Drug interactions
Escitalopram + Ibuprofen
Severity: Major
Escitalopram 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
Combining an SSRI with an NSAID increases the risk of gastrointestinal bleeding well above that of either drug alone. Older patients and those with ulcer history are at greatest risk.
What this interaction means in plain words
Escitalopram 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.
Escitalopram belongs to Central Nervous System; Ibuprofen belongs to Musculoskeletal.
Why it happens
SSRI-related platelet serotonin depletion impairs aggregation, adding to NSAID platelet inhibition and gastric mucosal injury.
What to do
Avoid if possible and use paracetamol for analgesia. If an NSAID is necessary, add a proton pump inhibitor 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
- Anadin Joint Pain 200mg Tablets - SmPC sections 4.3/4.5 (class statement: selective serotonin reuptake inhibitors (SSRIs); "Anti-platelet agents and selective serotonin reuptake inhibitors (SSRIs): increased risk of gastrointestinal bleeding (see section 4.4).") — electronic medicines compendium (UK SmPC)
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 Escitalopram
- Cisapride + Escitalopram Contraindicated
- Citalopram + Escitalopram Contraindicated
- Escitalopram + Isocarboxazid Contraindicated
- Escitalopram + Methylene blue Contraindicated
- Escitalopram + Phenelzine Contraindicated
- Escitalopram + Pimozide Contraindicated
Frequently asked questions
Can I take Escitalopram with Ibuprofen?
MediHelp rates the interaction as major. Escitalopram 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. Combining an SSRI with an NSAID increases the risk of gastrointestinal bleeding well above that of either drug alone. Older patients and those with ulcer history are at greatest risk.
How serious is the interaction between Escitalopram 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 if possible and use paracetamol for analgesia. If an NSAID is necessary, add a proton pump inhibitor 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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