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Ibuprofen: 7 things you should know
1. How it works
- Ibuprofen helps to relieve pain and inflammation by blocking the effects of cyclooxygenase (COX) enzymes. This prevents prostaglandin synthesis (prostaglandins elevate body temperature and make nerve endings more sensitive to pain transmission).
- Ibuprofen belongs to a group of medicines known as NSAIDs (nonsteroidal anti-inflammatory drugs).
2. Upsides
- Effective for the relief of minor aches and pains due to arthritis, backache, the common cold, headache and migraine, menstruation, muscular aches, and toothache in adults.
- Relieves minor aches and pain in children aged 6 months or older.
- Temporarily relieves fever.
- Does not cause dependence and is readily available at a low cost.
- The incidence of stomach-related side effects is about half that seen with aspirin or indomethacin when ibuprofen is used at low dosages. However, this benefit is lost with higher dosages.
- Available as tablets, capsules, chewable tablets, suspension, and in an injectable form.
- Widely available over-the-counter.
- Generic ibuprofen is available.
3. Downsides
If you are between the ages of 18 and 60, take no other medication or have no other medical conditions, side effects you are more likely to experience include:
- Stomach-related side effects including indigestion, heartburn, and bleeding. People of an older age, taking other medicines that affect the stomach, or who drink more than 3 glasses of alcohol per day may be more at risk. Ibuprofen has one of the lowest risks of stomach-related side effects compared with other NSAIDs.
- Most NSAIDs have been associated with an increased risk of stroke or heart attack. The risk may be higher in patients with pre-existing cardiovascular conditions and with dosages of ibuprofen greater than 1200mg per day.
- May require three to four times daily dosing because of short duration of acton.
- May not be suitable for some people including those with kidney disease, a history of stomach ulcers or other gastrointestinal disorders, with pre-existing cardiovascular disease, or following coronary artery bypass graft surgery.
- May interact with some other medicines such as warfarin, SSRIs, ACE inhibitors, and diuretics.
Note: In general, seniors or children, people with certain medical conditions (such as liver or kidney problems, heart disease, diabetes, seizures) or people who take other medications are more at risk of developing a wider range of side effects. View complete list of side effects
4. Bottom Line
Ibuprofen is effective for the short-term relief of minor aches and pains. Risk of stomach-related side effects is about half that seen with aspirin although the risk increases with higher dosages and a longer duration of use.
5. Tips
- Take with food or milk if stomach disturbances (such as indigestion) occur with use. See a doctor if these persist.
- Always use the lowest effective dose for the shortest duration consistent with the condition being treated.
- If you are taking ibuprofen and find it is not working very well for you, you may like to try a different NSAID.
- Response to different NSAIDs can vary so switching types (for example, from ibuprofen to naproxen) may improve response.
- See a doctor immediately if you experience any difficulty with breathing, unexplained sickness or fatigue, loss of appetite, vision changes, fluid retention or abnormal bleeding.
- NSAIDs should not be used in the last 3 months of pregnancy; ask your doctor before using any medication during pregnancy.
- Avoid ibuprofen if you have a history of asthma or hives due to aspirin use or other NSAIDs, like naproxen.
- Do not use this medicine if you have just had heart bypass surgery (also called coronary artery bypass graft, or CABG).
6. Response and Effectiveness
- Peak levels of ibuprofen are reached 1-2 hours after administration.
- Equally effects COX-1 and COX-2 enzymes.
7. Interactions
Medicines that interact with ibuprofen may either decrease its effect, affect how long it works for, increase side effects, or have less of an effect when taken with ibuprofen. An interaction between two medications does not always mean that you must stop taking one of the medications; however, sometimes it does. Speak to your doctor about how drug interactions should be managed.
Common medications that may interact with ibuprofen include:
- ACE inhibitors or ARBs, such as captopril, enalapril, or losartan
- antibiotics, such as ciprofloxacin or vancomycin
- anticoagulants (blood thinners) such as apixaban, dabigatran, fondaparinux, heparin, or warfarin
- antidepressants, such as citalopram, escitalopram, fluoxetine, or paroxetine
- antifungals, such as voriconazole
- antiplatelets, such as clopidogrel or ticagrelor
- beta-blockers, such as acebutolol, atenolol, bisoprolol, or carvedilol
- bisphosphonates, such as alendronate
- corticosteroids, such as dexamethasone or prednisone
- digoxin
- diuretics (water pills), such as chlorthalidone, chlorothiazide, hydrochlorothiazide (HCTZ), or furosemide
- glucagon
- haloperidol
- HIV medications (eg, Stribild, tenofovir)
- metformin
- other nonsteroidal anti-inflammatories (NSAIDs), such as celecoxib, diclofenac, etodolac, ketorolac, meloxicam, nabumetone, or naproxen
- sulfonylureas (a type of diabetes medication), such as glimepiride, glyburide, or glipizide
- supplements, such as glucosamine, omega-3 fatty acids, vitamin E
- others, such as cyclosporine, lithium, methotrexate, pemetrexed, pirfenidone, or tacrolimus.
