin, Bufferin Arthritis Strength, Bufferin Extra Strength, Buffex, cidofovir, Clexane, Clexane Forte, Coumadin, dalteparin, danaparoid, dasatinib, desirudin, dicumarol, drotrecogin, drotrecogin alfa, Easprin, Ecotrin, Ecotrin Adult Low Strength, Ecotrin Maximum Strength, Empirin, enoxaparin, Entaprin, Entercote, Extra Strength Bayer, Fasprin, FK506, Folex PFS, fondaparinux, Fragmin, Genacote, Gennin-FC, Genprin, Halfprin, Hepsera, ibritumomab, In-111 Zevalin, Innohep, iodine I 131 tositumomab, Iprivask, Jantoven, ketorolac, Litecoat Aspirin, Lovenox, Lovenox HP, Low Dose ASA, methotrexate, Methotrexate Sodium, Preservative Free, Minitabs, Miradon, Normiflo, Norwich Aspirin, Orgaran, Prograf, Rapamune, Rheumatrex Dose Pack, sirolimus, Sloprin, sodium biphosphate, Sprycel, St. Joseph Aspirin, St. Joseph Aspirin Adult Chewable, St. Joseph Aspirin Adult EC, Stanback Analgesic, tacrolimus, tenofovir, Therapy Bayer, tinzaparin, Toradol, Toradol IM, Toradol IV/IM, tositumomab, Trexall, Tri-Buffered Aspirin, Viread, Vistide, warfarin, Xigris, Y-90 Zevalin, YSP Aspirin, Zero-Order Release, Zorprin
Moderate Interactions
5-ASA, A-Hydrocort, A-Methapred, Abbokinase, Abbokinase Open-Cath, abciximab, Accupril, acebutolol, Aceon, Acetocot, acetoHEXAMIDE, Aclasta, Acova, Activase, Adalat, Adalat CC, Adbeon, Adlone-40, Adlone-80, Adrenocot, Adrenocot L.A., Afeditab CR, Aggrastat, Agrylin, alatrofloxacin, alcohol, alcohol, ethyl, Aldactone, alendronate, alendronate weekly, Alimta, Altace, alteplase, Amaryl, amikacin, Amikin, Amikin Pediatric, amiloride, amlodipine, Anafranil, anagrelide, Ancobon, Angiomax, anistreplase, Anturane, aprepitant, Apresoline, Aquacot, Aquatensen, Aquazide H, Arava, Aredia, argatroban, Aristocort, Aristocort For Injection, Aristocort Forte, Aristopak, Aristospan Injection, Asacol, Atacand, atenolol, Avapro, Avelox, Avelox I.V., Azmacort, Azulfidine, Azulfidine EN-tabs, balsalazide, Baraclude, benazepril, bendroflumethiazide, Benicar, benzthiazide, bepridil, Beta-Phos/AC, betamethasone, betamethasone acet-betamethasone na phosphate, betamethasone sodium phosphate, Betapace, Betapace AF, Betapace AF(obsolete), betaxolol, Bextra, bisoprolol, bivalirudin, Blocadren, Bondronat, Boniva, bosentan, Brevibloc, Bubbli-Pred, budesonide, bumetanide, Bumex, Bystolic, Calan, Calan SR, Canasa, Canasa Pac, candesartan, Capoten, captopril, Cardene, Cardene IV, Cardene SR, Cardizem, Cardizem CD, Cardizem LA, Cardizem Monovial, Cardizem SR, Cardoxin, Carozide, carteolol, Cartia XT, Cartrol, carvedilol, carvedilol extended release, Cathflo Activase, Celebrex, celecoxib, Celestone, Celestone Phosphate, Celestone Soluspan, Celexa, Cell-U-Jec, chlorothiazide, chlorproPAMIDE, chlorthalidone, Cidomycin, cilostazol, Cinobac, cinoxacin, Cipro, Cipro Cystitis Pack, Cipro I.V., Cipro XR, ciprofloxacin, ciprofloxacin extended release, citalopram, Clinacort, Clinalog, clofarabine, Clolar, clomiPRAMINE, clopidogrel, Colazal, Colocort, Coreg, Coreg CR, Corgard, Cort-K, Cortastat, Cortastat 10, Cortastat LA, Cortef, Cortenema, Cortifoam, cortisone, Cortone Acetate, Cotolone, Covera-HS, Cozaar, Cubicin, cycloSPORINE, Cymbalta, Dalalone, Dalalone D.P., Dalalone L.A., daptomycin, DDAVP, DDAVP Nasal, DDAVP Rhinal Tube, De-Sone LA, Decadron, Decadron 5-12 Pak, Decadron Phosphate, Injectable, Decadron-LA, Decaject, Decaject L.A., Dehydrated Alcohol, Deltasone, Demadex, Demadex I.V., Dep Medalone 80, Depmedalone, Depo-Medrol, Depo-Predate (obsolete), Depoject-80, Depopred, desmopressin, desvenlafaxine, Dexacen-4, Dexacort