The first mention of not taking ibuprofen (nurofen) that I was aware of came through in France the other day. I did NOT post because of conflicting views.
Today we are seeing confirmation from several sources that taking ibuprofen for covid-19 is questionable. Hence I am now posting.
Please read carefully and make your mind up. There is nothing more that I know about ibuprofen which is not in the available online sources. I am absolutely, 100%, NOT telling you what to do, just letting you know what has been published.
Health experts criticise NHS advice to take ibuprofen for Covid-19
Comments come after French authorities say such drugs could aggravate condition
Experts have criticised NHS advice that people self-isolating with Covid-19 should take ibuprofen, saying there is plausible evidence this could aggravate the condition.
The comments came after French authorities warned against taking widely used over the counter anti-inflammatory drugs. The country’s health minister, Olivier Véran, a qualified doctor and neurologist, tweeted on Saturday: “The taking of anti-inflammatories [ibuprofen, cortisone … ] could be a factor in aggravating the infection. In case of fever, take paracetamol. If you are already taking anti-inflammatory drugs, ask your doctor’s advice.”
NHS guidance states that people managing Covid-19 symptoms at home should take paracetamol or ibuprofen.
“I would advise against that,” said Prof Ian Jones, a virologist at the University of Reading. “There’s good scientific evidence for ibuprofen aggravating the condition or prolonging it. That recommendation needs to be updated.”
Paul Little, a professor of primary care research at the University of Southampton, said: “The general feeling is that the French advice is fairly sensible. There is now a sizeable literature from case control studies in several countries that prolonged illness or the complications of respiratory infections may be more common when non-steroidal anti-inflammatories [NSAIDs] are used.”
A trial by Little and his colleagues, published in the BMJ, found patients with respiratory infections such as coughs, colds and sore throats who were prescribed ibuprofen rather than paracetamol by their GP were more likely to subsequently suffer severe illness or complications. Several other studies have linked anti-inflammatory drugs to worsened pneumonia.
Little said this could be because inflammation is part of the body’s natural response to infection. “If you’re suppressing that natural response, you’re likely inhibiting your body’s ability to fight off infection,” he said.
The evidence in this area was “not 100% clear” and had not come directly from studies of patients with Covid-19, Little said. “I personally think that given there is plausible evidence for harm, the advice should be changed.
Should someone suffering from coronavirus with only ibuprofen in their bathroom cabinet grit their teeth and make do without? Little said despite the concerns, it would be reasonable to use ibuprofen as a last resort. For instance, if you were struggling to sleep, since getting enough rest is also important for recovery.
“If you’re desperate, particularly if you couldn’t get to sleep at night,then I’d take one,” he said. Otherwise, he recommended sweating it out or asking a friend or family member to post some paracetamol through the letterbox.
Charlotte Warren-Gash, an associate professor of epidemiology at the London School of Hygiene and Tropical Medicine, said: “For Covid-19, research is needed into the effects of specific NSAIDs among people with different underlying health conditions, which takes into account the severity of infection.
“In the meantime, for treating symptoms such as fever and sore throat, it seems sensible to stick to paracetamol as first choice.”
Public Health England was contacted for a comment.
In the first few hours after I saw the French statement, I also saw some counter-statements which themselves were questionable!
In the current climate, almost anything can get turned upside down in no time. Hence my strong statement that I know nothing! And the full story from the Guardian (I usually just post a little bit).
Thanks for posting. I saw the French advice and stopped taking my Etoricoxib. Better to be safe than sorry, especially as I have some sort of virus, hopefully not COVID-19!
I seem to remember the 2018-2019 colds and flu season came with advice to the public to think carefully before taking anti-inflammatory medicines of any kind, including paracetamol. Apologies, I didn't bookmark any references.
This advice followed a study (possibly more than one) which demonstrated prolonged viral illness and an increased risk of complications in people who took such drugs from the beginning of their infections in order to alleviate symptoms. I thought about that and it actually seemed to concur with advice from such medical 'renegades' as Sarah Myhill and Suzanne Humphries.
Healthier, in my own opinion, to sweat out the virus, allowing a fever to kill it. Anti-inflammatories have their place later on, if symptoms continue to worsen.
