Ibuprofen (an NSAID) Questions and Drug Interactions from BJC HealthCare - BJC Help For Your Health

Ibuprofen -- Advil, Motrin -- (A Nonsteroidal Anti-Inflammatory Drug -- NSAID) Questions and Drug Interactions

CAUTION: Take ibuprofen with food or milk to protect the stomach. Make sure all your health care providers have a complete list of your medications, including over-the-counter medications, herbals and vitamins.

First are drug interaction questions about ibuprofen, then general questions about ibuprofen.

Can I take ibuprofen -- Advil, Motrin -- (a nonsteroidal anti-inflammatory drug -- NSAID) with:

Adderall (mixed amphetamines)?	There are interactions possible. Do not take any antihistamine without speaking to your physician first. You may take plain Advil with the Adderall.
Adipex?	Yes. Take Adipex in the morning. If you have high blood pressure or heart problems, inform the prescribing physician.
Afrin (Oxymetazoline)?	Yes. If you have high blood pressure or heart disease, talk to your doctor before using Afrin. Afrin should be used no more than twice a day and not for longer than 3 days. Using more or longer increases the chance of rebound congestion. Take Motrin as needed with food or milk to prevent stomach upset.
Albuterol (Proventil)?	Yes. Take ibuprofen with food or milk and only as needed. Use albuterol as prescribed by your doctor.
Allegra?	Yes. Take these only as needed, and ibuprofen with food or milk.
Allegra D?	Yes.
Ambien (Zolpidem)?	Yes. Take Ambien only at bedtime. Ambien is only approved for short-term use. Avoid alcohol.
Amoxicillin?	Yes. Take the antibiotic until finished and ibuprofen as needed.
Amrix (Cyclobenzaprine)?	Yes. Amrix can cause drowsiness. Take these as prescribed.
Aspirin?	No. You should not take aspirin with NSAIDs.
Augmentin?	Yes. Take both with food. Take the antibiotic until finished.
Augmentin and Phenergan DM Syrup?	Yes. Take Phenergan DM as needed. Drink plenty of water. Take ibuprofen and Augmentin with food or milk. Take ibuprofen as needed. Take the antibiotic until finished.
Azithromycin (Zithromax)?	Yes. If you have high blood pressure or heart disease, speak to your physician before taking any oral decongestant.
Benadryl?	Yes.
Celebrex?	No, as both are nonsteroidal anti-inflammatory drugs (NSAIDs). Take the Celebrex as directed by your physician, usually once daily. Take acetaminophen (Tylenol) if you have additional pain.
Celebrex 200, Plaquenil and Percocet?	Are different physicians prescribing these medications? Do all your physicians know all the prescriptions you have? Watch for unusual bleeding with the Celebrex. You need to give all your physicians a complete medication list. And limit your acetaminophen to 3000mg per day or less.
Cheratussin AC?	Yes. Cheratussin AC can cause drowsiness. Drink plenty of water.
Cipro (Ciprofloxacin), Alprazolam (Xanax) and Cytotec (Misoprostol)?	The only documented interaction is in patients prone to seizures. Taking Cipro, or any quinolone antibiotic, with NSAIDS like ibuprofen, increases the risk and chance of seizure. If you do not have problems with seizures, there should be no issue. Take alprazolam and ibuprofen as needed. Take Cipro until the prescription is completed. Follow your physician's instructions on when to take Cytotec.
Claritin?	Yes. Drink plenty of water with the Claritin.
Clidinium (Librax)?	Yes. Clidinium can cause drowsiness.
Colchicine?	Yes. This combination can irritate the GI tract.
Coricidin?	Yes. This antihistamine can cause drowsiness. If you are a male with prostate problems, avoid antihistamines unless your physician prescribes them for you.
Cyclobenzaprine ER (Amrix)?	Yes. They may be taken together. Take Advil with food or milk to prevent stomach upset. Cyclobenzaprine will cause drowsiness. Be careful if you must be alert.
Delsym (Dextromethorphan)?	Yes. Take Advil with food or milk and Delsym not more than twice daily, only as needed.
Deplin?	Yes, but not at the same time. It could lower the effectiveness of the Deplin. Take ibuprofen a couple hours after Deplin.
Diclofenac?	Yes. Both are pain-relievers that can upset your stomach.
Dimetapp?	Yes. Take both only as needed. Take Motrin with food or milk to avoid stomach upset. Dimetapp can cause drowsiness. If you have high blood pressure or heart problems, talk to your doctor before taking any OTC nasal decongestant such as pseudoephedrine.
