Why You Should Avoid Taking Ibuprofen With This Common Antidepressant

Ibuprofen quickly goes to work in temporarily relieving pain from headaches, muscle strains, menstrual cramps, toothaches, and arthritis. You might not need to take it all the time, though, so you might forget to tell your doctor about your ibuprofen use at your annual exam. However, your doctor should be aware of any over-the-counter (OTC) medications or supplements that you are using, especially if you take medications for specific conditions. Taking ibuprofen is generally safe if taken in its proper dosage, but ibuprofen can interact with many medications. Drugs.com says 97 drugs have major interactions with ibuprofen and 283 have moderate ones. 

One of those medications that moderately interact with ibuprofen is the antidepressant Lexapro (escitalopram). Lexapro is commonly prescribed to treat anxiety and depression by increasing serotonin levels in the brain, which helps improve mood and emotional stability. Taking ibuprofen while also taking Lexapro could increase your risk of bleeding in your gastrointestinal tract. While anyone might experience this interaction, it's more likely in older adults or people with diseases of the liver or kidney.

A typical dose of over-the-counter ibuprofen can more than double your risk of gastrointestinal bleeding, according to a 2012 review in Current Medical Research and Opinion. Your risk increases if you're older or you're taking other medications. Lexapro is considered a serotonin reuptake inhibitor (SRI), and medications in this class can interfere with the way your blood platelets function, leading to more bleeding. Lexapro's medication guide lists an increased risk of bleeding as one of its side effects, particularly if you also take blood thinners, aspirin, or nonsteroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen. The guide also suggests letting your doctor know if you have a history of bleeding problems.

Signs of gastrointestinal bleeding such as dizziness, fatigue, abdominal cramps, or weakness can be common with other conditions. Black or bloody poop, pale skin, vomiting blood, or vomit that resembles coffee grounds are more unique symptoms of GI bleeding. Acute GI bleeding can cause you to go into shock, where you could have low blood pressure, an increased heart rate, or lose consciousness.

Lexapro comes with 261 major and 379 minor interactions with other drugs, according to Drugs.com. The antihistamine hydroxyzine is prescribed for itching due to allergies, but it can also treat short-term anxiety. If you mix the two, a rare side effect could be a serious irregular heartbeat. You're more at risk for this side effect if you also have a chronic heart condition or electrolyte imbalance.

Tramadol is classified as an opioid to treat pain. Both tramadol and Lexapro increase your levels of the neurotransmitter serotonin, so taking them together increases your risk of serotonin syndrome. Even though your body needs serotonin to regulate sleep, digestion, and mood, too much serotonin can cause restlessness, confusion, rapid heart rate, or high blood pressure. Life-threatening signs of serotonin syndrome include tremors, seizures, or a loss of consciousness.

Lexapro is also among the medications that can't be mixed with alcohol. Alcohol typically relaxes your nervous system and can make you feel drowsy, but drinking alcohol while taking Lexapro can increase Lexapro's side effects such as problems thinking clearly and slowed reactions to situations. Lexapro's medication guide says to avoid alcohol while taking this medication.