Cardioprotective Benefits of Aspirin Inhibited by Ibuprofen

PHILADELPHIA, (Reuters Health) – Ibuprofen can inhibit the cardioprotective benefits of a daily aspirin regimen, according to data presented Wednesday at the annual meeting of the American College of Rheumatology Meeting.

Therefore, patients with arthritis and concomitant coronary artery disease, “who take both drugs should take aspirin at least 2 hours prior to the anti-inflammatory drug,” Dr. Francesca Catella-Lawson told Reuters Health.

Dr. Catella-Lawson and colleagues, from the University of Pennsylvania Medical Center, in Philadelphia, randomized 18 healthy, nonsmoking individuals to cross-over administration of 81 mg of aspirin either before or after administration of three widely used arthritis medications. The patients, aged 18 to 65 years, had taken no aspirin for 2 weeks and no NSAIDs for 1 week prior to the study period and had a wash-out period of 14 days between the cross-over dosages.

The first cohort took aspirin 2 hours prior to 400 mg ibuprofen for 6 days. These patients exhibited serum thromboxane-B2 inhibition greater than 80% throughout day 1 and greater than 98% at all time points up to 24 hours postdosing on day 6, Dr. Catella-Lawson said. She added that “platelet aggregation was also irreversibly inhibited” in this group.

Conversely, when the same six patients took the same dose of ibuprofen 2 hours before taking aspirin the researchers found that “platelet aggregation and serum thromboxane-B2 were inhibited for 2 hours after ibuprofen intake, but then recovered steadily.”

Patients in the other two cohorts took aspirin and either 1000 mg acetaminophen or 25 mg rofecoxib using the same cross-over dosing schedule. “Acetaminophen and rofecoxib did not exhibit competition with aspirin,” Dr. Catella-Lawson told Reuters Health.

She added that if aspirin is taken 2 hours prior to ibuprofen, the cardioprotective effects of the aspirin are not inhibited. “Other aspirins Äsuch as entericÅ or NSAID types may further influence the effect of timing,” she said.

The study was sponsored by the Bayer Corporation, according to a statement issued by the University of Pennsylvania.

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