The Anticoagulant Effect of Ibuprofen and Interactions Including Anticoagulants

Ibuprofen (IBU) is a non-steroidal anti-inflammatory drug (NSAID). A clinician wishing to appropriately control more moderate to severe pain may consider a combination of orally administered ibuprofen (IBU) and acetaminophen for pain control. In dentistry, it is commonly recommended to take oral IBU 400 - 800 mg and acetaminophen 325 - 1000 mg to control postoperative pain following third molar extraction(s). This combination can avoid the use of a narcotic prescription for pain control. However, many patients are taking anticoagulants for a variety of medical conditions and are told not to take IBU, fearing an additive effect of IBU with the anticoagulant. This paper addresses the anticoagulant effects of IBU when administered as a single agent and the interactions with orally administered anticoagulant, antiplatelet, or antithrombotic agents. Ibuprofen may be taken by patients taking anticoagulants for 2 - 5 days without significant interaction. Nonetheless, the prudent clinician should ensure the patient is compliant and that alternative pain medications have been considered.