Can you take Ibuprofen if you have COVID-19 (coronavirus)?
- Acetaminophen is the preferred pain-reliever if you have COVID-19.
- There is currently no strong evidence to suggest that ibuprofen makes you more likely to catch coronavirus, or make the disease worse; however, certain expert organizations, including the FDA, are investigating the possibility further.
- If you already take NSAIDs, such as ibuprofen or naproxen, for another condition, such as arthritis or pain-relief, ask your doctor for advice.
Why is there such controversy about taking ibuprofen for probable/suspected COVID-19?
Concern was expressed by France’s Health Minister Olivier Veran in a tweet on March 14th 2020 that suggested that anti-inflammatory drugs, such as ibuprofen and cortisone could be an aggravating factor in people with COVID-19.
On the same day, the French government reported that NSAIDs, the family of drugs that include ibuprofen, were linked with "grave adverse effects" in patients affected by Covid-19.
This prompted the WHO to issue a statement on the 18th of March 2020 which recommended that people suffering COVID-19 symptoms should avoid taking ibuprofen after French officials warned that anti-inflammatory drugs could worsen the effects of the virus. Less than 24 hours later, the WHO had retracted that statement on its official twitter account, stating “The WHO does not recommend against the use of ibuprofen.”
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Why would there be concern about taking ibuprofen for COVID-19?
The product insert for ibuprofen already states that there is the potential for the drug to mask the symptoms of infections in general (not just COVID-19) which may mean that people are only diagnosed in more severe stages.
NSAIDs (such as ibuprofen, diclofenac, and naproxen) have occasionally been associated with acute kidney injury, and the risk of this is increased in people who are prone to dehydration, such as older and critically ill patients.
There is a hypothetical risk that NSAIDs might also affect the way SARS-CoV-2 binds to human cells, as research in animals has shown that NSAIDs such as ibuprofen increase levels of a protein called ACE2 on the surface of cells, the same protein that SARS-CoV-2 binds to.
These concerns apply to all NSAIDs, not only ibuprofen, such as naproxen and diclofenac.
Bottom line
So even though there isn't yet any widely accepted additional reason to avoid ibuprofen specifically for COVID-19, it makes sense to use acetaminophen instead, unless you cannot tolerate it.
People already prescribed NSAIDs for other conditions, such as arthritis or pain-relief, should not stop them without their doctor’s advice and can be reassured that currently there appears to be no evidence that NSAIDs increase their chance of acquiring COVID-19.
References
- Ibuprofen use and Coronavirus (COVID-19). Government UK. https://www.gov.uk/government/news/ibuprofen-use-and-covid19coronavirus
- FDA advises patients on the use of non-steroidal anti-inflammatory drugs (NSAIDs) for COVID-19. U.S. Food and Drug Administration. 19/03/2020 https://www.fda.gov/drugs/drug-safety-and-availability/fda-advises-patients-use-non-steroidal-anti-inflammatory-drugs-nsaids-covid-19
- France says ibuprofen may aggravate coronavirus. Experts say more evidence is needed March 18, 2020. https://edition.cnn.com/2020/03/16/health/coronavirus-ibuprofen-french-health-minister-scn-intl-scli/index.html
- Melville N, Nainggolan L. Are Warnings Against NSAIDs in COVID-19 Warranted? Medscape Pharmacists. March 17, 2020. https://www.medscape.com/viewarticle/926940
Read next
Can you take ibuprofen on an empty stomach?
Despite popular belief that you have to take ibuprofen with food, you can take ibuprofen on an empty stomach and this will give you faster pain relief than taking it with food. Food increases the time it takes for ibuprofen to be absorbed, although it won't affect how much is absorbed. There is actually no evidence that taking ibuprofen with food prevents gastric irritation – ibuprofen at OTC doses has a low incidence of gastric irritation anyway. Continue reading
Can you take expired ibuprofen?
Although taking expired ibuprofen is not recommended by the manufacturer, the actual shelf-life is likely to be longer than that indicated by the expiry date, with FDA testing showing many drugs are active for years beyond their expiry date, although specific data on ibuprofen is not available. Within reason, an ibuprofen tablet that is a few months past its expiry date is probably safe to take. Ibuprofen that is years past its expiry date should not be taken. Continue reading
Can you overdose on ibuprofen?
Despite ibuprofen having a wide safety margin, it is possible to overdose on it, but death from ibuprofen overdose is rare. Children are more susceptible to the effects of ibuprofen and likely to experience an overdosage of ibuprofen if dosages of more than 400mg/kg (in the range of 8000mg for a 20kg child [the equivalent of 40 x 200mg ibuprofen tablets]) are ingested. Studies have reported patients ingesting less than 99 mg/kg are unlikely to have symptoms. Continue reading
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Drug information
- Ibuprofen Information for Consumers
- Ibuprofen prescribing info & package insert (for Health Professionals)
- Side Effects of Ibuprofen (detailed)
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