Ibuprofen for Coronavirus: Can You Use NSAIDs to Manage the Symptoms?

What a wild few weeks it’s been for ibuprofen, huh? A high fever is one of the most common symptoms of the new coronavirus that warrant its use, with other possible symptoms like body aches and headaches. So it was pretty distressing to see headlines claiming that we should avoid using this common over-the-counter pain medication.

Since then, the CDC and WHO have said that you don’t actually need to avoid ibuprofen if you’re trying to treat symptoms of COVID-19. But that still doesn’t mean it’s the best choice for everyone. Your choice of pain medication may matter a lot for reasons that have nothing to do with the new coronavirus.

You have a few different choices when it comes to OTC pain and fever medications.

Whether you’re trying to manage the symptoms of a COVID-19 infection or your basic cold or flu, it’s important to know that you have options for pain relievers. In the grand scheme of things, none of these medications is significantly better than the others for dealing with fevers or minor aches and pains, Nikita Desai, M.D., a pulmonologist at Cleveland Clinic, tells SELF. So the medication you choose really depends on your personal preference, as well as any other health issues you might have.

NSAIDs: These are nonsteroidal anti-inflammatory drugs (NSAIDs), which include ibuprofen (Advil, Motrin), naproxen (Aleve), and aspirin. Drugs in this class are thought to calm inflammation by reducing the production and release of compounds called prostaglandins. Normally, these compounds act sort of like hormones in the body and contribute to pain and inflammation (including period cramps). Specifically, NSAIDs block two enzymes, COX-1 and COX-2, that are necessary for prostaglandins to form.

However, NSAIDs are also associated with an increased risk for kidney disease and gastrointestinal ulcers, especially among older people who are older, have more than three alcoholic drinks a day, and who take these medications for a longer period of time. And NSAIDS, other than aspirin, are also linked to an increased risk for heart attack, especially with prolonged use. So they aren’t ideal for people who already have those conditions or are at a higher risk for them. If that’s you, it’s likely your doctor has already warned you not to take these medications.

Acetaminophen: This type of medication (brand name Tylenol) also works to reduce fevers and pain, but through a different mechanism, one that we still don’t totally understand. Current thinking is that, in addition to some effects on COX enzymes, acetaminophen also has effects on a bunch of other compounds and neurotransmitters (including, possibly, endocannabinoids) that combine to lessen the feeling of pain.

But people with liver issues should not take acetaminophen because the drug is associated with an increased risk for liver damage, especially when combined with alcohol or taken in high doses. Again, if you deal with those conditions, your doctor has probably already warned you against taking acetaminophen.

In the hospital, doctors generally use acetaminophen more than NSAIDs because of the increased risk for developing kidney problems and gastrointestinal ulcers in the ICU, Judith Currier, M.D., chief of the UCLA Division of Infectious Diseases, tells SELF. But Dr. Desai adds that the decision still ultimately depends on the individual patient’s situation and any other conditions they’re dealing with, so you could still get an NSAID even in that setting.

In addition to these over-the-counter medications, doctors might prescribe steroids and or higher doses of NSAIDs or acetaminophen than you can find on your own to help manage pain or other symptoms.

Is it okay to use ibuprofen to manage COVID-19 symptoms?

Here’s where it gets bananas. The worry about whether or not it’s safe to treat coronavirus symptoms with NSAIDs like ibuprofen comes from a letter that was published in Lancet Respiratory Medicine, says Dr. Desai.

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