Ibuprofen

Cross reactivity between aspirin and NSAIDs including bronchospasm reported in aspirin-sensitive patients. Ibuprofen should not be administered to patients with aspirin sensitivity.

NSAIDs with benazepril may result in deterioration of renal function and acute renal failure, especially in elderly or volume-depleted patients. Antihypertensive effect may be attenuated.

NSAID co-administration with clopidogrel increases risk of gastrointestinal bleeding.

Ibuprofen produces elevation of plasma lithium levels and reduction in renal lithium clearance, increasing risk of lithium toxicity. Mean minimum lithium concentration increased 15% and renal clearance decreased 19%.

NSAIDs competitively inhibit methotrexate accumulation and may enhance methotrexate toxicity. Caution should be used when administered concomitantly.

NSAIDs may result in deterioration of renal function, acute renal failure, and attenuated antihypertensive effect in elderly, volume-depleted, or renal-impaired patients.

Ibuprofen increases pemetrexed exposure (AUC) and increases risk of toxicity in patients with mild to moderate renal impairment (CrCl 45-79 mL/min). Avoid ibuprofen for 2 days before, day of, and 2 days after pemetrexed administration.

Ibuprofen increases pemetrexed AUC and toxicity risk, especially in patients with mild to moderate renal impairment (CrCl 45-79 mL/min). Avoid ibuprofen for 2 days before, day of, and 2 days after pemetrexed administration.

Ibuprofen increases pemetrexed AUC and increases risk of pemetrexed toxicity in patients with mild to moderate renal impairment (CrCl 45-79 mL/min). Avoid ibuprofen for 2 days before, day of, and 2 days after pemetrexed administration.

NSAIDs may result in deterioration of renal function including possible acute renal failure in vulnerable patients. May attenuate antihypertensive effect of valsartan.

Bleeding has been reported when ibuprofen and warfarin are administered together. Effects on GI bleeding are synergistic, with combined use carrying higher risk of serious GI bleeding than either drug alone.

CYP3A4 inhibitor that increases carbamazepine plasma levels; close monitoring and dosage adjustment may be required.

Increases digoxin concentrations; magnitude unclear. Requires monitoring and dose adjustment.

NSAIDs with escitalopram may potentiate bleeding risk; inform patients of increased bleeding risk.

NSAIDs may cause renal function deterioration and acute renal failure in elderly, volume-depleted, or renally compromised patients; may attenuate antihypertensive effect.

NSAIDs may deteriorate renal function in elderly, volume-depleted, or renally compromised patients, and may attenuate antihypertensive effect of fosinopril. Periodic renal function monitoring recommended.

Ibuprofen can reduce the natriuretic effect of furosemide. Patient should be observed for signs of renal failure and to assure diuretic efficacy.

NSAID that may increase glucose-lowering effect of glimepiride, increasing susceptibility to hypoglycemia.

Interferes with platelet aggregation and may induce bleeding. Use with caution; dose reduction of antiplatelet agent or heparin recommended.

NSAID decreases renal blood flow, resulting in decreased renal clearance and increased serum lithium concentrations.

May increase serum potassium levels. Closely monitor potassium levels in patients receiving concomitant NSAIDs.

NSAIDs inhibit folate-dependent enzymes in laboratory experiments.

NSAIDs may diminish the antihypertensive effect of beta-blockers.

Ibuprofen can reduce the natriuretic effect of thiazide diuretics. Patient should be observed for signs of renal failure and to assure diuretic efficacy.

Co-administration of cimetidine with ibuprofen had no substantive effect on ibuprofen serum concentrations in human volunteer studies.

Misoprostol has no clinically significant effect on the kinetics of ibuprofen.

Co-administration of ranitidine with ibuprofen had no substantive effect on ibuprofen serum concentrations in human volunteer studies.

Terazosin has been used concomitantly with ibuprofen in at least 50 patients with no interactions observed.

Used concomitantly with terazosin in at least 50 patients with no interactions observed.

Ibuprofen is a CYP2C9 substrate that may interact with desogestrel metabolism. Clinical relevance of this interaction is unknown.