Something that came up in a biomedicine tutorial some time ago was that taking anti inflammatory meds might make us feel better short term, however lowering the body’s natural defence of increasing temperature to make us less hospitable hosts might make us ill longer. This was in reference to common colds, flu etc. So far this year I’ve taken higher doses of NSAIDs which has also reduced the efficacy of my thyroid hormones. I’ve increased the latter to try & get my temperature closer to “normal“ in the hope it will help my immune system, just in case I need this. Also eating & supplementing more vitamin C. 🤢💊🍊🍋🌶🦠Time to start preparing garlic soup! If I eat enough, that will ensure other folks’ social distancing. 📏
🧄 😂🤣😂 🧄 just been planting some elephant garlic at the allotment but the smaller stuff is far more pungent that went in too 🦠👋🏽 perhaps I should eat some of it rather than plant all of it 😊 I prefer thin sliced garlic butties for the burn 🔥 (gluten free sour dough of course) it certainly has social distancing powers 😉
That’s a shame I believe the wild garlic is also edible. I was thinking of trying to grow ginger and tumeric, and even papyrus (just cos it’s beautiful and I like a challenge...or maybe because I’m plain nuts!!!)
It's definitely edible, - I get it in my veg box now and then (as well as picking it when I'm in the right places) - but I don't know if it has the same properties as bulb garlic
You can grow ginger in a pot, but don't even bother outdoors unless you live in a hot country. Same with turmeric although more likely to succeed - but you have to cook it to get the benefit, so really easier to buy the powder
I suppose these days there is a challenge in buying tumeric powder from the shops but trying to grow it really appeals to me 😊 the botanic gardens here grows huge ginger plants outside despite it being the UK, they don’t seem to give them special treatment they are in a very sheltered spot near water. Only one way to find out ...but thanks for the advice!
I will do - she is an Italian greyhound - utterly adorable and deliciously naughty with eyes that can melt the heart of hardened dog haters at 100 metres she’ll get a cuddle from you by proxy & she will be very happy she’s super affectionate being a toy breed their purpose was just to be cuddled and pampered, the Romans had them at Pompei & they were the only dogs allowed in the house...they say.
I have two of those as well and a whippet 🥰 and did have two whippets and two Italian and Two greys a boy and girl of each it was perfect! But the boy whippet and Italian died 8 days apart a few years back.
Yeah 6 sighthounds in descending order of size - quite a spectacle we were a happy little family in fact I don’t think I was ever happier. I still have a little cry about the two boys the whippet was an oldster got a brain tumour but soldiered valiantly on to the end but the Italian was not that old, got bone cancer totally incurable and untreatable save pain killers he had to be pts three months from diagnosis with a tiny lump (which the vet could not find till I showed her where it was) and he was gone - heartbreaking he was the most beautiful gentle little soul ever. The lady Italian refused to go for walkies for a month she just hid under the duvet it was so sad, the others were very subdued but only for a week or so. We’ve stayed at four since tho I have found it hard to resist getting more. I never had children which might explain me wanting so many dogs all at once!
That’s a super pack! 🐕🐕🐕🐕🐕🐕🤗 Dogs are such lovely creatures. We can miss them more than people when they leave us. My rescue greyhound cried for my great aunt when he couldn’t find her, so they miss us too. 😢
As a mild asthmatic, its important to remember that ibuprofen can exacerbate the condition anyway so it's much safer to stick to paracetamol based products if you need them.
Well, there is a theory that many deaths with 1918 flu were from aspirin overdose. You'll be lucky to get any paracetamol in the shops, even here (which has been fairly sane) has empty shelves except for a few packets of nurofen - that's three supermarkets, two chemists, Wilkinsons and several cheap and pound shops.
Not sure what to think now... Just received an emailed advice notice from Dickson's pharmacy in Glasgow, the people who dispense my LDN. It's interesting reading, but I haven't assimilated all the information and opinion just yet:
"ANTI-INFLAMMATORIES & LDN & COVID-19
There was some "fake news" from the Health and Safety Executive in Ireland - saying Ibuprofen and associated NSAIDS could be harmful in COVID-19. This was proven to be malicious and untrue. The information did not come from the government or the doctor named. SEE HERE
The French health minister made a comment about not using Ibuprofen to treat fever or suspected COVID-19. This may have been in response to seeing this fabricated advice message from Ireland - and not based on any empirical evidence.
Neither Italy nor China has reported problems with Ibuprofen in COVID-19 - suggesting to the UK NHS that a trend would have been spotted by now. This may be subject to change as we see more cases hospitalised in the UK.
The comments made by the French health minister on social media have been embellished and expanded vastly beyond their value by the media and should be ignored in their entirety. SEE HERE
The actual advice was really quite sensible if you don't take NSAIDS(Ibuprofen etc) regularly - then choose paracetamol first if you need something to make you feel better. This is good advice at all times!
There *IS* advice on not using Ibuprofen in children with chickenpox, as it may cause complications. This is a very different scenario and a totally different mechanism.
SHOULD I STOP TAKING LDN?
People are calling worried that dampening down inflammation may make them sicker.
People are calling asking if they should stop LDN - just in case, not sure why, but worried having read some of the social media storms.
People are calling asking to be STARTED on LDN to prevent COVID-19 (no we will not prescribe or dispense for this).
