BMJ  2003;327:1298-1299 (6 December), doi:10.1136/bmj.327.7427.1298

Editorial

Giving aspirin and ibuprofen after myocardial infarction

Clinical consequences are still unknown

The first 150 words of the full text of this article appear below.

Aspirin is a highly effective antiplatelet agent that is used by millions of people to reduce cardiovascular morbidity and mortality.1 2 However, a recent pharmacodynamic study showed that ibuprofen, a non-aspirin, non-steroidal, anti-inflammatory drug, can inhibit the antiplatelet effects of aspirin.3 This effect occurred in people who took daily ibuprofen before taking aspirin or in those taking ibuprofen regularly. Participants who took a single daily ibuprofen after aspirin did not exhibit an inhibitory effect. It is therefore possible that ibuprofen, if taken regularly or before daily aspirin, could reduce or even negate the beneficial effects of aspirin. If this interaction is clinically relevant it could have enormous public health implications because non-aspirin nonsteroidals are among the most commonly used drugs in the world.4

Designing studies to address the clinical relevance of this interaction presents some unique challenges. The ideal study would accurately measure the use of aspirin and ibuprofen, both prescription . . . [Full text of this article]

Stephen E Kimmel, associate professor of medicine and biostatistics and epidemiology

(skimmel@cceb.med.upenn.edu)

Brian L Strom, professor of biostatistics and epidemiology

(bstrom@cceb.med.upenn.edu), University of Pennsylvania School of Medicine, Philadelphia, PA 19104-6021, USA


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Rapid Responses:

Read all Rapid Responses

Why prescribe aspirin and Ibuprofen together anyway??
Daniel M Sado
bmj.com, 5 Dec 2003 [Full text]
Why patients at risk of cardiovascular disease should avoid taking non-steroidal anti-inflammatory drugs alone
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