All Summaries of Evidence: 30 March 2020 Is it safe to use ibuprofen in the pharmacological treatment of a patient with COVID-19?

Is it safe to use ibuprofen in the pharmacological treatment of a patient with COVID-19?

What is the best evidence currently?

Ibuprofen is typically precribed for patients with pain or fever. As these may be symptoms of COVID-19, ibuprofen has been prescribed by some doctors in this context also.On March 11 2020, a commentary was published in the Lancet hypothesising that ibuprofen may raise the risk of being infected with COVID-19. Subsequently, the French Minister of Health advised via social media to avoid ibuprofen and other anti-inflammatories because they could be “an aggravating factor” in COVID-19 infections. No evidence for this advice was put forward. Some experts in the UK and France have advised that paracetamol should be considered instead as a first choice for treatment rather than ibuprofen but cautioned that more research is needed.

Both the Food and Drug Administrationand the European Medicines Agency have stated that they are not aware of any negative effects of ibuprofen given to COVID-19 patients, apart from the usual known side-effects that limit its use in certain populations. The HPSC states thatthere are no contraindications for ibuprofen use. However, it is noted that ibuprofen might mask COVID-19 symptoms and should be avoided in cases when an individual has been or is believed to have been in contact with someone infected with COVID-19, or for healthcare workers returning to Ireland after 16th March 2020.

Furthermore, the World Heath Organization is making no recommendation against the use of ibuprofen at this time. Both the Health Service Executive and the National Health Service have stated that there is no strong evidence that NSAIDs such as ibuprofen could worsen COVID-19 or have a negative impact on disease outcome.Both health services note that paracetamol is usually recommended as the first-line treatment for most people but that ibuprofen is safe to take if doing so on doctor’s advice. UpToDate state that there have been no clinical or population-based data that directly address the risk of NSAIDs in the context of COVID-19 and it also confirms that the World Health Organization and the European Medicines Agency do not recommend that ibuprofen be avoided.

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Authors

Ronan Hegarty, Librarian, Naas General Hospital[Author]; Caitriona Lee, Information Specialist, Health Research Board[Author]; Margaret Morgan, Librarian, Midland Regional Hospital Mullingar [Author]; Siobhan Egan, Clinical Research Unit, University Hospital Limerick [Clinical Advisor]; Brendan Leen, Regional Librarian, HSE South, St. Luke’s General Hospital, Kilkenny [Editor]

Refereneces

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