Can Brufen (ibuprofen) and Pause be given together?

Ibuprofen and Aspirin Should Not Be Taken Together Without Specific Timing Considerations

Ibuprofen (Brufen) and aspirin (Pause) should not be taken together simultaneously as ibuprofen can interfere with aspirin's cardioprotective effects unless specific timing protocols are followed. 1

Drug Interaction Mechanism

The interaction between ibuprofen and aspirin occurs at the molecular level:

• Ibuprofen blocks aspirin's ability to irreversibly acetylate the platelet COX-1 enzyme 1
• This interaction reduces aspirin's cardioprotective effects, which is particularly concerning for patients taking low-dose aspirin for cardiovascular protection 1
• The interaction is specific to ibuprofen and doesn't occur with certain other NSAIDs like rofecoxib, acetaminophen, or diclofenac 1

Recommendations for Concurrent Use

If both medications are absolutely necessary, follow these specific timing protocols:

• For immediate-release aspirin: Take ibuprofen at least 30 minutes AFTER aspirin ingestion, OR at least 8 hours BEFORE aspirin ingestion 1
• For enteric-coated aspirin: No specific recommendations can be made based on available data, as one study showed the antiplatelet effect of enteric-coated aspirin is still attenuated when ibuprofen is taken 2,7, and 12 hours after aspirin 1

Alternative Approaches

Consider these alternatives when both anti-inflammatory and cardioprotective effects are needed:

1. Alternative NSAID: Use a different NSAID that doesn't interfere with aspirin's cardioprotective effects (e.g., diclofenac) 1
2. Acetaminophen: Consider using acetaminophen instead of ibuprofen for pain relief when on aspirin therapy 1
3. Timing separation: If ibuprofen must be used, strictly adhere to the timing recommendations above 1

Special Considerations

• Cardiovascular risk: Both aspirin and ibuprofen carry cardiovascular risks that should be carefully considered, especially in patients with preexisting cardiovascular disease 1
• Gastrointestinal effects: The combination of aspirin and ibuprofen may increase the risk of gastrointestinal bleeding; consider adding a proton pump inhibitor for patients at risk 1
• Duration of therapy: Use NSAIDs at the lowest effective dose for the shortest duration possible 1

Monitoring Recommendations

When using both medications:

• Monitor for signs of decreased cardiovascular protection
• Watch for increased risk of gastrointestinal bleeding
• Monitor renal function and blood pressure, as both drugs can affect kidney function 1

Remember that this interaction is particularly important for patients taking low-dose aspirin for cardioprotection, as the interference with aspirin's antiplatelet effect could potentially lead to serious cardiovascular events.