Can I Take Aspirin and Ibuprofen Together?

​Your doctor has told you to take a daily aspirin to help reduce your risk of a heart attack or a stroke: Aspirin works by interfering with your blood’s ability to form dangerous clots, thus helping to prevent heart attacks and strokes. However, taking aspirin is not without risk. Aspirin can cause stomach upset and bleeding—including nose bleeds, stomach, and intestinal bleeding, and even bleeding in the brain. So taking daily aspirin is recommended only when the likely benefits greatly outweigh the likely risks in a particular individual.

Daily aspirin is often recommended for people who have had a heart attack or a stroke, who have coronary artery disease, or whose risk of developing cardiovascular disease within the next several years is judged to be high. However, the decision to take daily aspirin must be individualized, and always must be discussed with your doctor. It's important to learn more about whether taking a daily aspirin is right for you.

According to the U.S. Food and Drug Administration (FDA), ibuprofen can interfere with the anti-clotting effect of low-dose aspirin (81 mg per day), potentially making the aspirin less effective when it is used to help protect your heart and help prevent a stroke.

The FDA recommends that you consider the following:

• If you use ibuprofen occasionally, there is only a minimal risk that the ibuprofen will interfere with the effect of low-dose aspirin.
• If you need only a single dose of ibuprofen, take it 8 hours before or 30 minutes after taking a regular (not enteric-coated) low-dose aspirin.
• If you need to take ibuprofen more often, talk to your doctor about medication alternatives. Your doctor may recommend a painkiller that does not interfere with the effect of low-dose aspirin.

Ibuprofen belongs to a class of medications known as NSAIDs (non-steroidal anti-inflammatory drugs). You should not take another NSAID (such as medications containing naproxen) without talking to your doctor, since some other NSAIDs may have the potential to interfere with the protective effect of low-dose aspirin.

The FDA recommendations are only for regular (also called immediate-release) low-dose aspirin (81 mg). Ibuprofen's ability to interfere with the anti-clotting effects of enteric-coated aspirin or larger doses of aspirin (such as an adult aspirin—325 mg) is not known.

Unlike aspirin and ibuprofen, which should not be mixed, ibuprofen (such as Motrin) and acetaminophen (such as Tylenol) can be mixed.

In fact, results from one small study published in the British Journal of Anaesthesia suggest that when ibuprofen and acetaminophen are taken together (in the form of a mixed formulation called Maxigesic) by participants who had just undergone oral surgery, this combination results in superior pain relief.