Ibuprofen leads to inhibition of cardioprotective effects
of aspirin
Ibuprofen might limit the cardioprotective effect of
aspirin, new research shows.
Researchers from the University of Pennsylvania
investigated whether or not anti-inflammatory drugs inhibited the effects
of aspirin. They explain that aspirin binds irreversibly to cyclo-oxygenase-1
(COX-1) in a narrow channel in the enzyme. Non-steroidal anti-inflammatory
drugs (NSAIDs) bind reversibly in the same channel, giving potential for
a competitive interaction.
The researchers found that ibuprofen blocked aspirin's
inhibition of COX-1 and its impairment of platelet aggregation. "The inhibitory
effects of daily low-dose aspirin on platelets are competitively inhibited
by the prolonged use of multiple daily doses of ibuprofen, even when aspirin
is administered before the first dose of the NSAID," they say. They expect
that indomethacin will have the same effect.
However, twice-daily delayed-release diclofenac
did not inhibit aspirin's antiplatelet effect. The COX-2 inhibitor, rofecoxib
(Vioxx), was found to have no effect on aspirin's antiplatelet activity,
and neither did paracetamol.
The study is published in The New England Journal
of Medicine (2001;345:1809).
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