Ibuprofen & COVID-19: Here's What You Need to Know

In recent days, there’s been some confusion as to whether or not ibuprofen - a common over-the-counter treatment for headaches and other symptoms of the flu and, indeed, COVID-19 - can be safely used to treat COVID-19 symptoms.

Confusion over WHO guidance

Originally, on March 17, the World Health Organization (WHO) recommended avoiding taking ibuprofen for COVID-19 symptoms:

• WHO’s guidance followed a March 11, 2020, study in The Lancet hypothesizing that an enzyme boosted by anti-inflammatory drugs (such as ibuprofen) could facilitate - and even worsen - COVID-19 infections.
• At the time, WHO spokesman Christian Lindmeier said, “[W]e recommend using rather paracetamol, and do not use ibuprofen as a self-medication.”

The WHO walked back its guidance on March 18:

Arguments against using ibuprofen

However, some medical professionals remain opposed to ibuprofen use in COVID-19 patients if other options are available.

Dr. Charlotte Warren-Gash, an associate professor of epidemiology at the London School of Hygiene and Tropical Medicine, says that for particularly vulnerable patients, “it seems sensible to stick to paracetamol as first choice."

FDA does not recommend against the use ibuprofen

• A March 19 FDA statement doesn’t recommend against using ibuprofen to address COVID-19 symptoms. That is, the FDA is not saying "Don't use ibuprofen" but they're also not saying "Yes, use ibuprofen!"
• The FDA does note that all prescription non-steroidal anti-inflammatory drugs (NSAIDs), including ibuprofen, may “diminish the utility of diagnostic signs in detecting infections.”

"At this time, FDA is not aware of scientific evidence connecting the use of NSAIDs, like ibuprofen, with worsening COVID-19 symptoms. The agency is investigating this issue further and will communicate publicly when more information is available.” -FDA statement 

Dr. Anthony Fauci says data doesn’t contraindicate ibuprofen

• In a March 18 #JAMALive info session, National Institute of Allergy and Infectious Diseases (NIAID) Director Dr. Anthony Fauci - one of the leaders of the federal response to COVID-19 in the U.S. - said he hadn’t seen data showing ibuprofen was a concerning factor in treating COVID-19.

“I have not seen any firm data to indicate there is a problem or prove there is not a problem."

Some patients may be advised to take acetaminophen

Dr. Angela Rogers, chair of the intensive care unit’s COVID-19 task force at Stanford University Medical Center, says acetaminophen (sold under the brand name Tylenol) is recommended for patients who are sick enough to go to the hospital as it’s less likely than is to damage the kidneys when taken long-term.

However, it’s important to note that acetaminophen can cause liver damage at high doses.

— Lorelei Yang

(Photo Credit: iStockphoto / geotrac)