Drinking alcohol while taking ibuprofen may increase the risk of gastrointestinal-related side effects or kidney damage.
Note that this list is not all-inclusive and includes only common medications that may interact with ibuprofen. You should refer to the prescribing information for ibuprofen for a complete list of interactions.
https://www.drugs.com/tips/ibuprofen-patient-tips
And then even though there is this - I still don't feeel comfy in this little time, so no more for me. Tylenol and Imitrex it is.
Here’s What We Know About Ibuprofen and COVID-19
- Experts say there’s no clear evidence that ibuprofen makes COVID-19 worse.
- One thing specific to COVID-19 is that some lab experiments are showing that ibuprofen may boost the amount of ACE2 receptors that the virus uses to infect cells and could make the virus spread faster.
- But that’s just theoretical.
The World Health Organization (WHO) has changed its stance on taking ibuprofen if you have COVID-19, but people are still scratching their heads over what they should take if or when they contract the virus.
After previously announcing that people with the virus shouldn’t take ibuprofen to treat pain and fever, the WHO now says they don’t advise against it.
The flip-flopping has a lot of people confused — especially those stocking up on medication in anticipation of getting the virus.
Dr. Otto O. Yang, a professor of medicine in the infectious diseases division at the David Geffen School of Medicine at UCLA, told Healthline there’s no evidence that ibuprofen causes worsening of COVID-19, “although there is circulating misinformation to that effect.”
Fever (medication) frenzy
The concern began after a study in The LancetTrusted Source stated that ibuprofen boosts the angiotensin-converting enzyme 2 (ACE2), which may facilitate and worsen COVID-19. As a result, WHO originally warned most patients to stick with acetaminophen, which is also known as paracetamol or Tylenol.
Patients likely have increased ACE2 expression if they’re treated with ACE inhibitors, angiotensin II type I receptor blockers (ARBs), or thiazolidinediones, the report noted. Those drugs are commonly taken by those with cardiovascular disease, hypertension, and diabetes. Ibuprofen can also increase ACE2, the study noted.
Anti-inflammatory drugs and COVID-19
The notion that anti-inflammatory drugs increase the risk of complications during fever or infection is “mostly theoretical,” Yang said.
Medical experts debate whether or not reducing the inflammation that causes fever and muscle ache actually lowers the effectiveness of the immune response. On the flip side, patients who have worse symptoms may be more likely to take ibuprofen, and their outcome may have nothing to do with the medication itself.
“There are some clinical observations of small numbers of patients that suggest ibuprofen could slow recoveryTrusted Source from bacterial pneumonias or make some viral infections like chickenpox more severe, but these aren’t careful prospective scientific studies,” Yang said.
“Other publications have even argued that ibuprofen can be helpful in lung infectionsTrusted Source by reducing the amount of inflammation, which may be damaging to the lung,” he added.
One thing specific to COVID-19 is that some lab experiments are showing that ibuprofen may boost the amount of ACE2 receptors that the virus uses to infect cells and could make the virus spread faster. But that is “purely theory that so far is not backed by clinical evidence in patients,” Yang said.
It’s unclear if what has been seen in the lab translates to the clinic, Yang added.
For example, ibuprofen may increase the ACE2 level in cells. “But that may be meaningless in a person if that increase is small, or if there is already so much receptor that adding more doesn’t matter,” Yang explained.
Evidence lacking
There’s not enough evidence to show that ibuprofen could make COVID-19 worse, Rodney E. Rohde, PhD, a professor at Texas State University, told Healthline.
“I do not believe there is enough evidence due to a small sample size of patients,” he said. “However, if one is concerned, then they may want to avoid those drugs or drug families.”
Rohde explained that ibuprofen is known to diminish the response of the body’s immune system. The inflammatory process is a vital component of the overall immune response, especially the second line of defense that triggers many third-line defense mechanisms, such as T and B cell responses, he said.
For now, Rohde said there’s “no hard evidence” not to take over-the-counter or prescription pain medications. That said, Rohde advises people to talk to their doctors for more recommendations based on their individual health.
As for the National Institute of Allergy and Infectious Diseases, it gave a statement to Healthline and suggested people reach out to the Centers for Disease Control and Prevention (CDC) for updated COVID-19 treatment guidelines. “More research is needed to evaluate reports that ibuprofen and other over-the-counter anti-inflammatory drugs may affect the course of COVID-19,” it said.
“Currently, there is no conclusive evidence that ibuprofen and other over-the-counter anti-inflammatory drugs increases the risk of serious complications or of acquiring the virus that causes COVID-19. There is also no conclusive evidence that taking over-the-counter anti-inflammatory drugs is harmful for other respiratory infections.”
https://www.healthline.com/health-ne...n-and-covid-19