5 known interactions • 2 major • 3 moderate • 0 minor
Always disclose all medications to your healthcare providers — prescription medicines, OTC medications, vitamins, and herbal supplements. This list may not include every possible interaction. Use our Medicine Interaction Checker to screen your complete medication list.
Potentially life-threatening or causing permanent damage. Avoid combination.
May worsen condition or require dose adjustment. Monitor closely.
Usually limited clinical effect. Manage with routine monitoring.
ACE inhibitors / ARBs / diuretics
NSAIDs reduce renal prostaglandin synthesis, impair renal blood flow regulation, blunt antihypertensive effect ('triple whammy' combination with ACE inhibitor + diuretic causes acute kidney injury).
Management: Avoid 'triple whammy' combination. Monitor BP and renal function. Use lowest NSAID dose.
Warfarin / anticoagulants
NSAIDs inhibit platelet function AND can cause GI bleeding, dramatically increasing hemorrhagic risk.
Management: Avoid combination when possible. If necessary, use gastroprotection (PPI), shortest duration, lowest dose.
Aspirin (low-dose cardioprotective)
Ibuprofen can interfere with aspirin's irreversible platelet COX-1 inhibition if taken before aspirin, reducing cardioprotective effect.
Management: Take aspirin at least 30 min before ibuprofen, or use ibuprofen >8 hours after aspirin. Consider naproxen (less interaction) if concomitant NSAID needed.
Lithium
NSAIDs reduce renal lithium clearance, increasing lithium levels and toxicity risk.
Management: Monitor lithium levels when starting/stopping ibuprofen; dose adjustments may be needed.
SSRIs / SNRIs
Additive risk of GI bleeding via serotonin depletion in platelets and GI mucosal effects.
Management: Add PPI gastroprotection if combination unavoidable, especially in elderly.
Always ask your pharmacist about potential interactions with food, alcohol, and supplements specific to Ibuprofen. Some medicines have significant interactions with grapefruit juice, high-fat meals, dairy products, or vitamin K-rich foods.