Can Brufen (Ibuprofen) and Cetirizine Be Taken Together?
Yes, Brufen (ibuprofen) and cetirizine can be safely taken together—there are no clinically significant drug interactions between these medications, and they are commonly co-prescribed for conditions involving both pain/inflammation and allergic symptoms.
Safety Profile of the Combination
No documented contraindications exist for the concurrent use of NSAIDs like ibuprofen with cetirizine in clinical practice 1, 2.
Cetirizine is predominantly eliminated renally with a mean half-life of 8.3 hours and has no measurable affinity for receptors other than H1 receptors, making drug-drug interactions uncommon 3.
The British Association of Dermatologists explicitly recommends NSAIDs (specifically diclofenac) alongside antihistamine therapy in certain clinical contexts, demonstrating the safety of this drug class combination 4.
Clinical Context Where This Combination Is Used
Allergic conditions with pain/inflammation: Patients with urticaria, allergic rhinitis, or dermatologic conditions who also have musculoskeletal pain, headache, or fever commonly receive both medications 1, 2.
Post-operative settings: The combination may be used when managing both allergic symptoms and post-procedural pain 4.
Cetirizine 10 mg once daily is the standard adult dose for allergic conditions, while ibuprofen dosing varies by indication (typically 200-800 mg every 6-8 hours for adults) 1, 3.
Important Safety Considerations
For Cetirizine:
Mild sedation occurs in 13.7% of patients (vs 6.3% with placebo), so patients should be counseled about potential drowsiness, especially when starting therapy 1, 2.
Renal impairment requires dose adjustment: In moderate renal impairment (creatinine clearance 10-50 mL/min), reduce cetirizine to 5 mg once daily; avoid entirely in severe renal impairment (CrCl <10 mL/min) 1, 2.
Evening dosing of cetirizine may minimize daytime sedation if drowsiness occurs 1.
For Ibuprofen:
Standard NSAID precautions apply: avoid in patients with active peptic ulcer disease, severe renal impairment, heart failure, or those on anticoagulants without appropriate monitoring.
Ibuprofen should be taken with food to minimize gastrointestinal irritation.
Pregnancy Considerations:
Both medications should ideally be avoided in pregnancy, especially in the first trimester 1, 2.
Cetirizine is FDA Pregnancy Category B, making it a relatively safer antihistamine option if treatment is necessary during pregnancy 1, 5.
NSAIDs like ibuprofen are contraindicated in the third trimester due to risk of premature closure of the ductus arteriosus.
Common Pitfalls to Avoid
Don't assume cetirizine is completely non-sedating—counsel patients about the 13.7% sedation risk and advise caution with driving or operating machinery until individual response is known 2.
Don't forget renal dose adjustments for cetirizine—this is particularly important in elderly patients or those with known kidney disease 1, 2.
Don't overlook gastrointestinal protection with ibuprofen—consider proton pump inhibitor co-prescription in high-risk patients (elderly, history of GI bleeding, concurrent corticosteroid use).
Don't combine with other sedating medications without considering additive CNS effects, as cetirizine can potentiate sedation when used with other CNS depressants 1.
Practical Prescribing Approach
Start with standard doses: Cetirizine 10 mg once daily (preferably in evening if sedation is a concern) and ibuprofen 200-400 mg every 6-8 hours as needed with food 1, 3.
Monitor for sedation during the first few days of cetirizine therapy, particularly if the patient needs to remain alert for work or driving 1.
Assess renal function before initiating therapy, especially in elderly patients, as both medications require dose adjustment or avoidance in renal impairment 1, 2.
Consider duration of therapy: Cetirizine can be used long-term safely for chronic conditions, while ibuprofen should generally be used at the lowest effective dose for the shortest duration necessary 2, 3.