Can You Take Ibuprofen With the COVID-19 Treatment Paxlovid?

Can You Take Ibuprofen With Paxlovid?

Paxlovid is a promising antiviral medication for treating COVID-19. As more people gain access to Paxlovid, questions arise about taking other medications alongside it. One common question is whether you can take ibuprofen while using Paxlovid. Understanding how Paxlovid works and its interactions with ibuprofen can help ensure safe and effective treatment.

What is Paxlovid?

Paxlovid is an oral antiviral therapy produced by Pfizer and authorized for emergency use by the FDA in December 2021. It is prescribed to treat mild-to-moderate COVID-19 in high-risk individuals age 12 and older who weigh at least 88 pounds.

Paxlovid consists of nirmatrelvir tablets and ritonavir tablets. Nirmatrelvir blocks replication of the SARS-CoV-2 virus to stop infection from progressing. Ritonavir slows the breakdown of nirmatrelvir to make it last longer in the body.

Paxlovid must be taken within 5 days of COVID-19 symptom onset to be effective. The standard dosage is 300 mg nirmatrelvir with 100 mg ritonavir taken together orally twice per day for 5 days.

Paxlovid's Effectiveness

Clinical trials showed Paxlovid reduced risk of COVID-19 hospitalization or death by 89% when taken within 3 days of symptoms appearing. Taken within 5 days, it still reduced risk by 88%. These dramatic results made Paxlovid the first COVID antiviral treatment easily accessible by prescription.

Paxlovid also reduced duration of COVID-19 symptoms by 5 days in clinical trials. Its impressive ability to prevent severe COVID-19 has made it a critical tool for protecting vulnerable populations.

Is It Safe to Take Ibuprofen With Paxlovid?

There are no severe interactions between ibuprofen and Paxlovid. Ibuprofen is an NSAID, or nonsteroidal anti-inflammatory drug. It can be safely taken while using Paxlovid, within recommended dosing limits.

Study Results

A 2022 study specifically looked at interactions between Paxlovid and common medications, including ibuprofen. No significant interactions were found between ritonavir doses used in Paxlovid and NSAIDs like ibuprofen.

Researchers concluded ibuprofen is unlikely to impact the efficacy of Paxlovid treatment and can be used if needed for pain, fever, or inflammation while taking Paxlovid.

Rare Risk of Kidney Issues

While ibuprofen does not directly interact with Paxlovid, there is a rare risk of kidney problems when ibuprofen is combined with ritonavir. Ritonavir can increase levels of some medications in the blood due to effects on kidney filtration.

In very rare cases, this effect combined with ibuprofen may worsen kidney function. However, this risk is minimal at the low ritonavir doses used in Paxlovid compared to doses for other HIV and hepatitis C treatments.

Suggested Dosage Limits

To be safe, it is recommended to limit ibuprofen dosage when taking Paxlovid. The standard OTC dose is 200-400 mg ibuprofen every 4-6 hours as needed. While using Paxlovid, limit ibuprofen use to 400 mg or less per day.

At standard OTC doses, ibuprofen is considered compatible with Paxlovid. But staying below maximum daily dosage limits reduces any risks.

Other Medication Considerations With Paxlovid

While ibuprofen appears safe, Paxlovid may interact with other medications you are taking. Ritonavir can affect how the liver metabolizes many drugs. A full medication review is advised before starting Paxlovid.

Effects on Other Drugs

Paxlovid may increase levels of certain prescription medications in the blood to unsafe levels. These include antiarrhythmics, antidepressants, antifungals, cholesterol drugs, hepatitis C drugs, sedative-hypnotics, and more.

Dosage adjustments or close monitoring may be required if you take medications potentially impacted by ritonavir. Your doctor can advise specific precautions based on your medical history.

Effects on Paxlovid

Some ulcer medications like Prilosec can lower levels of Paxlovid in the blood, reducing its effectiveness. Anticonvulsants, antimycobacterials, anti-inflammatories, herbal supplements, and statins may also lower Paxlovid levels.

Your doctor may recommend adjusting the timing between Paxlovid and other medications to maximize its efficacy and minimize negative interactions.

Contraindicated Drugs

Paxlovid cannot be taken along with certain medications due to serious interactions. These contraindicated drugs include pimozide, ergot derivatives like ergotamine, lovastatin, simvastatin, and herbal supplements containing St. Johns wort.

Alternatives to Ibuprofen With Paxlovid

While you can generally take ibuprofen as needed with Paxlovid, you may want to consider alternatives to minimize even rare risks. Several options can provide pain, fever, and anti-inflammatory relief without interacting with Paxlovid.

Acetaminophen

Acetaminophen (Tylenol) is a go-to option for mild pain or fever while using Paxlovid. Studies found no significant interactions between acetaminophen and ritonavir at doses used for Paxlovid. The recommended dosage is 650-1,000 mg every 4-6 hours as needed.

Aspirin

Low-dose aspirin is considered safe to take with Paxlovid at recommended cardio-protective doses (usually 81 mg per day). For treating COVID-19 symptoms, limit aspirin use to no more than 4 grams per day.

Naproxen

The NSAID naproxen appears compatible with Paxlovid treatment. One study found no significant interaction between Paxlovid's ritonavir dose and naproxen. Follow dosage limits of no more than 1,000 mg daily.

Other Therapies

Soaks in warm baths, ice packs, heating pads, massage, and rest can ease discomfort associated with COVID-19 without medication. Staying well hydrated and using humidifiers also helps.

Talk to Your Doctor

Current research indicates taking ibuprofen with Paxlovid should be safe, as long as maximum dosing limits are followed. But to confirm, talk with your prescribing doctor about your complete medication history before starting Paxlovid.

Your doctor can help identify any potential interactions with your current drugs and recommend proper precautions. With a doctors input, Paxlovid and ibuprofen can be used together effectively.

Disclaimer: This article is for informational purposes only and does not constitute medical advice. Always consult with a healthcare professional before starting any new treatment regimen.