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No Aspirin right after Ibuprofen

As a stroke survivor, you may be very familiar with aspirin. Many patients after an ischemic stroke are prescribed aspirin to. Aspirin normally prevents the blocking of blood vessels. Aspirin shows a reduction of risk of recurrent strokes and transient ischemic attacks (TIAs) by 18%. Because of its established efficacy and low cost, aspirin is considered by many as first-line therapy in the majority of stroke patients.

Inevitably, you are at the same time more than familiar with ibuprofen (Non-steroidal anti-inflammatory drug – NSAID), a very common pain relief medicine. However, a group of researchers at the University of Buffalo in USA has shown that there’s a far less than ignorable interaction between the two drugs aspirin and ibuprofen. The study suggests that ibuprofen may block aspirin form its initial effect, and undermine its ability of prevention of a secondary stroke.

Conducted in 2008, this research has included a cohort of 28 patients in Dent Neurologic Institute were identified as taking both aspirin and ibuprofen daily and all were found to have no aspirin’s effect from their daily dosage. On the other hand, the effect is temporary because when afterwards, the researchers found in 18 of the 28 patients back for a second neurological visit after discontinuing NSAID, the sensitivity to aspirin is coming back. These patients also regained aspirin ability to prevent blocking blood vessels.

Though the study might be limited by its small size, the pharmacodynamics and clinical data are of a great importance. US FDA has released the warning saying “patients who use immediate-release aspirin (not enteric-coated) and take a single dose of ibuprofen, 400mg, should dose the ibuprofen at least 30 minutes or longer after aspirin ingestion, or more than 8 hours before aspirin ingestion to avoid attenuation of aspirin’s effect.” In addition, the data from this trial suggest that even little as over-the-counter doses can all the same produce this pharmacodynamic interaction. Other medicine from the same category NSAID could also be risky while being taken with aspirin, like naproxen. Any doubt, please don’t hesitate to ask your physician.

It is the first one to demonstrate the clinical consequences of the aspirin-NSAID interaction in patients which delivered us an extremely important message: No Aspirin right after Ibuprofen.

This study also showed us that it is critical to notice unexpected interaction among drugs which are administrated in the same period of time. NeuroAid has been approved to be safe to stroke patients and lack of interaction with aspirin, this safety research of the therapy combining NeuroAid and aspirin has been published in Cerebral Vascular Diseases last May.

Stroke ( Journal )
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Posted on November 3, 2010

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