ibuprofen
4 interactions related to ibuprofen
lithium + ibuprofen
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 + ginkgo
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.
methotrexate + nsaids
Methotrexate is cleared almost entirely by the kidneys. NSAIDs reduce renal blood flow by blocking prostaglandins and compete with methotrexate at renal tubular transporters, both of which slow methotrexate elimination and raise its blood levels. The danger is greatest with high-dose methotrexate (cancer chemotherapy) or pre-existing kidney impairment, where the buildup can cause bone marrow suppression, mouth and gut ulceration, liver injury, and acute kidney injury. In low-dose weekly methotrexate for autoimmune disease with healthy kidneys, the interaction is usually more modest and often manageable under prescriber supervision.
alcohol + 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.