Avoid Taking Ibuprofen With These Common Medications At All Costs

Ibuprofen has become a household staple found in medicine cabinets worldwide as an over-the-counter remedy for its efficacy in combating pain, inflammation, and fever. As a nonsteroidal anti-inflammatory drug (NSAID), ibuprofen's mechanism of action involves inhibiting the production of prostaglandins, chemicals in the body that play a pivotal role in triggering pain and inflammation responses (per the National Library of Medicine). Thus, it is highly sought after for easing the discomfort associated with conditions such as headaches, menstrual cramps, arthritis, and minor injuries.

Because ibuprofen is easy to get and seems safe, people often use it without thinking about how it might interact with other medicines they're taking. According to the U.S. Food and Drug Administration (FDA), drug interactions happen when one medication is combined with other medicines (drug-drug interactions) or foods (drug-food interactions), causing its effects to become heightened or lessened, including unwanted side effects. Therefore, it's crucial to understand how ibuprofen works with other medications to avoid any problems it might cause. Keep reading to learn how ibuprofen interacts with other drugs to avoid mixing them in the future. However, note that this is not a comprehensive list of medications. Thus, be sure to inform your healthcare provider about all the medications you're taking before consuming ibuprofen, including those available without a prescription.

You should avoid taking ibuprofen if you're on blood pressure-lowering medications such as angiotensin-converting enzyme (ACE) inhibitors or beta-blockers. ACE inhibitors, such as Lotensin, Capoten, Vasotec, Zestril, and Monopril, work by relaxing and widening blood vessels, thereby enhancing blood flow and reducing blood pressure (via Healthline). However, their effectiveness may be compromised when taken alongside pain relievers like ibuprofen. Per Drugs.com, the combination of these medications can not only decrease the blood pressure-lowering effects of ACE inhibitors but also potentially impact kidney function, particularly with frequent or chronic use. If you notice symptoms like nausea, vomiting, changes in urination patterns, weight fluctuations, fluid retention, swelling, shortness of breath, muscle cramps, fatigue, dizziness, confusion, or irregular heart rhythm, be sure to seek immediate medical attention, as they may indicate potential kidney damage.

Additionally, beta-blockers such as Lopressor work by lowering both blood pressure and heart rate (via the Cleveland Clinic). Like ACE inhibitors, mixing beta-blockers with ibuprofen also diminishes their blood pressure-lowering efficacy. According to Drugs.com, one potential explanation is that ibuprofen may cause fluid retention, which can put additional strain on the heart and blood vessels, resulting in higher blood pressure levels.

Anti-inflammatory painkillers like naproxen and aspirin function by reducing the production of prostaglandins, meaning that they both belong to the same class of drugs known as NSAIDs, just like ibuprofen (per Medical News Today). Thus, using them together can increase the risk of adverse effects, including gastrointestinal (GI) bleeding and kidney damage. This is because all NSAIDs share similar mechanisms of action and can potentiate each other's side effects when used at the same time, and, according to Healthline, ibuprofen even comes with boxed warnings from the FDA about its risk of causing severe GI side effects.

According to Drugs.com, using ibuprofen alongside naproxen is generally discouraged due to the increased risk of GI side effects, which include inflammation, bleeding, ulceration, and, in rare cases, perforation (a severe medical emergency that happens when a hole forms in the stomach or intestine, potentially leading to life-threatening complications). The same goes when mixing ibuprofen and aspirin. Signs of GI to look out for include dizziness, black or red (tarry) stools, vomiting blood, severe headaches, or weakness. On the other hand, aspirin is also a blood thinner used to treat heart conditions (via Medical News Today). However, mixing it with ibuprofen may lower aspirin's efficacy when taken for heart attack or stroke prevention (per Drugs.com). You may find naproxen available under various brand names, including Aleve, Aflaxen, and Naprosyn (via the Mayo Clinic). In contrast, "Aspirin" was originally a brand name for the generic term acetylsalicylic acid (per Medical News Today).

