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Back to Pharmacology Articles

 Sunday, 16 February 2003 05:30 PM GMT


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.

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.

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).

Article reviewed by:

Dr. Tamer Fouad, M.D.


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