Major
Acetylsalicylic acid × Ibuprofen
Antiplatelet agents (low dose) / NSAIDs (analgesic dose)×Non-steroidal anti-inflammatory drugs (NSAIDs)
Mechanism
Ibuprofen reversibly binds platelet COX-1 and blocks aspirin's access to its irreversible acetylation site. Aspirin's antiplatelet effect is lost – cardiovascular event risk.
Symptoms
No symptoms – risk is loss of cardioprotection.
Management
If ibuprofen needed – take 8 hours BEFORE or 30 minutes AFTER aspirin. Alternative in cardiovascular risk – paracetamol.
Check the full regimen, not just this pair
Opens the checker with these two drugs prefilled. Add the rest of the regimen and recompute additive risks.