A specific class of antidepressant medications called selective serotonin reuptake inhibitors (SSRIs) work by increasing the levels of serotonin, a chemical messenger associated with mood regulation, in the brain (via Healthline). Among the SSRIs are medications such as escitalopram and fluoxetine, which are available under various brand names. Escitalopram, sold under the brand name Lexapro, is primarily used to alleviate symptoms of depression and generalized anxiety disorder (via the Mayo Clinic). In contrast, fluoxetine, known by its brand name Prozac, is utilized for depression, obsessive-compulsive disorder (OCD), bulimia nervosa, and panic disorder (per Drugs.com). Some people who don't respond well to SSRIs may try another class of antidepressants known as serotonin-norepinephrine reuptake inhibitors (SNRIs), which, aside from targeting serotonin, also increase norepinephrine levels in the brain to regulate mood. Duloxetine, marketed as Cymbalta, is a type of SNRI prescribed to treat depression, anxiety disorders, and certain types of chronic pain conditions (per Healthline).

While both SSRIs and SNRIs are generally considered safe and effective for treating mood disorders, they can interact with other medications, including ibuprofen. According to Drugs.com, the combination may increase the risk of GI bleeding due to the medications' potential to interfere with the function of platelets, a group of blood cells essential for clotting.

Warfarin, often sold under the brand names Coumadin and Jantoven, is an anticoagulant medication (a.k.a. a blood thinner) commonly prescribed to prevent the formation and breakage of blood clots. It works by interfering with the body's ability to form blood clots by inhibiting the action of vitamin K, an essential nutrient involved in the clotting process. This property makes warfarin highly effective in preventing conditions such as stroke, heart attack, and deep vein thrombosis. However, warfarin also poses a risk of excessive bleeding, which must be carefully monitored and managed by healthcare providers (via the Cleveland Clinic).

When it comes to interactions with other medications, warfarin can interact with ibuprofen, namely by increasing the previously mentioned risk of bleeding, which is considered a highly clinically significant drug-drug interaction due to its potentially life-threatening effects. One reason behind this interaction is ibuprofen's effect on inhibiting platelet function and impairing the blood's ability to clot (per Drugs.com), meaning that their effects might add up. Overall, while warfarin is highly effective in preventing blood clots, its interaction with ibuprofen emphasizes the importance of being careful when taking common over-the-counter medications.

Steroid medications such as dexamethasone and prednisolone are powerful anti-inflammatory drugs that work by suppressing the immune system's inflammatory response. They do so by acting as corticosteroids, meaning they work by mimicking the action of cortisol, a hormone naturally produced by the body that regulates inflammation. Thus, by stopping inflammatory responses, steroids help relieve symptoms such as pain, swelling, and redness (via Medical News Today). Dexamethasone is known by brand names like Decadron, Baycadron Elixer, and DexPak (via the Mayo Clinic), while prednisolone is sold under brand names including Prelone and Orapred (per the Mayo Clinic). These medications are prescribed for a wide range of conditions, including allergic reactions, autoimmune diseases, asthma, and inflammatory conditions such as arthritis.

However, when it comes to interactions with other medications, steroid medications like dexamethasone and prednisolone may interact with ibuprofen because both steroids and NSAIDs can irritate the stomach lining and increase the risk of ulcers or bleeding (per Drugs.com). Therefore, combining steroid medications with ibuprofen requires careful monitoring from a healthcare provider, which is why it is advised against taking them simultaneously without supervision.

Blood-sugar-lowering medications are generally prescribed to manage type 2 diabetes. One class of blood-sugar-lowering drugs is known as sulfonylureas. According to the National Library of Medicine, these medications, which include glimepiride and tolbutamide, work by stimulating the pancreas to produce more insulin, a hormone that helps regulate blood sugar. By increasing insulin production, sulfonylureas help cells absorb more glucose from the bloodstream, thereby lowering blood sugar levels. Glimepiride is marketed under the brand name Amaryl (via Healthline), while tolbutamide is sold under the brand name Tol-Tab (per the Mayo Clinic).

