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Sunday, 16 February 2003 05:30 PM GMT
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Ibuprofen may counteract the anti-platelet activities of aspirin leading to
increased clot formation.
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New research published this week in The
Lancet medical journal suggests that ibuprofen may counteract the antiplatelet
activities of aspirin.
Aspirin normally binds to an enzyme called
cyclooxygenase in blood platelets, which stops them clumping together into
vessel-clogging clots. Aspirin is recommended for most patients with cardiac
ischemia or stroke. An unknown number of those also take ibuprofen for pain
relief. The study suggests that ibuprofen may block aspirin from binding
to cyclooxygenase. This compromises aspirin's ability to protect against
the formations of clots and may eventually lead to death.
The study which was conducted
by the Medicines Monitoring Unit of Britain's Medical Research Council checked
the medical records of 7,107 heart patients who had been discharged from
hospitals between 1989 and 1997 (8 years) with aspirin prescriptions and
had survived at least one month after leaving the hospital.
They were divided into
four groups according to their prescriptions. The first group included those
on aspirin alone. The second were given aspirin and ibuprofen and the third
group had aspirin with another pain killer, diclofenac. Ibuprofen and diclofenac
both belong to a widely used class of pain relievers known as nonsteroidal
anti-inflammatory drugs, or NSAIDs. The last group included those taking
aspirin with any other NSAID, such as acetaminophen, which is in Tylenol.
It was found that heart patients taking
both aspirin and ibuprofen were twice as likely to die during the study
period as those who were taking aspirin alone or with other types of common
pain relievers.
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In a preliminary study in 2001, FitzGerald
showed that taking ibuprofen at night can block the anti-clotting effects
of an aspirin swallowed the next morning. "The caution index for doctors
has been raised appreciably," he says.
References
MacDonald, T. M. & Wei, L. Effect of ibuprofen on cardioprotective effect
of aspirin. Lancet, 361, 573 - 574, (2003).
Catella-Lawson, F. et al. Cyclooxygenase inhibitors and the antiplatelet
effects of aspirin. New England Journal of Medicine, 345, 1809 - 1817, (2001).
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