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Ibuprofen Drug Interactions
Some of the drugs that can potentially interact with ibuprofen include aspirin, lithium, and diuretics. Ibuprofen has also been known to interact with a number of herbal and nutritional supplements to increase your risk of bleeding. Certain drug interactions can increase your risk of stomach ulcers; others may change the way your body metabolizes some medicines, and cause some drugs to be less effective.
An Overview of Ibuprofen Interactions
Ibuprofen (marketed under brand names such as Motrin®, Advil®, Genpril®, and Nuprin®) can potentially interact with a number of medicines. Some of these medications include:- Angiotensin-converting enzyme inhibitors (ACE inhibitors), including:
- Benazepril (Lotensin®), benazepril-hydrochlorothiazide (Lotensin HCT®), or benazepril-amlodipine (Lotrel®)
- Captopril (Capoten®) or captopril-hydrochlorothiazide (Capozide®)
- Enalapril (Vasotec®), enalapril-hydrochlorothiazide (Vaseretic®), or enalapril-felodipine (Lexxel®)
- Fosinopril (Monopril®) or fosinopril-hydrochlorothiazide (Monopril-HCT®)
- Lisinopril (Prinivil®, Zestril®) or lisinopril-hydrochlorothiazide (Prinzide®, Zestoretic®)
- Quinapril (Accupril®) or quinapril-hydrochlorothiazide (Accuretic®, Quinaretic™)
- Ramipril (Altace®)
- Angiotensin II receptor blockers (ARBs), such as:
- Azilsartan (Edarbi™) or azilsartan/chlorthalidone (Edarbyclor™)
- Candesartan (Atacand®) or candesartan-hydrochlorothiazide (Atacand HCT®)
- Eposartan (Teveten®) or eposartan-hydrochlorothiazide (Teveten® HCT)
- Irbesartan (Avapro®) or irbesartan-hydrochlorothiazide (Avalide®)
- Losartan (Cozaar®) or losartan-hydrochlorothiazide (Hyzaar®)
- Olmesartan (Benicar®), olmesartan-hydrochlorothiazide (Benicar HCT®), or amlodipine and olmesartan (AZOR™)
- Telmisartan (Micardis®) or telmisartan-hydrochlorothiazide (Micardis® HCT)
- Valsartan (Diovan®) or valsartan-hydrochlorothiazide (Diovan HCT®)
- Beta blockers, such as:
- Acebutolol (Sectral®)
- Atenolol (Tenormin®)
- Betaxolol (Kerlone®)
- Bisoprolol (Zebeta®)
- Carvedilol (Coreg®, Coreg CR®)
- Esmolol (Brevibloc®)
- Labetalol (Trandate®)
- Metoprolol (Lopressor®, Toprol-XL®)
- Nadolol (Corgard®)
- Nebivolol (Bystolic®)
- Penbutolol (Levatol®)
- Propranolol (Inderal®, Inderal® LA, InnoPran XL™)
- Sotalol (Betapace®)
- Timolol
- Bile acid sequestrant cholesterol medications, including:
- Cholestyramine (Prevalite®, Questran®, Questran® Light)
- Colesevelam (WelChol®)
- Colestipol (Colestid®)
- Corticosteroids, including (but not limited to):
- Betamethasone (Celestone®)
- Cortisone
- Dexamethasone (Decadron®)
- Fludrocortisone (Florinef®)
- Hydrocortisone (Cortef®)
- Methylprednisolone (Depo-Medrol®, Medrol®)
- Prednisolone (Orapred®, Pediapred®)
- Prednisone
- Triamcinolone (Kenalog®, Aristospan®)
