From the Guidelines
I would not recommend taking 400mg of Advil (ibuprofen) at 10am and then 75mg of diclofenac at 5:15pm on the same day, as this combination increases the risk of gastrointestinal, kidney, and cardiovascular side effects, particularly stomach irritation, ulcers, and bleeding, as noted in studies such as 1 and 1.
Risks Associated with NSAID Combination
When taking two NSAIDs together, the risk of adverse effects increases significantly, including:
- Gastrointestinal complications, such as dyspepsia, abdominal pain, and GI bleeding, as reported in 1
- Cardiovascular complications, such as worsening hypertension, myocardial infarction, and stroke, as discussed in 1
- Kidney damage and impaired renal function, as mentioned in 1
Alternative Pain Management Strategies
If you need additional pain relief after taking Advil, consider the following options:
- Acetaminophen (Tylenol), which works through a different mechanism and has a lower risk of gastrointestinal side effects, as suggested in the example answer
- Consult with your healthcare provider to develop a safer and more effective pain management strategy, taking into account your individual risk factors and medical history, as recommended in 1
Important Considerations
- Always wait at least 24 hours after your last dose of one NSAID before taking a different one, to minimize the risk of adverse effects, as implied in 1
- Be aware of the potential interactions between NSAIDs and other medications, such as anticoagulants, corticosteroids, and proton pump inhibitors, as discussed in 1 and 1
From the Research
Interaction Between Advil (Ibuprofen) and Diclofenac
- The provided studies do not directly address the interaction between taking 400mg Advil (ibuprofen) at 10am and then 75mg diclofenac at 5:15pm 2, 3, 4, 5, 6.
- However, it is known that both ibuprofen and diclofenac are nonsteroidal anti-inflammatory drugs (NSAIDs) and their combined use may increase the risk of adverse effects such as gastrointestinal bleeding or renal impairment.
Efficacy and Safety of NSAIDs
- A study comparing the analgesic efficacy of oral ibuprofen at different doses found that 400mg of ibuprofen has similar analgesic efficacy to higher doses for short-term pain relief in adult patients presenting to the emergency department with acute pain 2.
- Another study found that ibuprofen was consistently superior to paracetamol at conventional doses in a range of painful conditions, including acute pain, osteoarthritis, and migraine 3.
- The concomitant use of selective serotonin reuptake inhibitors (SSRIs) and NSAIDs, including diclofenac, has been associated with increased risk of psychiatric contacts and mortality 4.
Synergism Between Paracetamol and NSAIDs
- A study found that the coadministration of paracetamol with NSAIDs, including diclofenac, resulted in synergistic antinociceptive effects in an experimental acute pain model 5.
- However, another study found that binary mixtures of diclofenac with paracetamol, ibuprofen, naproxen, and acetylsalicylic acid induced oxidative stress on the aquatic organism Hyalella azteca, suggesting potential environmental toxicity 6.