09/14/2006

The FDA recently posted a MedWatch Alert regarding concomitant use of ibuprofen and aspirin.  When taken together ibuprofen can reduce the cardiovascular benefits of aspirin.  Administer ibuprofen 400 mg 30 minutes after or 8 hours before immediate-release aspirin to avoid competitive inhibition of platelet’s cyclooxygenase (COX) acetylation site.  Data on enteric-coated aspirin are not available.  Infrequent use of ibuprofen has little effect on overall cardioprotective effects of aspirin because of aspirin’s long-lasting effect on platelets.  Other non-selective NSAIDs theoretically will have the same effect as ibuprofen and should be dosed accordingly.  Healthcare professionals should educate patients on appropriate timing of these medications to preserve the cardiovascular benefit of aspirin.  Consider alternative medications in high-risk cardiovascular populations.

Additional information is available from the following links:

• FDA MedWatch alert
  http://www.fda.gov/medwatch/safety/2006/safety06.htm#aspirin
   
• Healthcare Professional Sheet-FDA
  http://www.fda.gov/cder/drug/InfoSheets/HCP/ibuprofen_aspirinHCP.htm