Updated 03/18/2020: The World Health Organization (WHO) has also advised people suffering from COVID-19 to avoid taking ibuprofen until more research is carried out. WHO spokesman Christian Lindmeier told reporters on Tuesday: "In the meantime, we recommend using rather paracetamol [acetaminophen], and do not use ibuprofen as a self-medication. That's important."
If you’re feeling sick with a nasty cold and a banging headache, ibuprofen can quickly help soothe some of your symptoms. But is this a good idea if you’re struck down with COVID-19?
Scientists and public health authorities are divided. However, many health experts are saying it's safest to avoid ibuprofen if you're ill with COVID-19 because there is a small amount of evidence that it may aggravate the condition. If you're in need of pain relief, acetaminophen (aka paracetamol if you're from the UK, and tylenol if you prefer brand names) is the most sensible and low-risk option.
French authorities were among the first to warn against taking anti-inflammatory painkillers, including ibuprofen, if you have a fever from the COVID-19 infection. Olivier Véran, France’s health minister, tweeted last weekend: “The taking of anti-inflammatories (ibuprofen, cortisone, ...) could be a factor in aggravating the infection. In case of fever, take acetaminophen. If you are already taking anti-inflammatory drugs or in doubt, ask your doctor’s advice.”
A number of experts have also since affirmed this view and lightly cautioned against the use of ibuprofen. However, as with much of the current outbreak, there’s not yet a huge wealth of scientific research on the matter yet.
“In the meantime, for treating symptoms such as fever and sore throat, it seems sensible to stick to acetaminophen as first choice,” says Prof Paul Little, professor of primary care research at the University of Southampton, UK.
Professor Little was co-author of a trial, published in the British Medical Journal, that found patients with respiratory infections – such as coughs and colds, not COVID-19 – were more likely to subsequently suffer further health complications if they were prescribed ibuprofen rather than acetaminophen.
As for why some health experts are suggesting exercising caution with regards to anti-inflammatory medicines: “The advice relates to Ibuprofen’s anti-inflammatory properties, that is, it dampens down the immune system, which may slow the recovery process,” explains Professor Ian Jones, virologist at the University of Reading.
“In addition, it is likely, based on the substantial literature around SARS I and the similarities this new virus (SARS-CoV-2) has to SARS I, that the virus reduces a key enzyme which part-regulates the water and salt concentration in the blood and could be part of the pneumonia seen in extreme cases,” Prof Jones added. “Ibuprofen aggravates this while acetaminophen does not. It is recommended that people use acetaminophen to reduce temperature if you are feverish.”
However, a number of health authorities are not promoting this view. As of March 17, the UK's National Health Service still recommends taking ibuprofen to help ease symptoms. Equally, other infectious disease experts have expressed concern that the advice to avoid ibuprofen might confuse and cause unnecessary worry to the public
Meanwhile, Reckitt Benckiser – the makers of Nurofen, a best-selling pain medication containing ibuprofen – has looked to quash warnings against taking their drug, saying they are "not aware of any evidence that ibuprofen adversely impacts the outcome in patients suffering from COVID-19 infection."
As mentioned, many aspects of this viral outbreak are not yet fully understood as scientists have only had a few months to get to grips with it. As such, our growing knowledge might mean that information quickly becomes outdated or irrelevant. Until more is known, your safest bet is to opt for acetaminophen-based medicines first.