Ibuprofen Interactions

Ibuprofen and other NSAIDs inhibit renal prostaglandin synthesis, which reduces renal blood flow and the kidney's ability to clear lithium. This can raise serum lithium levels, and published case reports describe clinically significant lithium toxicity after an NSAID was started.

Ibuprofen reduces platelet aggregation through COX-1 inhibition, and Ginkgo biloba has antiplatelet activity through ginkgolide B's antagonism of platelet-activating factor. Used together they can compound the effect on platelets and raise bleeding risk; a fatal intracerebral hemorrhage has been reported in a long-term ginkgo user who started regular ibuprofen.

Alcohol and ibuprofen each irritate the stomach lining and impair platelet function, and combining them raises the risk of gastrointestinal bleeding and ulcers. Both also stress the kidneys — ibuprofen reduces renal blood flow while alcohol drives dehydration — which can add up to acute kidney injury, especially in older adults or people with existing kidney problems.