Dimetapp DM?	Yes. Dimetapp can cause drowsiness.
Donnatal Elixir?	Yes. Donnatal, a combination of antispasmodics and phenobarbital, can cause drowsiness.
Effexor (Venlafaxine)?	There have been articles documenting a drug interaction that may result in an increased risk of bleeding. It appears those at risk have history of ulcers or other bleeding disorders. Talk to your doctor.
Effient (Prasugrel), Metoprolol (Lopressor, Toprol) and Zyrtec (Cetirizine)?	An interaction is possible, but Motrin and antihypertensive agents, including metoprolol (drugs that treat high blood pressure), are often used together. Long-term Motrin use can decrease an antihypertensive's ability to control blood pressure, especially in older patients. If you take Motrin and antihypertensives together for long periods, your health care provider may monitor your blood pressure more regularly to make sure it is well-controlled. If you check your own blood pressure at home and notice an increase in your blood pressure, contact your doctor. Effient taken with Motrin can cause increased risk of bruising and bleeding. If you notice this, contact your doctor. There are no problems with Zyrtec and any of the medications. Take Motrin and Zyrtec as needed.
Excedrin Back and Body, alternating with Advil?	Yes, as long as you are not allergic to aspirin. Every six hours is good spacing. Take both with food or milk.
Excedrin (Acetaminophen, Aspirin, Caffeine), Zoloft (Sertraline), Vicodin (Hydrocodone with Acetaminophen) and Voltaren (Diclofenac)?	There are several possible problems with this group of medications. You have a duplication of NSAIDs with Voltaren and Advil. Do not take both. Voltaren is a more potent and longer-acting drug. NSAIDs, Excedrin and Vicodin can irritate the stomach. Zoloft can add to stomach irritation and may cause bleeding if used regularly with the others. Two medications have acetaminophen. It is easy to take more than the daily recommendation (3000mg) of acetaminophen when you take multiple drugs that contain this product. Do not stop taking Zoloft without physician direction. Talk to your physician about your back pain and inflammation. Consider taking your complete list of drugs to your pharmacist for help with a medication plan that will limit the chance of GI irritation and bleeding, keep you from exceeding the daily limit of Tylenol, but still keep your pain and inflammation controlled.
Flexeril?	Yes. Flexeril can cause drowsiness.
Lasix (Furosemide), Mucinex DM and Zyrtec?	Take Advil at least 4-6 hours away from the Lasix, because the NSAID (Advil) can decrease the diuretic and antihypertensive effects of the Lasix. You may take Tylenol (acetaminophen) with the Lasix.
Lunesta (Eszopiclone)	Yes. The Lunesta is only indicated for sleep so take this at bedtime.
Levoxyl (Synthroid or Levothyroxine)?	Yes. Take Levoxyl early in the morning on an empty stomach.
Librax?	Yes. Take them if you do not have any allergies to these to medications.
Lipitor (Atorvastatin)?	Yes. Take Lipitor every day at the same time.
Metformin (Glucophage)?	Yes, but not at the same time. Ibuprofen needs to be taken with food to protect the stomach. Taking Metformin with food may result in reduced extent and rate of its absorption. Take several hours apart.
Methocarbamol (Robaxin)?	Yes. They are commonly prescribed together. Methocarbamol is a muscle relaxant that can cause drowsiness. Take ibuprofen with food or milk to avoid stomach upset.
Methocarbamol (Robaxin) and Naproxen (Naprosyn)?	Methocarbamol is a muscle relaxant that can cause drowsiness. You can take it with either naproxen OR ibuprofen, as these are NSAIDs (nonsteroidal anti-inflammatory drugs). Do not take naproxen and ibuprofen at the same time. Take NSAIDs with food or milk.
Mobic (Meloxicam)?	No. These drugs may represent duplicative therapies. If the Mobic is not completely working, add acetaminophen (Tylenol) to help relieve pain.
Mucinex?	Yes. Drink plenty of fluids.
Naproxen (Naprosyn)?	Do not take both ibuprofen and naproxen at the same time. They are both NSAIDs. You could take them on alternate days, but they have different durations of action and should not be used in the same day for safety reasons. Take each of these with food or milk to avoid stomach upset.
