Major
Ibuprofen × Prednisolone
Non-steroidal anti-inflammatory drugs (NSAIDs)×Glucocorticoids
Mechanism
Additive gastroesophageal ulcer and bleeding risk. Glucocorticoids reduce GI mucosal repair; NSAIDs block protective prostaglandins.
Symptoms
Black or tarry stools (melena), vomiting blood or coffee-ground material, epigastric pain. Risk multiplies in older patients and with prior peptic ulcer disease.
Management
Avoid prolonged combination. If ibuprofen is needed for a short course on prednisolone, use the minimum effective dose for 5–7 days with mandatory pantoprazole cover. For chronic analgesia: paracetamol or celecoxib.
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.