Use of Ibuprofen and NSAIDs for covid patients

The Commission on Human Medicines’ Expert Working Group was asked to review the safety of ibuprofen in patients with COVID-19. They concluded that there is currently insufficient evidence to establish a link between use of ibuprofen, or other non-steroidal anti-inflammatory drugs (NSAIDs), and contracting or worsening of COVID-19.

Patients can take paracetamol or ibuprofen when self-medicating for symptoms of COVID-19, such as fever and headache, and should follow NHS advice if they have any questions or if symptoms get worse - https://www.nhs.uk/conditions/coronavirus-covid-19/

When Prescribing ibuprofen consider a patient’s individual risk factors such as:

  • history of cardiovascular or gastrointestinal illness
  • known renal impairment
  • Prescribe the lowest effective dose of ibuprofen for the shortest duration necessary to control symptoms.
  • Patients who have NSAIDs for a long-term condition, such as arthritis, should keep taking these medicines as normal.
  • Adult patients who take low-dose 75 mg aspirin for prevention of heart attacks or for vascular disease should continue to do so.

NICE has published a COVID-19 rapid evidence summary: acute use of non-steroidal anti-inflammatory drugs (NSAIDs) for people with or at risk of COVID-19 Evidence summary Published: 14 April 2020 www.nice.org.uk/guidance/es23

The purpose of this NICE review was to assess the best available evidence to determine:

  • If there is any increased risk of developing COVID-19 due to acute use of NSAIDs.
  • If acute use of NSAIDs can lead to an increased risk of developing more severe symptoms of COVID-19.

This review did not consider those taking NSAIDs for existing chronic conditions and concluded that no evidence from published scientific studies was found to determine whether acute use of NSAIDs is related to increased risk of developing COVID-19 or increased risk of a more severe illness.

The available evidence suggests that, although NSAIDs reduce acute symptoms such as fever, they may either have no effect on, or worsen, long-term outcomes, possibly by masking symptoms of worsening acute respiratory tract infection.

Further evidence is needed to confirm this, and to determine whether these results also apply to infections such as COVID-19.

NHSE released a rapid policy statement on 14th April reiterating advice in the CMO alert and NICE.