Norco (actaminophen with hydrocodone)?	Yes. Take the Advil with food or milk.
NyQuil?	Yes. Some NyQuil formulas have alcohol in them and can make you drowsy.
NyQuil and Sudafed (pseudoephedrine)?	No direct drug interactions, but there is a duplication. Sudafed is an ingredient in most NyQuil formulas. There is no need to take both. If you have heart disease or high blood pressure, you should not take either NyQuil or Sudafed before talking to your doctor. Ibuprofen may be taken with either NyQuil or Sudafed.
Penicillin and Tylenol with Codeine	Yes. They may all be taken together. Take the penicillin until finished, and the others as needed. Take ibuprofen with food or milk, and be careful if you must be alert when taking anything with codeine.
Promethazine DM Syrup (Phenergan DM)?	Yes. They may be taken together if needed. Take each only as needed. Take Advil with food or milk. Promethazine DM can cause drowsiness, so be careful if you must be alert.
Promethazine with Codeine?	Yes. There is a side effect of stomach problems. Promethazine with codeine can cause drowsiness.
Inderal (Propranolol)	Although an interaction is possible, Advil (ibuprofen) and antihypertensive agents (drugs which reduce high blood pressure like propranolol like Inderal) are often used together.
Sleeping Pills?	If you are inquiring about Advil and diphenhydramine -- the safest and most frequently recommended sleep aid -- the answer is yes. Advil can be purchased with diphenhydramine in one tablet (Advil PM). I cannot recommend sleeping medications.
Soma (Carisoprodol)?	Yes. They may be taken together. Soma can cause drowsiness. Take Motrin with food or milk to avoid stomach upset. Take these as needed unless otherwise instructed by your physician.
Sudafed?	Yes. If you have high blood pressure or heart disease, talk to your doctor before taking any Sudafed product.
Triaminic?	Yes. Motrin can be taken with any of the Triaminic formulations.
Tussin DM (Robitussin DM, Guaifenesin with Dextromethorphan)?	Yes. They may be taken together if needed. Take each only as needed. Take ibuprofen with food or milk and tussin DM with plenty of water.
Ultram?	Yes. Ultram can make you drowsy. Be careful if you must be alert.
Vicodin?	I would not recommend taking these two drugs simultaneously, as they both can cause stomach distress and should be taken with food or milk. Talk with your physician before mixing the two.
Vicodin (Hydrocodone with Acetaminophen) and Methocarbamol (Robaxin)?	Concurrent use of centrally acting muscle relaxants (methocarbamol) and opioid analgesics (Vicodin) can result in additive respiratory depression. If you have trouble breathing, contact your physician. These can cause drowsiness. Take only as needed.
Wine?	Both alcohol and any NSAID (nonsteroidal anti-inflammatory drug) -- like ibuprofen -- can irritate the stomach. The more irritants you add at the same time, the more likely you are to have a problem. Alcohol will not directly interact with ibuprofen.
Zanaflex (Tizanidine)?	Yes.
Zithromax?	Yes.
Zoloft (Sertraline)?	There are some documented cases involving interactions with ibuprofen and Zoloft. It can be dangerous if you are prone to ulcers or bleeding. An alternative to ibuprofen is Tylenol (acetaminophen).
Zoloft and Mirapex?	Ibuprofen (or any NSAID -- nonsteroidal anti-inflammatory drug) when taken with Zoloft (sertraline) or any SSRI (selective serotonin reuptake inhibitor) can cause an increase risk of bleeding. If prescribed by the same physician and you take the ibuprofen infrequently with plenty of food or milk, you most likely would not notice a problem. If you take them regularly or if they were prescribed by different doctors, be careful and talk to your doctors.
Zyrtec, Mucinex DM and Lasix?	Lasix (furosemide), a diuretic, and ibuprofen, an NSAID, can be taken together, but not at the same time. Wait 4-6 hours between taking these medications, because the Advil can decrease the diuretic and antihypertensive effects. You may take Tylenol (acetaminophen) with the Lasix.
Zyrtec (Cetirizine) and Triprolidine?	Take Advil with either cetirizine OR triprolidine, but not both, as they are both antihistamines. Take one or the other. Cetirizine is a long-acting product that has a better side effect profile and causes less drowsiness than triprolidine. Drink plenty of water with the antihistamines. Take only as needed.