- Cyclosporine (Gengraf®, Neoral®, Sandimmune®)
- Digoxin (Digitek®, Lanoxin®)
- Diuretics, such as:
- Amiloride (Midamor®) or amiloride-HCTZ (Moduretic®)
- Bumetanide (Bumex®)
- Chlorothiazide (Diuril®)
- Chlorthalidone (Thalitone®)
- Ethacrynic acid (Edecrin®)
- Furosemide (Lasix®)
- Hydrochlorothiazide (Esidrix®, HydroDIURIL®, Microzide®, Oretic®)
- Metolazone (Zaroxolyn®)
- Spironolactone (Aldactone®) or spironolactone-HCTZ (Aldactazide®)
- Torsemide (Demadex®)
- Triamterene (Dyrenium®) or triamterene/HCTZ (Dyazide®, Maxzide®)
- Lithium (Eskalith®, Lithobid®)
- Medications that "thin" the blood or otherwise increase bleeding risk (such as anticoagulant and antiplatelet drugs), such as:
- Antithrombin (ATryn®, Thrombate III®)
- Apixaban (Eliquis®)
- Argatroban
- Aspirin (Bayer® and others)
- Bivalirudin (Angiomax®)
- Cilostazol (Pletal®)
- Clopidogrel (Plavix®)
- Dabigatran (Pradaxa®)
- Dipyridamole (Persantine®)
- Drotrecogin alfa (Xigris®)
- Eptifibatide (Integrilin®)
- Fondaparinux (Arixtra®)
- Heparin or heparin-like products, including dalteparin (Fragmin®), enoxaparin (Lovenox®), or tinzaparin (Innohep®)
- Lepirudin (Refludan®)
- Other nonsteroidal anti-inflammatory drugs (NSAIDs), such as:
- Celecoxib (Celebrex®)
- Diclofenac (Cambia™, Cataflam®, Flector®, Solaraze® Gel, Voltaren®, Voltaren® Gel, Voltaren®-XR, Voltaren Ophthalmic®, Zipsor™)
- Etodolac (Lodine®, Lodine® XL)
- Indomethacin (Indocin®, Indocin SR®)
- Ketoprofen (Orudis®, Actron®, Oruvail®)
- Ketorolac (Toradol®)
- Meloxicam (Mobic®)
- Nabumetone (Relafen®)
- Naproxen (Naprosyn®) or naproxen sodium (Aleve®, Anaprox®, Naprelan®)
- Oxaprozin (Daypro®)
- Piroxicam (Feldene®)
- Others (see List of NSAIDs for a more complete list of these medications)
- Pentoxifylline (Trental®)
- Prasugrel (Effient®)
- Rivaroxaban (Xarelto®)
- Thrombolytics, such as:
- Alteplase (Activase®)
- Reteplase (Retavase®)
- Streptokinase (Streptase®)
- Tenecteplase (TNKase®)
- Ticagrelor (Brilinta®)
- Ticlopidine (Ticlid®)
- Tirofiban (Aggrastat®)
- Warfarin (Coumadin®, Jantoven®)
- Methotrexate (Rheumatrex®, Trexall®)
- Probenecid
- SSRI or SNRI medications, including:
- Citalopram (Celexa®)
- Duloxetine (Cymbalta®)
- Desvenlafaxine (Pristiq®)
- Escitalopram (Lexapro®)
- Fluoxetine (Prozac®, Sarafem®, Selfemra™)
- Fluvoxamine (Luvox®, Luvox® CR)
- Levomilnacipran (Fetzima™)
- Milnacipran (Savella™)
- Paroxetine (Paxil®, Paxil CR®, Pexeva®, Brisdelle™)
- Sertraline (Zoloft®)
- Venlafaxine (Effexor®, Effexor XR®).
Several herbal and nutritional supplements can also interact with ibuprofen and may increase the risk of bleeding. Examples of these include, but are not limited to:
- Dong quai
- Feverfew
- Garlic
- Ginger
- Ginkgo biloba
- Ginseng
- St. John's wort
- Fish oil supplements.
Written by/reviewed by: Kristi Monson, PharmD; Arthur Schoenstadt, MD
Last reviewed by: Kristi Monson, PharmD