If you have heart disease
While low-dose aspirin can help prevent heart attack, other painkillers in the nonsteroidal anti-inflammatory drug family (NSAIDs)—which include ibuprofen—have been associated with an increase in the chance for heart attack or stroke.
A 2017 British Medical Journal study reported a 20 to 50 percent elevated risk of heart attack among people who used NSAIDs daily for a week or more. The increased risk associated with ibuprofen could be as high as 75 percent. The greatest danger occurred within the first month of NSAID use and at high doses.
Those with heart disease or at risk for heart disease should be especially mindful of these findings, though the elevated risk affects everyone, says Catherine Sherwin, PhD, chair of the clinical pharmacology track at the American Association of Pharmaceutical Scientists PharmSci 360 Meeting. If you’re taking blood-pressure medication, be especially cautious—NSAIDs could make them less effective.
Talk to your doctor about alternative medications to treat your pain, whether it’s, say, a Tylenol for a headache or physical therapy for back pain. Find out more about how ibuprofen can increase your risk for heart attacks.
If you’re on anti-clotting meds
Anticoagulants (such as Warfarin) and antiplatelets (such as Plavix) prevent blood from clotting easily. Anticoagulants are typically prescribed for people at high risk for stroke (such as those with atrial fibrillation or artificial heart valves), or those who’ve suffered from a pulmonary embolism; antiplatelets are usually advised for those who’ve already suffered a heart attack or stroke, as a way to prevent it from happening again. The problem? “The combination of these drugs with ibuprofen could significantly increase the risk for bleeding complications,” says David Craig, PharmD, pharmacist lead at the Moffitt Cancer Center, and American Pain Society E-News editor. So instead, discuss other options with your doctor; for instance, you may consider celecoxib, which may be less likely to induce bleeding.