Supplements and Ibuprofen.
Ibuprofen, sold under the brand names Nurofen, Brufen, is a non-steroidal anti-inflammatory drug (NSAID): it inhibits cyclooxygenase enzymes, with documented gastrointestinal and renal long-term risks.
Ibuprofen is the most prescribed NSAID in England and one of the most commonly used OTC medicines in the UK. It inhibits both COX-1 and COX-2, reducing pain and inflammation driven by prostaglandins. It also reduces the protective gastric and renal prostaglandin signalling that drives the side effect profile. Sustained use, or use at high doses, carries gastric ulceration risk, reduced antihypertensive effect of ACE inhibitors and ARBs, additive renal stress in CKD3+, and additive antiplatelet effect with aspirin or clopidogrel. The supplement interactions divide into two patterns. Anti-inflammatory supplements (curcumin, boswellia, omega-3 EPA at higher doses) overlap mechanism with ibuprofen, so additive effects are real but rarely problematic at OTC doses. Ginkgo, garlic extract, and fish oil at high doses add to bleeding risk when stacked with ibuprofen, especially around dental work or surgery. CKD3+ context shifts the risk profile sharply. The renal hit from chronic NSAIDs in already impaired kidneys is the single most flagged interaction class.
Below are the 6 documented pairs we have explicitly assessed against Ibuprofen in the Distil database: 6 amber. The pairs cluster around 4 mechanisms: Additive hyperkalaemia (raised potassium), Additive renal stress, Additive antiplatelet effect, and Reduced renal lithium clearance. Every call is cited to either a clinical reference (PMID) or the British National Formulary. Anything not on this list is either still to be assessed or beyond our database scope. The checker beneath surfaces assessments by supplement, and the missing-item form at the bottom of the page routes any uncatalogued supplement into our next curation pass.
Documented interactions
Additive hyperkalaemia (raised potassium)
Anti-inflammatory painkillers like ibuprofen can make the kidneys hold on to a little more potassium. On their own the effect is usually small, but added to a potassium supplement, and especially if your kidneys are not working at full strength or you take a blood-pressure medicine that also raises potassium, it can nudge your potassium higher. If you take ibuprofen regularly, mention any potassium supplement to your GP or pharmacist.
Additive renal stress
On its own, creatine is safe for the kidneys in healthy people, and an occasional ibuprofen is fine alongside it. The caution is for taking ibuprofen often over a long stretch, or if you already have reduced kidney function: ibuprofen lowers blood flow through the kidneys, and that is the situation where adding creatine's extra workload is worth a doctor's eye. One more practical point: creatine naturally pushes up a blood marker called creatinine, which is the same marker used to check your kidneys, so tell your GP or the lab you take creatine before any kidney blood test on ibuprofen, or the result can look worse than it really is.
Reviewer-flagged: awaiting clinical-reviewer sign-off.
Additive antiplatelet effect
High-dose garlic extract has its own mild antiplatelet effect on top of ibuprofen's. For occasional pain relief at standard doses, this is rarely a problem. For chronic NSAID use or pre-surgery, the combined effect can mean more bleeding and bruising. Stop garlic supplements at least one week before any planned surgery.
Both ginkgo and ibuprofen can slow blood clotting. Used together for short periods at standard doses, the combined effect is usually mild. Used at high doses for long periods, the combined effect can mean more bleeding and bruising. Stop ginkgo at least two weeks before any planned surgery.
High-dose omega-3 (typically more than 3g of combined EPA plus DHA per day) has a mild antiplatelet effect that adds to ibuprofen's. At typical supplement doses of 1 to 2g and short-course NSAID use, the combined effect is usually mild. At high doses or for chronic NSAID use, the additive bleeding tendency is worth knowing about.
Reduced renal lithium clearance
Anti-inflammatory painkillers such as ibuprofen can make the kidneys hold on to lithium, which raises the lithium level in the blood. With prescription lithium this is a recognised caution. At the small amount of lithium in a typical lithium orotate supplement (around 5 mg) the effect is expected to be very small; it matters more for higher-strength products (around 20 mg) and for anyone whose kidney function is reduced. If you take regular anti-inflammatories, check with your pharmacist or GP before using a lithium supplement.
Reviewer-flagged: awaiting clinical-reviewer sign-off.
What this list does not say. Pairs not flagged here are not implicitly safe. They are either not yet in our database, or fall outside our inclusion scope (food-supplement interactions only; for drug-drug interactions, the BNF is authoritative). Use the checker below to surface any supplement, and submit a missing item if you take something we have not catalogued.
How we grade severity, choose what's in scope, and what we exclude.
Every call on this page is reasoned. We publish the full rubric for severity tiers, the medication inclusion logic, the evidence grades we accept, and what we deliberately leave out. About three thousand words. Worth reading once if you use this tool more than occasionally.
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This page checks the pairs you enter. The personalised Distil report goes further:
- the same graded, cited interaction check across your whole stack, not just the pairs you thought to type in
- where your current routine may be leaving you short of your goals
- the evidence-backed compounds worth adding, and the ones worth dropping
It's a paid report: £79, or £49 for the first 25 customers. The interactions check is one section of it, and you can read a real one in full before you buy.
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