While it might be easy to think that taking blood-sugar-lowering medications together with a painkiller like ibuprofen might not be a big deal, this is far from the truth. According to Drugs.com, mixing NSAIDs with diabetes medications may actually potentiate the blood-sugar-lowering effects of sulfonylureas, increasing the risk of reaching dangerously low blood sugar levels. This happens because NSAIDs also promote insulin production. Thus, by mixing them, their effects can combine or add up. Low blood sugar level symptoms to be aware of include dizziness, tachycardia or rapid heartbeat, headaches, drowsiness, confusion, tremors, nausea, hunger, weakness, and sweating.

Antibiotics such as levofloxacin and ciprofloxacin are part of the fluoroquinolone class of medications commonly prescribed to treat bacterial infections. These antibiotics work by interfering with the DNA in bacteria, hindering bacterial growth and ultimately leading to the destruction of bacterial cells. This mechanism of action makes fluoroquinolones effective in treating a wide range of bacterial infections, which is why they are known as broad-spectrum antibiotics (via Drugs.com). Levofloxacin is known by the brand name Levaquin (per the Mayo Clinic), while ciprofloxacin is sold under the brand name Cipro (per Medical News Today).

When ibuprofen is taken with fluoroquinolone antibiotics, there is a potential for increased risk of certain side effects, namely central nervous system toxicity. According to Drugs.com, the exact mechanism of this interaction is still unknown. Yet, it is believed that since fluoroquinolones may rarely lead to side effects such as tremors, muscle movements, anxiety, confusion, depression, hallucinations, or seizures, combining them with ibuprofen may amplify the effects. Therefore, the site recommends keeping a close eye on any signs of central nervous system toxicity if the two medications were to be combined through a medical prescription.

Diuretics, or water pills, help the body get rid of excess water and salt through urine. There are three main types of prescription diuretics: thiazide, loop, and potassium-sparing diuretics. Hydrochlorothiazide, a kind of thiazide diuretic, is primarily used to treat high blood pressure, and it is commonly sold under the brand name Microzide. Similarly, furosemide, a loop diuretic marketed as Lasix, is often prescribed for heart failure (via Healthline).

However, when diuretics like hydrochlorothiazide or furosemide are taken together with painkillers like ibuprofen, there's a potential risk of adverse effects on kidney function and a reduction in the diuretic's blood pressure-lowering effects. According to Drugs.com, there are multiple possible explanations for the negative drug interaction. First, NSAIDs inhibit the production of prostaglandins in the kidneys, affecting how well the kidneys work. Second, when prostaglandins are blocked, it can cause increased activity of substances in the body that raise blood pressure. Thus, the hypotensive (blood pressure-lowering) effects of diuretics may be diminished, potentially leading to elevated blood pressure. And third, NSAIDs are known to contribute to sodium and water retention, counteracting the effects of diuretic therapy. To mitigate these risks, it is best to avoid mixing said diuretics with ibuprofen. However, people using this combination as instructed by their healthcare provider should ensure adequate hydration and regularly monitor their blood pressure and kidney function to avoid any potential damage.

Despite not being classified as a "medication," fish oil is one of the most commonly consumed supplements in the U.S. (via the National Center for Complementary and Integrative Health (NCCIH)), which is why we're also talking about its potential interaction with ibuprofen in this article. Fish oil (together with fish liver oil and krill oil) is one type of dietary supplement that contains omega-3 fatty acids, which can also be found naturally in seafood like salmon. Omega-3s are essential for various bodily functions and are notoriously famous for promoting heart health (per the Cleveland Clinic). Like ibuprofen, fish oil is consumed for its anti-inflammatory effects and has also been proven effective in relieving conditions like arthritis (per the Mayo Clinic). Likewise, a study published in the Caspian Journal of Internal Medicine determined that fish oil may help ease menstrual cramps by suppressing prostaglandin synthesis, similar to ibuprofen.

While omega-3 supplements generally cause mild side effects such as bad breath and GI discomfort, they can occasionally increase the risk of bleeding when taken with medications like ibuprofen that also affect blood clotting (via Drugs.com). Although the exact mechanism is still unknown, omega-3s may have slight blood-thinning properties. Therefore, the impact of using both substances together may be stronger or more pronounced compared to using each one individually.