IBUPROFEN MAY HINDER ASPIRIN'S PROTECTION AGAINST HEART ATTACKS

Patients who take low-dose aspirin to help prevent heart attacks may interfere with that protection if they also take the painkiller ibuprofen, according to an FDA announcement.

In a background paper released Sept. 8, CDER said that healthcare professionals should advise consumers and patients on the appropriate use of aspirin and ibuprofen in combination. Aspirin is used "for secondary prevention of myocardial infarction," the paper noted.

The paper pinpointed a pharmacodynamic interaction between low-dose aspirin (81 mg per day) and 400 mg of ibuprofen, which may interfere with the "antiplatelet cardioprotective effect" of aspirin. For example, a study published in the New England Journal of Medicine in 2001 showed that the antiplatelet effect of enteric-coated low dose aspirin is lessened when the patient takes 400 mg ibuprofen two, seven and 12 hours after the aspirin.

Other nonselective over-the-counter nonsteroidal anti-inflammatory drugs may also interfere with the antiplatelet effect of low-dose aspirin unless proven otherwise, the paper added. It recommended that healthcare professionals consider analgesics, such as acetaminophen, that do not interfere with the antiplatelet effect of low-dose aspirin for populations at high risk of cardiovascular events.

The background paper and related information can be seen at www.fda.gov/cder/drug/infopage/ibuprofen/default.htm (http://www.fda.gov/cder/drug/infopage/ibuprofen/default.htm).