Moderate
Established
Mô tả
Ibuprofen can block aspirin's irreversible platelet inhibition by competing for the same COX-1 active site, potentially reducing aspirin's cardioprotective effect.
Cơ chế
Ibuprofen reversibly occupies the COX-1 active site before aspirin can acetylate Ser530, preventing the irreversible platelet inhibition needed for aspirin's antiplatelet effect.
Ý nghĩa lâm sàng
FDA has warned that regular ibuprofen use (≥3 consecutive days) may attenuate the cardioprotective benefit of low-dose aspirin; single-dose or intermittent use carries less risk.
Xử trí
If both are needed, administer aspirin at least 30 minutes before or 8 hours after ibuprofen; consider alternative analgesics in patients on antiplatelet aspirin therapy.