From the Guidelines
People with angina should generally avoid taking ibuprofen and other NSAIDs unless specifically approved by their doctor. NSAIDs can increase the risk of cardiovascular events like heart attack and stroke, which is particularly concerning for those who already have heart disease such as angina 1. These medications work by inhibiting cyclooxygenase enzymes, which can lead to increased blood pressure, reduced kidney function, and interference with the cardioprotective effects of aspirin that many angina patients take.
Key Considerations
- Ibuprofen can interfere with aspirin’s ability to irreversibly acetylate the platelet COX-1 enzyme, potentially reducing the protective effect of aspirin on risk for atherothrombotic events 1.
- To minimize potential interactions, patients taking immediate release low-dose aspirin and ibuprofen 400 mg should take the ibuprofen at least 30 minutes after aspirin ingestion, or at least 8 hours before aspirin ingestion 1.
Alternatives and Precautions
- If pain relief is needed, acetaminophen (Tylenol) is typically a safer alternative for people with heart conditions.
- If you absolutely need an anti-inflammatory medication, speak with your cardiologist first who might recommend the lowest effective dose for the shortest possible duration while monitoring your heart condition closely.
- Never start or stop any medication without consulting your healthcare provider, especially when you have a condition like angina.
From the FDA Drug Label
Cardiovascular Thrombotic Events Nonsteroidal anti-inflammatory drugs (NSAIDs) cause an increased risk of serious cardiovascular thrombotic events, including myocardial infarction and stroke, which can be fatal. Ibuprofen Tablets are contraindicated in the setting of coronary artery bypass graft (CABG) surgery
Key Points:
- Increased risk of cardiovascular events: Ibuprofen, an NSAID, may increase the risk of serious cardiovascular thrombotic events, including myocardial infarction and stroke.
- Contraindication in CABG surgery: Ibuprofen is contraindicated in patients undergoing coronary artery bypass graft (CABG) surgery.
A person with angina should exercise caution when taking ibuprofen due to the potential increased risk of cardiovascular events 2. It is recommended to consult a healthcare provider before taking ibuprofen, especially if you have a history of cardiovascular disease or are at risk for cardiovascular events.
From the Research
Angina and Ibuprofen
- There is no direct evidence in the provided studies that specifically addresses whether a person with angina can take ibuprofen.
- The studies focus on the management of stable angina using antianginal drugs, antiplatelet agents, and other pharmacological therapies 3, 4, 5, 6, 7.
- Ibuprofen, a Nonsteroidal Anti-Inflammatory Drug (NSAID), is not mentioned in the context of angina management in the provided studies.
- However, it is known that NSAIDs like ibuprofen can have cardiovascular side effects and may interact with other medications commonly used in angina management, such as antiplatelet agents and anticoagulants 6.
- Patients with angina should consult their healthcare provider before taking any new medications, including ibuprofen, to discuss potential risks and benefits 5.