Avoid Mixing Ibuprofen With This Common Medication

When the pain of menstrual cramps, muscle aches, or a pounding headache sets in, many of us reach for over-the-counter (OTC) pain-relief medications. Classified as a nonsteroidal anti-inflammatory drug, ibuprofen is the number one NSAID used most frequently around the globe, according to updated 2023 research published in the National Library of Medicine. The drug works by dampening the body's cellular pain and inflammatory responses.

Just because ibuprofen can be purchased without a prescription doesn't mean it can't produce possible side effects. More mild adverse effects may include constipation, dizziness, bloating, or gas. In more severe cases, ibuprofen use may cause breathing difficulty, an accelerated heart rate, pale skin, a rash, or numerous other potentially serious side effects, particularly in the event of an allergic reaction. In addition to having potential adverse effects, ibuprofen can also interact negatively with other drugs. According to GoodRx Health, this includes one medication commonly taken to reduce bloating by ridding the body of excess fluid: diuretics.

A combination of blood pressure medication, diuretics, and ibuprofen may pose risks to kidney health

While diuretics used for bloating purposes can often be purchased OTC, prescription diuretics are used to help manage high blood pressure, among other health conditions. When taken alongside ibuprofen, however, they can negatively impact kidney function (via GoodRx). 2010 research published in the scientific journal Pharmaceuticals outlines how older adults, particularly those with health conditions like chronic kidney disease or cirrhosis of the liver, who also take a mix of medications, including certain antihypertensive drugs, diuretics, and NSAIDs, may be at an increased risk for kidney failure.

A 2022 study conducted by researchers at the University of Waterloo and published in Mathematical Biosciences revealed similar findings. Using digital simulations, the study team determined that people who utilize renin-angiotensin system (RSA) inhibitors (a type of blood pressure medication) and diuretics should be mindful about taking ibuprofen as it may increase these patients' risk for potentially permanent kidney damage. "It's not that everyone who happens to take this combination of drugs is going to have problems," professor and researcher on the study Anita Layton stated via Science Daily. "But the research shows it's enough of a problem that you should exercise caution."

Dehydration from diuretics is a risk factor for kidney damage

The researchers of the 2022 study described this three-way drug combination of RSA inhibitors, diuretics, and ibuprofen as a "triple whammy" (via Science Daily). They explained that because diuretics and RSA inhibitors rid the body of excess water, this can fuel dehydration. Lack of hydration is a major contributor to cases of acute kidney injury, which occurs in approximately 0.88% to 22% of patients taking all three drugs (via Mathematical Biosciences). Adding an NSAID on top of these drugs diminishes the body's ability to react to excessive fluid depletion.

For this reason, the researchers emphasized the importance of patients taking these medications to alternatively reach for acetaminophen for temporary pain relief. Moreover, it's important to remember that patients who are only able to take ibuprofen for health reasons may be approved to do so under medical supervision while having their kidney health monitored more closely.