Interactions between ibuprofen and antihypertensive drugs: Incidence and clinical relevance in dental practice

ABSTRACT

It has been well documented in the literature that ibuprofen interacts with different groups of antihypertensivedrugs (beta-adrenergic blockers, alpha-adrenergic blockers, diuretics and angiotensin-converting enzyme inhibitors),reducing their antihypertensive activity. The mechanism of action of ibuprofen involves inhibition of the enzymecyclooxygenase, thereby inhibiting the synthesis of inflammatory prostaglandins and vasodilatory prostaglandins thatincrease renal blood flow and thus favor the excretion of water and sodium. More than five days of treatment withboth drugs are normally required for the interaction to manifest. Although the changes in blood pressure resultingfrom this interaction are typically small, some patients can experience substantial elevations in both systolic anddiastolic blood pressure. It has been estimated that the avoidance of minor changes in systolic pressure in patientswith osteoarthritis subjected to treatment with nonsteroidal antiinflammatory drugs would avoid over 30,000 deathsdue to myocardial infarction, and over 2000 deaths due to coronary disease, in the United States alone (AU)