From the Guidelines
Ibuprofen is contraindicated in patients with a history of gastrointestinal bleeding or ulceration, severe heart failure, third trimester of pregnancy, severe kidney or liver impairment, and hypersensitivity to ibuprofen or other NSAIDs, as well as those taking certain medications like anticoagulants, due to increased risk of bleeding and other adverse effects 1.
Contraindications for Ibuprofen
The contraindications for ibuprofen are based on its mechanism of action, which involves the inhibition of cyclooxygenase enzymes and affects prostaglandin production throughout the body. This can impact various bodily systems, including the gastrointestinal mucosa, renal function, platelet aggregation, and cardiovascular system.
- Severe heart failure: Ibuprofen can worsen heart failure by inhibiting prostaglandin synthesis, which affects kidney function and vascular tone 1.
- History of gastrointestinal bleeding or ulceration: Ibuprofen can increase the risk of gastrointestinal bleeding and perforation, especially in patients with a history of peptic ulcer disease, advanced age, male sex, and concurrent corticosteroid therapy 1.
- Third trimester of pregnancy: Ibuprofen can cause premature closure of the ductus arteriosus and should be avoided in the third trimester of pregnancy 1.
- Severe kidney or liver impairment: Ibuprofen can worsen renal function and should be used with caution in patients with renal insufficiency or compromised fluid status 1.
- Hypersensitivity to ibuprofen or other NSAIDs: Patients with a history of hypersensitivity to ibuprofen or other NSAIDs should avoid ibuprofen due to the risk of allergic reactions, including anaphylaxis 1.
Special Considerations
In addition to the contraindications listed above, ibuprofen should be used with caution in certain patient populations, including:
- Patients with aspirin-sensitive asthma: Ibuprofen may trigger bronchospasm in patients with aspirin-sensitive asthma 1.
- Patients taking anticoagulants: Ibuprofen can increase the risk of bleeding complications when taken with anticoagulants like warfarin or heparin 1.
- Patients with hypertension, heart disease, or fluid retention: Ibuprofen can worsen these conditions by inhibiting prostaglandin synthesis, which affects kidney function and vascular tone 1.
- Patients with inflammatory bowel disease: Ibuprofen may exacerbate symptoms of inflammatory bowel disease 1.
From the FDA Drug Label
Ibuprofen tablets are contraindicated in patients with known hypersensitivity to ibuprofen. Ibuprofen tablets should not be given to patients who have experienced asthma, urticaria, or allergic-type reactions after taking aspirin or other NSAIDs. In the setting of coronary artery bypass graft (CABG) surgery Ibuprofen tablets are contraindicated in patients with previous serious skin reactions to NSAIDs Ibuprofen Tablets are contraindicated in the setting of coronary artery bypass graft (CABG) surgery
The contraindications for Ibuprofen (Nonsteroidal Anti-Inflammatory Drug, NSAID) are:
- Hypersensitivity to ibuprofen
- Patients with a history of asthma, urticaria, or allergic-type reactions after taking aspirin or other NSAIDs
- Coronary artery bypass graft (CABG) surgery
- Patients with previous serious skin reactions to NSAIDs 2, 2, 2
From the Research
Contraindications for Ibuprofen
The following are contraindications for Ibuprofen (Nonsteroidal Anti-Inflammatory Drug, NSAID):
- Patients with treatment-resistant hypertension, high risk of cardiovascular disease, and severe chronic kidney disease (CKD) should avoid NSAIDs whenever possible 3
- Patients with a history of bleeding or gastrointestinal disorders, such as peptic ulcer disease, should use NSAIDs with caution 4, 3
- Patients with pre-existing hypertension receiving renin-angiotensin system blockers should have their blood pressure monitored and may require adjustment of their antihypertensive medication 3
- Patients with cardiovascular disease, such as heart failure or previous myocardial infarction, should use NSAIDs with caution due to the increased risk of adverse cardiovascular events 5, 3
- Patients with renal disease should use NSAIDs with caution due to the potential for worsening renal function 3
Special Considerations
- Patients with a high risk of peptic ulcer disease should use a selective cyclo-oxygenase-2 (COX-2) inhibitor or a non-selective NSAID with a proton pump inhibitor (PPI) 3
- Patients with unexplained iron-deficiency anaemia should be investigated for gastrointestinal bleeding before starting NSAID therapy 3
- Blood pressure and renal function should be monitored in patients taking NSAIDs, especially in those with pre-existing hypertension or renal disease 3