http://www.nature.com/nsu/030210/030210-10.html
Ibuprofen melts aspirin's heart Double prescription could sap
painkiller's cardiovascular benefit. 
14 February 2003 
HELEN PEARSON 

 
Aspirin and ibuprofen are two of the most commonly consumed
non-prescription drugs. 
� GettyImages 
 
 

The over-the-counter painkiller ibuprofen may slash the beneficial
effects of aspirin on the heart, warns a new report. 

The study followed more than 7,000 cardiovascular patients in Tayside,
UK, who took aspirin to ward off a heart attack. Those who also popped
ibuprofen frequently were twice as likely to die during the eight-year
study than those taking aspirin alone1. Aspirin and ibuprofen are two of
the most commonly consumed non-prescription drugs.

"It would seem prudent not to take the two drugs together," advises study
leader Tom MacDonald of Ninewells Hospital and Medical School in Dundee.
He suggests that some patients should use an alternative painkiller such
as paracetamol.

The American Heart Association recommends a regular dose of aspirin for
the roughly 3 million US patients who have had a heart attack or stroke.
An unknown number of these also take ibuprofen for unrelated pain
conditions such as arthritis.

"People should at least be alerted," agrees president of the American
Heart Association, Robert Bonow. He would also like to see follow-up
studies to find the patient groups most at risk.

People should at least be alerted 
Robert Bonow
American Heart Association  
 
 

Ibuprofen is believed to block aspirin from thinning the blood. Aspirin
normally binds to an enzyme called cyclooxygenase in blood platelets,
which stops them clumping together into vessel-clogging clots.

The study is thought to be most pertinent to people who take the two
drugs long term � in most cases a single ibuprofen pill is probably
harmless. And so far other painkillers in the same class as ibuprofen,
called NSAIDS, have not been found to have the blocking effect.

But in some cases, even one dose of ibuprofen might counteract aspirin's
effects, speculates pharmacologist Garret FitzGerald of the University of
Pennsylvania in Philadelphia � for example, when air passengers swallow
aspirin to avert deep vein thrombosis.

In a preliminary study in 2001, FitzGerald showed that taking ibuprofen
at night can block the anti-clotting effects of an aspirin swallowed the
next morning2. "The caution index for doctors has been raised
appreciably," he says. 
 
 
References
MacDonald, T. M. & Wei, L. Effect of ibuprofen on cardioprotective effect
of aspirin. Lancet, 361, 573 - 574, (2003). |Homepage| 
Catella-Lawson, F. et al. Cyclooxygenase inhibitors and the antiplatelet
effects of aspirin. New England Journal of Medicine, 345, 1809 - 1817,
(2001). |Article|  

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