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Drug Info

Can you take ibuprofen with Paxlovid?

Yes, it is generally safe to take ibuprofen during a course of Paxlovid
By | Aug. 15, 2024
An ibuprofen tablet and an Rx pill: Can you take ibuprofen with Paxlovid?

Key takeaways

  • Paxlovid is a newly popular pill for fighting COVID-19, and ibuprofen is a longtime anti-inflammatory drug used for analgesia and fever reduction.

  • Taking Paxlovid along with ibuprofen does not create any direct drug interactions between the two or negate the beneficial effects of either medicine.

  • Interactions with other drugs are a major concern with Paxlovid and ibuprofen, and the side effect potential of ibuprofen is significant, meaning that the decision to take each medication must be made carefully and with the medical advice of a healthcare professional.

  • Underlying health conditions, like kidney disease, can make Paxlovid and ibuprofen use more dangerous, and as a result, some people will need to avoid one or both of these drugs.

In this article:

The antiviral medication Paxlovid (nirmatrelivir and ritonavir) gained popularity during the rise of COVID-19 rates. Ibuprofen, the popular nonsteroidal anti-inflammatory drug (NSAID), has been a popular pick for decades when relief from aches or fever is needed. Fortunately, ibuprofen can be taken with Paxlovid in some cases. However, safe use depends on the situation. Here, we’ll explore appropriate use and highlight situations where this combination should be avoided.

Can you take ibuprofen with Paxlovid?

According to the Medscape Drug Interaction Checker, Paxlovid and ibuprofen do not interact. This means that the two drug compounds do not negatively impact one another when taken together, regardless of the dose.

However, drug interactions are a major issue with Paxlovid, enough that the U.S. Food and Drug Administration (FDA) placed a warning label on the drug. Over-the-counter medications and herbal supplements can even be a problem when coupled with Paxlovid.

Paxlovid can interact with several prescription drug classes, including anticoagulants, antidepressants, statins, medications for prostate conditions, hypertension, and irregular heartbeat. Additionally, it can interact with some over-the-counter (OTC) drugs and opioid pain relievers, which are an alternative to nonsteroidal anti-inflammatory drugs (NSAIDs). There are too many to list here, but examples of drugs that interact with Paxlovid include some recognizable names, such as the following:

  • Eliquis (apixaban)
  • Xarelto (rivaroxaban)
  • Buspirone
  • Viibryd (vilazodone)
  • Lipitor (atorvastatin)
  • Crestor (rosuvastatin)
  • Flomax (tamsulosin)
  • Norvasc (amlodipine)
  • Lanoxin (digoxin)
  • Flecainide
  • Roxicodone (oxycodone)
  • Hydrocodone-acetaminophen

Besides looking for interactions, you also want to look for overlapping effects, both beneficial and adverse, before taking a combination of medications. Paxlovid and ibuprofen have decidedly different actions, one as an antiviral against COVID-19 and the other as an anti-inflammatory. However, adverse effects do overlap somewhat, with both having a potential for stomach upset and skin rashes, but this is not enough to prohibit taking both drugs together in most circumstances.

What happens if you take Paxlovid and ibuprofen together?

After initially authorizing Paxlovid for emergency use authorization (EUA) in December 2021, the FDA granted full approval for the drug in May 2023. The benefit of Paxlovid is a reduction in the chance that coronavirus symptoms will progress to hospitalization or death. That benefit is only significant to those with the most underlying risk. Paxlovid’s indication from the FDA for mild to moderate COVID-19 treatment has a stipulation that it is only recommended for those with high-risk concurrent medical conditions. Unlike other antiviral medications used for hospitalized patients with severe COVID-19, this treatment is specifically for individuals experiencing mild to moderate symptoms and can be taken at home.

While ibuprofen won’t directly combat the COVID-19 virus, it can offer significant symptom relief. The NSAID may alleviate symptoms such as headache, body aches, sore throat, and fever. Taken together, ibuprofen and Paxlovid can help a person try to beat COVID-19’s cause and effects.

Since both Paxlovid and ibuprofen interact with several medications, you need to get the medical advice of your healthcare provider before taking the two in combination. For instance, Paxlovid must be dosed differently or avoided in the setting of renal insufficiency or kidney function impairment. 

While ibuprofen (Advil, Motrin) is a common pain reliever, it can pose problems for people with kidney issues. Similarly, those with liver, stomach, or heart disease should also exercise caution when taking it. This isn’t due to a direct interaction between ibuprofen and Paxlovid, but rather the potential for complications. For example, acute kidney damage caused by ibuprofen could impair the body’s ability to eliminate Paxlovid.

Tylenol (acetaminophen) may be a safer choice for pain relief and fever reduction for those with kidney dysfunction. Lagevrio (molnupiravir) may be a safer antiviral against COVID-19 for those with advanced kidney disease or drug interactions with Paxlovid. It has yet to be fully approved, but an EUA from the FDA is still in place for Lagevrio. Fully-approved Paxlovid can be pricey, making a SingleCare discount card quite helpful in reducing the expense.

Ibuprofen does not enhance or negate Paxlovid’s effects. Potential adverse events with ibuprofen use can still be an issue, though, such as stomach ulcers, bleeding, fluid retention, renal or liver impairment, and cardiovascular events like heart attacks. Stress and dehydration during an illness like COVID-19 could increase the risk of ibuprofen’s adverse effects. Taste disturbance, rash, and stomach upset can occur with Paxlovid. 

How long should I wait to take ibuprofen after taking Paxlovid?

While both ibuprofen and Paxlovid can be taken together in some situations, consulting your healthcare provider is essential before doing so. If your healthcare provider approves the combination, there’s no specific time requirement between taking Paxlovid and ibuprofen. It’s important to note that Paxlovid comes as a treatment course, with tablets taken twice a day. Ibuprofen pills are taken every six hours as needed.

Is it safe to mix Paxlovid and ibuprofen?

Taking ibuprofen when necessary during the five-day treatment course of Paxlovid is probably safe for most individuals. The bigger question is whether the individual drugs are too risky for you. Paxlovid and ibuprofen each interact with many medications, particularly Paxlovid. Ibuprofen has an array of potentially serious side effects. Always consult with your healthcare team to determine the most appropriate course of action. They can advise you on whether it’s safe to take either medication alone or if taking them together is a viable option for managing your specific symptoms.