COVID-19: Should I Take Ibuprofen or other NSAIDs?

Questions have been raised regarding the safety of taking ibuprofen during a coronavirus infection.

Ibuprofen is a non steroidal anti-inflammatory (NSAID) medication that is often used for symptom control when we are sick (trade names include Advil and Motrin). NSAIDs work to reduce the inflammatory response during an infection, helping to control fever and reducing discomfort and pain. In addition, many people take NSAIDs regularly to manage arthritis, chronic pain and other inflammatory conditions.

In mid March, the French government reported observations that NSAID use was associated with worse coronavirus symptoms, which led the World Health Organization (WHO) to advise us not to take ibuprofen if we have symptoms of COVID-19. The following day, the WHO retracted this statement on Twitter:

On March 20th, Health Canada issued a statement that there is no scientific evidence that ibuprofen worsens COVID-19 symptoms.

Is there any basis upon which ibuprofen and other NSAIDs could be a concern? As I pointed out in my recent live video interview, taking NSAIDs, especially taking a lot of them, can be damaging to kidney function, which could lead to total body fluid overload and worsen COVID symptoms. Whether my hypothesis could be responsible for France’s observations, or whether there was some other factor at play, is not known.

Note also that taking NSAIDs can mask signs of coronavirus infection. So, if you take NSAIDs on a regular basis for a chronic health condition, you could have COVID-19 but not know it because the NSAIDs are covering up your symptoms.

BOTTOM LINE: There is currently not scientific evidence that ibuprofen worsens COVID-19 symptoms. However, this is currently being studied actively. Recommendations for or against ibuprofen use differ by country. Health Canada advises:

When choosing a fever or pain relief medication for COVID-19, patients and healthcare professionals should consider all available treatment options, including acetaminophen and other NSAIDs. Each product has its own benefits and risks, listed in the product labelling.

It is important to note that Canadians who currently use any NSAIDs (such as ibuprofen and naproxen) to treat their chronic diseases should not stop their treatment and should speak to their healthcare professional if they have any questions about changing medications.

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