Ibuprofen makes aspirin less effective in preventing stroke

Washington, Mar 13 : It may not be advisable for stroke patients to take ibuprofen, the nonsteroidal anti-inflammatory drug (NSAID) to ease the pain from arthritis or any other condition while also taking aspirin, for a new study has found that the ibuprofen can destroy aspirin's positive effect on stroke risk.

The study, by researchers at the University at Buffalo, found that ibuprofen does so by undermining aspirin's ability to act as an anti-platelet agent.

As a part of the research, the boffins analysed 28 patients from the Dent Neurologic Institute who were taking both ibuprofen and aspirin daily.

On a first visit, the team led by Francis M. Gengo, Pharm.D, found that 13 patients had had a second stroke while taking aspirin and a NSAID, and that these patients had been platelet non-responsive to aspirin (aspirin resistant) at the time of that stroke.

When 18 of the 28 patients returned for a second neurological visit after discontinuing NSAID use, the researchers noted that they had regained their aspirin sensitivity and its ability to prevent blood platelets from aggregating and blocking arteries.

The study, the researchers say, is important as it is the first one of its kind to show the clinical consequences of the aspirin/NSAID interaction in patients being treated for prevention of a second stroke.

"This interaction between aspirin and ibuprofen or prescription NSAID's is one of the best-known, but well-kept secrets in stroke medicine," said Gengo.

"It's unfortunate that clinicians and patients often are unaware of this interaction. Whatever number of patients who have had strokes because of the interaction between aspirin and NSAIDs, those strokes were preventable.

"Our data report the entire time course of this interaction. The results showed that platelets resumed aggregating within 4-6 hours when aspirin and ibuprofen were taken close together, leaving patients with no anti-platelet effect for 18-20 hours a day. Normally, a single dose of aspirin has an effect on platelet aggregation for 72-96 hours," he added.

America's Food and Drug Administration (FDA) currently warns that ibuprofen might make aspirin less effective, but states that the clinical implications of the interaction have not been evaluated.

The study was supported by the Dent Family Foundation and was published in the January issue of the Journal of Clinical Pharmacology.

ANI