Does ibuprofen interfere with the cardio-protective effect of aspirin?
Although there is ex-vivo evidence of an interaction between aspirin and ibuprofen, there is inadequate clinical evidence to suggest that there is a loss in the cardioprotective effect of aspirin when given together.8,13 The FDA advises that when used together the doses of ibuprofen and aspirin are staggered to minimise any interaction (e.g., ibuprofen at least 30 minutes after and 8 hours before aspirin).13 The MHRA and other EU Regulators keep this issue under continual review; however, in view of the lack of supportive clinical evidence no updated prescribing advice has been issued in Europe. Cardiorenal effects Cardiorenal effects of NSAIDs (e.g. oedema, hypertension, heart failure) may be important contributors to long-term CV risk; however, current evidence does not suggest that COX-2 selectivity per se is an important determinant of risk.8 Clinical studies suggest that individual NSAIDs may differ in their cardiorenal effect.
