Patients taking aspirin to reduce risk of second stroke 'should avoid ibuprofen'

Daily Mail UK

Aspirin helps prevent the blood from thickening in stroke patients

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Patients who take aspirin to reduce their risk of having another stroke should avoid taking ibuprofen to relieve pain, say researchers.

They found aspirin stopped working effectively when patients took the two drugs together.

In a group of patients seen by doctors at the Dent Neurologic Institute in New York, 28 patients were identified as taking both aspirin and ibuprofen daily and all were found to have no anti-platelet (thinning) effect from their daily aspirin.

Thirteen of these patients were being seen because they had a second stroke while taking aspirin and ibuprofen, and were aspirin resistant at the time of that stroke.

The researchers from Buffalo University found that when 18 of the 28 patients returned for a second neurological visit after discontinuing ibuprofen use and were tested again, all had regained their aspirin sensitivity and its ability to prevent blood platelets from aggregating and blocking arteries.

The study is the first to show the clinical consequences of the interaction between aspirin and ibuprofen in patients being treated for prevention of a second stroke.

The NHS currently warns that ibuprofen might make aspirin less effective, but states the current level of evidence is not sufficient to make clear recommendations.

"It's unfortunate that clinicians and patients often are unaware of this interaction," lead author Professor Francis M. Gengo said.

"Whatever number of patients who have had strokes because of the interaction between aspirin and NSAIDs (ibuprofen), those strokes were preventable.

"The results showed that platelets resumed aggregating within 4-6 hours when aspirin and ibuprofen were taken close together, leaving patients with no anti-platelet effect for 18-20 hours a day. Normally, a single dose of aspirin has an effect on platelet aggregation for 72-96 hours," he said.

"When I lecture to pharmacy students, I tell them 'Please, you have a responsibility to the patients you care for. When you counsel a patient taking aspirin to lower stroke risk, tell patients they may have some transient headaches, but to avoid ibuprofen. You may have prevented that patient from having another stroke.'"

The study was supported by the Dent Family Foundation.

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