Drug interactions
Clopidogrel + Ibuprofen
Severity: Major
Clopidogrel and Ibuprofen: major interaction.
Last updated Sources: UK SmPC
For healthcare professionals — reference only. This page is a brief summary, not medical advice and not a substitute for official labeling or clinical judgement. Always verify before prescribing or dispensing.
Summary
Both drugs impair platelet function and ibuprofen can injure the gastric mucosa, so combined use increases the risk of gastrointestinal and other bleeding. Ibuprofen may also interfere with the antiplatelet effect of some antiplatelet agents.
What this interaction means in plain words
Clopidogrel and Ibuprofen can interact in a way that may be serious. Using them together is sometimes necessary, but it needs a deliberate decision by the prescriber, a plan for monitoring, and clear advice on the warning signs to watch for.
Clopidogrel belongs to Cardiovascular; Ibuprofen belongs to Musculoskeletal.
Why it happens
Additive platelet inhibition (P2Y12 blockade plus COX-1 inhibition) with NSAID-induced mucosal injury.
What to do
Avoid regular ibuprofen with clopidogrel and use paracetamol where possible. If an NSAID is required, consider gastroprotection with a proton pump inhibitor that has little CYP2C19 inhibition, such as pantoprazole, and monitor for bleeding.
What to ask your pharmacist
- Does the benefit of taking both outweigh the risk in my case?
- Do I need any blood test, ECG or other check while on both?
- What early warning signs should I watch for, and what should I do if they appear?
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References
Other interactions of Ibuprofen
- Ibuprofen + Ketorolac Contraindicated
- Ibuprofen + Ketorolac intranasal Contraindicated
- Acemetacin + Ibuprofen Major
- Alteplase + Ibuprofen Major
- Amiloride + Ibuprofen Major
- Apixaban + Ibuprofen Major
Other interactions of Clopidogrel
Frequently asked questions
Can I take Clopidogrel with Ibuprofen?
MediHelp rates the interaction as major. Clopidogrel and Ibuprofen can interact in a way that may be serious. Using them together is sometimes necessary, but it needs a deliberate decision by the prescriber, a plan for monitoring, and clear advice on the warning signs to watch for. Both drugs impair platelet function and ibuprofen can injure the gastric mucosa, so combined use increases the risk of gastrointestinal and other bleeding. Ibuprofen may also interfere with the antiplatelet effect of some antiplatelet agents.
How serious is the interaction between Clopidogrel and Ibuprofen?
MediHelp rates it major, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Avoid regular ibuprofen with clopidogrel and use paracetamol where possible. If an NSAID is required, consider gastroprotection with a proton pump inhibitor that has little CYP2C19 inhibition, such as pantoprazole, and monitor for bleeding.
What other medicines interact with Ibuprofen?
MediHelp also lists interactions of Ibuprofen with, for example, Ketorolac, Ketorolac intranasal, Acemetacin. The full list is on the Ibuprofen page.
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