Phosphate in Respihaler, Dexacort-LA, Dexacorten, dexamethasone, dexamethasone acetate, Dexamethasone Intensol, dexamethasone sodium phosphate, Dexasone, Dexasone LA, dexfenfluramine, Dexone, Dexone LA, Dexpak Jr. Taperpak, Dexpak Taperpak, DiaBeta, Diabinese, Diaqua, Diaqua-2, Didronel, Didronel I.V., Digitek, digoxin, digoxin capsule, Dilacor XR, Diltia XT, diltiazem, diltiazem 24 hour extended release, diltiazem extended release, Diltiazem Hydrochloride CD, Diltiazem Hydrochloride SR, Diltiazem Hydrochloride XR, Diltiazem Hydrochloride XT, Diovan, Dipentum, dipyridamole, Diucardin, Diurese, Diuril, Diuril Sodium, drospirenone, duloxetine, Duralone, Dymelor, Dynacirc, Dynacirc CR, Dyrenium, Edecrin, Edecrin Sodium, Effexor, Effexor XR, Eloxatin, Emend, Emend 3-Day, Emend for Injection, enalapril, enalaprilat, Enduron, enoxacin, entecavir, Entocort, Entocort EC, eplerenone, epoprostenol, eprosartan, eptifibatide, escitalopram, Esidrix, Eskalith, Eskalith-CR, esmolol, ethacrynic acid, ethanol, Ethyl Alcohol, etidronate, etravirine, Exna, Ezide, Factive, felodipine, felodipine extended release, fenfluramine, FIV-ASA, Flo-Pred, Flolan, Florinef Acetate, Floxin, Floxin I.V., flucytosine, fludrocortisone, fluoxetine, fluoxetine extended release, fluvoxamine, fluvoxamine extended release, Fosamax, fosaprepitant, fosinopril, furosemide, Garamycin, gatifloxacin, gemifloxacin, Gengraf, gentamicin, Gleevec, glimepiride, glipiZIDE, glipiZIDE extended release, GlipiZIDE XL, Glucotrol, Glucotrol XL, glyBURIDE, glyBURIDE micronized, Glynase PresTab, grepafloxacin, HCTZ, Hep-Lock, Hep-Pak, Hep-Pak CVC, heparin, Heparin Lock Flush, Hexadrol, Hexadrol Phosphate, Hydeltra-T.B.A., Hydeltrasol, hydrALAZINE, Hydro Par, hydrochlorothiazide, hydrocortisone, hydrocortisone acetate, hydrocortisone cypionate, hydrocortisone hemisuccinate, hydrocortisone sodium phosphate, Hydrocortisone Sodium Succinate, Hydrocortone, Hydrocortone Phosphate, HydroDIURIL, hydroflumethiazide, Hygroton, ibandronate, iloprost, imatinib, indapamide, Inderal, Inderal LA, InnoPran XL, Inspra, Integrilin, Intelence, irbesartan, Isoptin, Isoptin I.V., Isoptin SR, isradipine, isradipine extended release, Kabikinase, kanamycin, Kantrex, Ken-Jec 40, Kenaject-40, Kenalog-10, Kenalog-40, Kerlone, Key-Pred, Key-Pred SP, Kinlytic, labetalol, Lanoxicaps, Lanoxin, Lasix, leflunomide, lepirudin, Levaquin, Levaquin Leva-Pak, Levatol, levofloxacin, Lexapro, Lialda, Liquid Pred, lisinopril, lithium, lithium carbonate, lithium carbonate extended release, lithium citrate, Lithobid, Lithonate, Lithotabs, Lo-Aqua, lomefloxacin, Lopressor, Loqua, losartan, Lotensin, Lozol, Luvox, Luvox CR, M-PREDNISolone, Mavik, Maxaquin, Med-Jec-40, Medicort, Medidex, Medidex LA, Medipred, Medralone, Medralone 40, Medralone 80, Medrol, Medrol Dosepak, Meridia, mesalamine, mesalamine extended release, Mesasal Enteric Coated, Metahydrin, Methacort 40, Methacort 80, methyclothiazide, Methylcotol, Methylcotolone, Methylpred DP, methylPREDNISolone, methylPREDNISolone acetate, MethylPREDNISolone Dose Pack, methylPREDNISolone sodium succinate, Meticorten, metolazone, metoprolol, metoprolol extended release, metoprolol succinate, Metoprolol Succinate ER, metoprolol tartrate, Micardis, Micronase, Microzide, Midamor, Minipress, Minirin, moexipril, Monopril, moxifloxacin, Mykrox, nadolol, nalidixic acid, Naqua, nateglinide, Naturetin-10, Naturetin-5, Nebcin, Nebcin Pediatric, nebivolol, Neggram, Neoral, netilmicin, Netromycin, niCARdipine, niCARdipine