The basic answer is, there is no advice specifically regarding LDN.
There is no reason it would make your condition worse if you were to get COVID-19.
There is also no reason it will make you more likely to get COVID-19.
There has been a lot of discussion in the LDN healthcare professionals groups about using LDN as an adjunct to help treat people with severe COVID-19 as it may help reduce the severity of something called a Cytokine Storm (the main reason why people with COVID-19 die).
WHAT ABOUT MY OTHER DRUGS! I'm on Immunosuppressants!
The reason why people are on immunosuppressants varies wildly.
Generally being on an immunosuppressant will increase your risk of catching any infection, and patients on these will already know this.
Do not stop taking these drugs unless on medical advice! Instead practice good hygiene, social isolation and follow the latest government advice on gatherings.
The best thing you can do is to stay calm, don't perpetuate panic - especially on social media - and make sure you have some support in place to do shopping / errands if you have to isolate yourself for a while."
I too read of suggestions that the information was fake, had been posted from a hacked account, etc. Which was why I looked further and posted as I did.
I have now looked again. And found this (whole link posted as it is so important):
Covid-19: ibuprofen should not be used for managing symptoms, say doctors and scientists
Scientists and senior doctors have backed claims by France’s health minister that people showing symptoms of covid-19 should use paracetamol (acetaminophen) rather than ibuprofen, a drug they said might exacerbate the condition.
The minister, Oliver Veran, tweeted on Saturday 14 March that people with suspected covid-19 should avoid anti-inflammatory drugs. “Taking anti-inflammatory drugs (ibuprofen, cortisone . . .) could be an aggravating factor for the infection. If you have a fever, take paracetamol,” he said.
His comments seem to have stemmed in part from remarks attributed to an infectious diseases doctor in south west France. She was reported to have cited four cases of young patients with covid-19 and no underlying health problems who went on to develop serious symptoms after using non-steroidal anti-inflammatory drugs (NSAIDs) in the early stage of their symptoms. The hospital posted a comment saying that public discussion of individual cases was inappropriate.
But Jean-Louis Montastruc, a professor of medical and clinical pharmacology at the Central University Hospital in Toulouse, said that such deleterious effects from NSAIDS would not be a surprise given that since 2019, on the advice of the National Agency for the Safety of Medicines and Health Products, French health workers have been told not to treat fever or infections with ibuprofen.
Experts in the UK backed this sentiment. Paul Little, a professor of primary care research at the University of Southampton, said that there was good evidence “that prolonged illness or the complications of respiratory infections may be more common when NSAIDs are used—both respiratory or septic complications and cardiovascular complications.”
He added, “The finding in two randomised trials that advice to use ibuprofen results in more severe illness or complications helps confirm that the association seen in observational studies is indeed likely to be causal. Advice to use paracetamol is also less likely to result in complications.”
Ian Jones, a professor of virology at the University of Reading, said that ibuprofen’s anti-inflammatory properties could “dampen down” the immune system, which could slow the recovery process. He added that it was likely, based on similarities between the new virus (SARS-CoV-2) and SARS I, that covid-19 reduces a key enzyme that part regulates the water and salt concentration in the blood and could contribute to the pneumonia seen in extreme cases. “Ibuprofen aggravates this, while paracetamol does not,” he said.
Charlotte Warren-Gash, associate professor of epidemiology at the London School of Hygiene and Tropical Medicine, said: “For covid-19, research is needed into the effects of specific NSAIDs among people with different underlying health conditions. In the meantime, for treating symptoms such as fever and sore throat, it seems sensible to stick to paracetamol as first choice.”
Rupert Beale, an infectious diseases researcher at the Francis Crick Institute, had a warning on cortisone, however. “Patients taking cortisone or other steroids should not stop them except on advice from their doctor,” he said.
The complex role that the immune system might play in covid-19 disease has been underscored by reports that Swiss drug company Roche has secured approval from China for its anti-inflammation drug Actemra (tocilizumab) to treat patients developing severe complications from covid-19.
Some doctors in Italy, including Paolo Ascierto of the Pascale Hospital in Naples, claim that they have had success treating severely ill patients with the drug, which blocks the key inflammatory molecule interleukin-6.
There is speculation that the drug might prevent fatal “cytokine storms,” in which the immune system of seriously ill patients can cause organ failure.
I find it unsatisfactory that the reversal seems to have come from outside the NHS.
And that there were quite a few sources that poured scorn on the "avoid ibuprofen" message from positions of ignorance. Claiming fake news, hacked accounts, etc.
I had the most frightening experience after taking ibuprofen prior to receiving autoimmune thyroid diagnosis, it compromised my airways, I felt as though I could not breath ... I'm not surprised there are warnings about taking it for Covid-19. Please don't.
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