Is it safe to take ibuprofen while taking lisinopril (10mg), hydrochlorothiazide (25mg) and cyclobenzaprine (10mg)?
Although an interaction is possible, ibuprofen and antihypertensive agents are often used together. Long-term use of ibuprofen may decrease the ability of antihypertensives to control your blood pressure, especially in older patients. The cyclobenzaprine (Flexeril) does not have any direct drug interactions with the other three. Ibuprofen, as well as all NSAIDS, may increase the risk of serious cardiovascular thrombotic events, heart attacks and stroke. This is rare but has been reported.

I have been prescribed Cytotec. How long after taking it do I need to wait to take an NSAID?
Cytotec (misoprostol) starts working in about 30 minutes after taking a dose and hits maximum effect within 60-90 minutes. So if you take your NSAID between 30-60 minutes, you should be fine.

Does loratadine have ibuprofen in it?
There is nothing but loratadine (Claritin or Alavert) in a plain loratadine tablet. There are some formulations of loratadine that include a decongestant (pseudoephedrine), but none have ibuprofen (Motrin).

Can I take Medrol and diclofenac at the same time?
Both Medrol and diclofenac are anti-inflammatory medications. Normally these are not given together. Although an interaction is possible, these drugs may be used together for short periods of time. Side effects such as stomach upset, nausea, or heartburn may get worse if you also take a steroid medication (like Medrol), especially if taken together for prolonged periods of time. There are topical diclofenac products that would not interact with the Medrol at all.

Can I take ibuprofen with metoprolol, pantoprazole and fluoxetine?
There are some possible interactions with this list. The fluoxetine (Prozac) may interact with both the ibuprofen (Motrin) and metoprolol (Toprol or Lopressor). Although an interaction is possible, these drugs may be used together. With the metoprolol, if your heart rate or blood pressure drops too low while taking these drugs, you may become dizzy or feel faint; do not stand or sit up too quickly. With the ibuprofen (or other NSAIDS) report stomach irritation that continues to be bothersome, or any signs of bleeding (like unusual dark tarry stools) to your doctor right away. Then with both the ibuprofen and metoprolol together, long-term use of ibuprofen may decrease the ability of antihypertensives (like metoprolol) to control your blood pressure, especially in older patients. The pantoprazole (Protonix) is fine with any of the others on your list. Always take the ibuprofen with food or milk.

Would ibuprofen trigger blood sugar to go up?
There are no warnings or medical articles indicating that ibuprofen has any direct relationship to increased blood sugar. One issue that can affect diabetics taking NSAIDS like ibuprofen, is that kidney function can be affected by long-term NSAID use. Talk to your physician if you have unexplained out-of-normal blood sugar readings. Limit your daily intake of ibuprofen to no more than 3000mg per day. Always take NSAIDS with food or milk.

Can I take prescription strength Allegra with Advil Cold & Sinus?
Yes. There are no direct drug interactions between Allegra (fexofenadine) and Advil Cold & Sinus (ibuprofen with pseudoephedrine). They may be taken together if needed. The Advil product should be taken with food or milk. If you have high blood pressure or heart problems, talk to you doctor before taking any oral decongestant like pseudoephedrine.

Does methocarbamol have ibuprofen in it?
There is no ibuprofen in methocarbamol (Robaxin), a muscle relaxant. They may be taken together if needed. Take ibuprofen with food. Methocarbamol can cause drowsiness.

Does Motrin (ibuprofen) have aspirin in it?
No. Motrin is a nonsteroidal, anti-inflammatory drug (NSAID) that is in the class of medications called propionic acids. Aspirin is also an NSAID, but is in the salicylate class. They both have similar side effects. There is a chance of cross allergies. They are both indicated for similar problems. The advantage the propionic acids have is the patient can take less to get the same result as aspirin. So, the side effects are less. Both should be taken with food or milk and if you are allergic to one, I would suggest avoiding the other.

Does NyQuil have ibuprofen in it?
No. Vicks NyQuil has many different formulas but none contain ibuprofen. They all have acetaminophen for pain and fever, a cough suppressant (dextromethorphan) and an antihistamine (doxylamine). There is also alcohol, sodium, various sugars , flavors and colors. Take only as needed.

Instead of taking 2 hc-ibuprofen can I take one and a couple hours later take a Tylenol #3?
I assume you mean hydrocodone-ibuprofen and Tylenol with codeine #3. Talk with your physician about taking the Tylenol with codeine. Some doctors suggest alternating various pain relievers for added effect or to avoid stomach problems.