The interaction of ibuprofen and diclofenac with aspirin in healthy volunteers

Authors

  • MP Schuijt,

    1. Clinical Chemistry, Canisius Wilhemina Hospital, Nijmegen, The Netherlands, and
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    • Present address: Clinical Chemistry, Slingeland Hospital, Doetinchem, The Netherlands.

  • HWHA Huntjens-Fleuren,

    1. Clinical Pharmacy, Canisius Wilhemina Hospital, Nijmegen, The Netherlands
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  • M De Metz,

    1. Clinical Chemistry, Canisius Wilhemina Hospital, Nijmegen, The Netherlands, and
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  • EJ Vollaard

    Corresponding author
    1. Clinical Pharmacy, Canisius Wilhemina Hospital, Nijmegen, The Netherlands
      Dr EJ Vollaard, Clinical Pharmacy A16, Canisius Wilhelmina Hospital, Weg door Jonkerbos 100, Nijmegen 6532 SZ, The Netherlands. E-mail: h.vollaard@cwz.nl
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Dr EJ Vollaard, Clinical Pharmacy A16, Canisius Wilhelmina Hospital, Weg door Jonkerbos 100, Nijmegen 6532 SZ, The Netherlands. E-mail: h.vollaard@cwz.nl

Abstract

Background and purpose:  Aspirin reduces the risk of myocardial infarction and stroke by inhibiting thromboxane production in platelets. This inhibition can be competitively antagonized by some non-steroidal anti-inflammatory drugs (NSAIDs).

Experimental approach:  By measuring thromboxane B2 production in healthy volunteers, we investigated whether ibuprofen (800 mg three times daily for 7 days) or diclofenac (50 mg three times daily for 7 days) taken concurrently with aspirin 80 mg (once daily for 7 days) influenced the inhibitory effect of aspirin. The effects were compared with aspirin 30 mg (once daily for 7 days), which is the lowest dose of aspirin with a proven thromboprophylactic effect.

Key results:  The median percentage inhibition of thromboxane B2 levels by 30 mg or 80 mg aspirin was 90.3% (range 83.1–96.0%) and 98.0% (range 96.8–99.2%) respectively. The inhibition by concurrent administration of slow release diclofenac and 80 mg aspirin was 98.1% (range 97.2–98.9%), indicating no interference between aspirin and diclofenac. The inhibition decreased significantly by concurrent administration of immediate release ibuprofen and 80 mg aspirin (86.6%; range 77.6–95.1%) to a level less than 30 mg aspirin.

Conclusions and implications:  As alternatives are easily available, NSAIDs such as diclofenac should be preferred to ibuprofen for combined use with aspirin.

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