Can You Take Ibuprofen with Metformin?
Last reviewed: · Source: US FDA drug label database
Use with caution — ibuprofen can affect kidney function, which may cause metformin to accumulate to unsafe levels.
Is it safe to take Ibuprofen with Metformin?
Ibuprofen and metformin are not directly incompatible, but regular or high-dose ibuprofen use can reduce blood flow to the kidneys. Since metformin is eliminated almost entirely by the kidneys, any reduction in kidney function can cause metformin to build up in the body, increasing the risk of a rare but serious complication called lactic acidosis. For most people with good kidney function, occasional low-dose ibuprofen is unlikely to cause a problem, but regular use should be discussed with a doctor.
How do Ibuprofen and Metformin interact?
Ibuprofen inhibits prostaglandin synthesis, reducing renal afferent arteriole dilation and decreasing glomerular filtration rate (GFR). Metformin is excreted unchanged by tubular secretion in the kidneys with virtually no hepatic metabolism. Reduced GFR from NSAID use leads to reduced metformin clearance and potentially toxic plasma concentrations. Lactic acidosis, while rare, has a high mortality rate when it occurs.
Data sourced from the US Food and Drug Administration (FDA) drug label database: FDA metformin drug label — renal impairment warning; OpenFDA drug label data.
Who should be careful?
People with any degree of kidney impairment (common in type 2 diabetes) should avoid regular ibuprofen entirely. Elderly patients with diabetes should use paracetamol instead. Anyone dehydrated (illness, vomiting, diarrhoea, hot weather) should stop ibuprofen temporarily.
What if I've already taken Ibuprofen and Metformin?
If you have taken both together occasionally, no immediate action is needed. If you experience unusual muscle pain, weakness, difficulty breathing, stomach pain, or feel cold and dizzy (signs of lactic acidosis), seek emergency medical attention.
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Frequently Asked Questions
Can I take ibuprofen with metformin?
Occasionally for short periods is generally low risk if your kidneys are healthy. Regular use should be avoided. Paracetamol is a safer alternative for type 2 diabetics.
Why is ibuprofen dangerous with metformin?
Ibuprofen can reduce kidney function. Since metformin is cleared by the kidneys, reduced kidney function can cause metformin to build up, increasing the risk of lactic acidosis.
What painkillers are safe with metformin?
Paracetamol is the recommended painkiller for people taking metformin. It does not affect kidney function in normal doses.
What is lactic acidosis?
Lactic acidosis is a rare but serious side effect of metformin toxicity where lactic acid builds up in the blood. Symptoms include weakness, muscle pain, breathing difficulties, stomach pain, and feeling cold or dizzy. It requires emergency treatment.