extended release, Nifediac CC, Nifedical XL, NIFEdipine, NIFEdipine extended release, nimodipine, Nimotop, nisoldipine, norfloxacin, Normodyne, Noroxin, Norvasc, ofloxacin, olmesartan, olsalazine, Oncaspar, Orapred, Orapred ODT, Orasone, Oretic, Orinase, oxaliplatin, pamidronate, paroxetine, paroxetine extended release, paroxetine mesylate, Paxil, Paxil CR, Pediapred, pegaspargase, pemetrexed, penbutolol, Penetrex, Pentasa, perindopril, Persantine, Persantine IV, Pexeva, pindolol, Plavix, Plendil, Pletal, polythiazide, Pondimin, Prandin, prazosin, Pred-Ject-50, Predacort 50, Predacorten, Predaject-50, Predalone 50, Predate-50, Predcor, Predicort RP, Predicort-50, Prednicen-M, Prednicot, prednisoLONE, prednisoLONE acetate, prednisoLONE sodium phosphate, prednisoLONE tebutate, predniSONE, Prelone, Pri-Cortin 50, Priftin, Primethasone, Prinivil, Pristiq, Procardia, Procardia XL, propranolol, propranolol extended release, Proquin XR, prostacyclin, Prozac, Prozac Weekly, Pulmicort Flexhaler, Pulmicort Nebuamp, Pulmicort Respules, Pulmicort Turbuhaler, quinapril, ramipril, Rapiflux, Raxar, Reclast, Redux, Refludan, Remodulin, Renese, Reopro, repaglinide, Retavase, reteplase, rifapentine, rofecoxib, Rowasa, Salofalk, Saluron, Sandimmune, Sarafem, Sectral, Selestoject, Septopal, sertraline, sibutramine, Solu-Cortef, Solu-Medrol, Solurex, Solurex LA, Sorine, sotalol, Sotalol Hydrochloride AF, Sotalol Hydrochloride AF(obsolete), sparfloxacin, spironolactone, Starlix, Sterapred, Sterapred DS, Stimate, Streptase, streptokinase, streptomycin, Sular, sulfasalazine, Sulfazine, sulfinpyrazone, TAC 3, Taztia XT, telbivudine, telmisartan, tenecteplase, Tenormin, Tequin, Tequin Teqpaq, Teveten, Thalitone, Tiazac, Ticlid, ticlopidine, timolol, tirofiban, tissue plasminogen activator, TNKase, Tobi, tobramycin, Tol-Tab, TOLAZamide, TOLBUTamide, Tolinase, Toprol-XL, torsemide, TPA, Tracleer, Tramacort-D, Trandate, trandolapril, treprostinil, Triam-A, Triam-Forte, triamcinolone, triamcinolone acetonide, triamcinolone diacetate, triamcinolone hexacetonide, triamcinolone ophthalmic, Triamcot, Triamonide 40, triamterene, trichlormethiazide, Triesence, Trilog, Trilone, Tristoject, trovafloxacin, Trovan, Tyzeka, U-Tri-Lone, Univasc, urokinase, valdecoxib, valsartan, Vascor, Vasotec, venlafaxine, venlafaxine extended release, Ventavis, verapamil, verapamil 24 hour extended release, verapamil extended release, Verelan, Verelan PM, verteporfin, VFEND, Vioxx, Visken, Visudyne, voriconazole, Zagam, Zagam Respipac, Zaroxolyn, Zebeta, Zestril, zoledronic acid, Zoloft, Zometa, Zometa Concentrate
Minor Interactions
Aricept, Aricept ODT, Axid, Axid AR, Axid Pulvules, Benemid, cimetidine, Cognex, Concentrated Phillips Milk of Magnesia, Depacon, Depakene, Di-Phen, Dilantin, Dilantin Infatabs, Dilantin Kapseals, Dilantin-125, donepezil, Ex-Lax Milk of Magnesia, famotidine, Heartburn Relief, Leader Acid Reducer, magnesium hydroxide, Mg hydroxide, Milk of Magnesia, Mylanta AR, nizatidine, Norvir, Norvir Soft Gelatin, Pepcid, Pepcid AC, Pepcid AC Maximum Strength, Pepcid RPD, Phenytek, phenytoin, phenytoin extended release, Phenytoin Sodium, Prompt, Phillips Milk of Magnesia, probenecid, ranitidine, ranitidine bismuth citrate, ritonavir, sodium valproate, tacrine, Tagamet, Tagamet HB, tetrahydroaminocrideine, Tritec, valproic acid, Zantac, Zantac 150, Zantac 300, Zantac 300 GELdose, Zantac 75, Zantac EFFERdose, Zantac GELdose
Adapted from the FDA Package Insert.