BUFFALO, N.Y. -- Stroke patients who use ibuprofen for arthritis pain or other conditions while taking aspirin to reduce the risk of a second stroke undermine aspirins ability to act as an anti-platelet agent, researchers at the University at Buffalo have shown.
In a cohort of patients seen by physicians at two offices of the Dent Neurologic Institute, 28 patients were identified as taking both aspirin and ibuprofen (a nonsteroidal anti-inflammatory drug, or NSAID) daily and all were found to have no anti-platelet effect from their daily aspirin.
Thirteen of these patients were being seen because they had a second stroke/TIA while taking aspirin and a NSAID, and were platelet non-responsive to aspirin (aspirin resistant) at the time of that stroke.
The researchers found that when 18 of the 28 patients returned for a second neurological visit after discontinuing NSAID 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 aspirin/NSAID interaction in patients being treated for prevention of a second stroke, and presents a possible explanation of the mechanism of action.
The Food and Drug Administration currently warns that ibuprofen might make aspirin less effective, but states that the clinical implications of the interaction have not been evaluated.
This interaction between aspirin and ibuprofen or prescription NSAIDs is one of the best-known, but well-kept secrets in stroke medicine, said Francis M. Gengo, Pharm.D., lead researcher on the study.
Its unfortunate that clinicians and patients often are unaware of this interaction. Whatever number of patients who have had strokes because of the interaction between aspirin and NSAIDs, those strokes were preventable.
Gengo is professor of neurology in the UB School of Medicine
|Contact: Lois Baker|
University at Buffalo