Ibuprofen (brand names include Advil and Motrin)and prednisone (a corticosteroid) are common medications used to manage pain and inflammation. However, both have potential gastrointestinal side effects, which can be amplified if an individual taking the prescription drug prednisone decides to also take ibuprofen. Anyone considering taking an over-the-counter (OTC) anti-inflammatory alongside a corticosteroid such as prednisone should consult with a physician first.
Continue reading to learn more about each medication and the risks of taking them simultaneously.
Ibuprofen and Prednisone Interactions: GI Risks
Ibuprofen is a non-steroidal anti-inflammatory drug (NSAID) used to treat mild to moderate pain, fever, rheumatoid arthritis and other inflammatory conditions. The pain reliever works by reducing the production of prostaglandins, hormone-like substances associated with pain and inflammation. Ibuprofen is available over the counter or with a prescription.
Gastrointestinal side effects can occur with ibuprofen because of the drug’s mechanism of action, explains Stefanie Nigro, PharmD, an associate clinical professor in the Department of Pharmacy Practice at the University of Connecticut. NSAIDs reduce bicarbonate and mucus production in the stomach, two substances that work in tandem to neutralize and mitigate the effects of stomach acid, she explains. When gastric acid becomes too prevalent, the stomach lining can become susceptible to irritation.
This acidic environment increases the risk of an ulcer, Dr. Nigro says. “Bleeding occurs when these ulcers begin to erode, and the tissue breaks down.”
Prednisone is a prescription-only corticosteroid often used to treat autoimmune and inflammatory disorders. When used in the short term, prednisone can alter gastrointestinal structure and function, says Joseph Michalisin, MD, an orthopedist at Northwell Lenox Hill Hospital in Manhattan.
The FDA also warns of an increased risk of stomach bleeding when taking ibuprofen. Combining NSAIDs and steroids creates a synergistic effect that can further increase the risks of gastric bleeding and ulceration, says Dr. Michalisin.
With those mechanisms in mind, individuals taking both ibuprofen and prednisone should monitor themselves for severe stomach pain or bloating, which may indicate the presence of an ulcer, Dr. Nigro says. If bleeding is present, they may have dark, tar-colored stools or vomit that looks like coffee grounds.
These symptoms often indicate a medical emergency and, if experienced, necessitate immediate medical attention.
Additional side effects of taking both medications include nausea, drowsiness, dizziness, headache, and ringing in the ears, notes Dr. Michalisin.
Safe Alternatives for Ibuprofen
If you’ve been prescribed prednisone, a good alternative for treating mild to moderate pain is acetaminophen (Tylenol), notes Dr. Michalisin. The combination of prednisone and acetaminophen is safer because there are no dangerous interactions between that pain reliever and steroids.
Topical modalities, such as lidocaine patches, might also prove helpful, says Dr. Michalisin. When absorbed through the skin, these gels or creams create numbing sensations to reduce pain and inflammation. Generally, lidocaine is quite safe when applied topically and has very few side effects, including mild itching or redness at the application site.
Natural supplements like turmeric and curcumin might also help decrease inflammation, Dr. Michalisin adds. However, because of the risks of combining medications and supplements, it’s always best to consult your medical team before adding anything new to your prescribed regimen.
