Nurofen producer Reckitt Benckiser sought to quash warnings against taking the drug, saying it was not aware of any evidence that the pills’ active ingredient ibuprofen adversely impacted patients suffering from COVID-19. Reuters Health reports that the company's statement followed a warning by France's health minister that people should not use anti-inflammatory drugs such as ibuprofen if they have coronavirus-like symptoms.
Nurofen, one of Reckitt’s more popular drugs, contains 200 mg of Ibuprofen as its active ingredient in each tablet and is indicated for “effective pain and inflammation relief and reducing fever,” according to the company’s website. “RB has neither received new safety information nor been involved in the evaluation of any adverse events regarding the use of ibuprofen in COVID-19,” the company said.
“Appropriate use of ibuprofen and paracetamol is still currently being recommended by most European health authorities as part of the symptomatic treatment of COVID-19.”
French authorities had earlier warned that widely used over-the-counter anti-inflammatory drugs may worsen the coronavirus, reports The Guardian. The country’s health minister, Olivier Véran, who is a qualified doctor and neurologist, tweeted: “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.”
Health officials point out that anti-inflammatory drugs are known to be a risk for those with infectious illnesses because they tend to diminish the response of the body’s immune system. The health ministry added that patients should choose paracetamol – which is known in the US by the generic name acetaminophen and commonly by the brand name Tylenol – because “it will reduce the fever without counterattacking the inflammation”.
The report says French patients have been forced to consult pharmacies since mid-January if they want to buy popular painkillers, including ibuprofen, paracetamol and aspirin, to be reminded of the risks. Jean-Louis Montastruc, the head of pharmacology at Toulouse Hospital, said: “Anti-inflammatory drugs increase the risk of complications when there is a fever or infection.”
Experts have questioned official UK government advice that people with mild symptoms of coronavirus should take ibuprofen over fears that it can make symptoms worse. The Daily Telegraph reports that the concerns have grown after Veran’s tweet.
The official advice on the NHS 111 website for people with mild symptoms of coronavirus is to rest and drink plenty of fluids and take paracetamol or ibuprofen, the active ingredient of popular brands such as Nurofen and Lemsip Max tablets, to reduce fever and aches and pain. However, some UK experts have backed Veran and say that people with mild symptoms should take paracetamol only and avoid anti-inflammatories.
Ian Jones, professor of virology at the University of Reading, said that as an anti-inflammatory ibuprofen could dampen the immune system, slowing recovery, as well as aggravating pneumonia symptoms. And, the report says, Dr Charlotte Warren-Gash, associate professor of epidemiology at the London School of Hygiene and Tropical Medicine, said anti-inflammatories such as ibuprofen could exacerbate some cardiovascular and kidney problems.
“Most deaths from Covid-19 have been among older people and those with underlying health conditions such as cardiovascular disease. We already know that non-steroidal anti-inflammatory drugs should be prescribed with caution for people who have underlying health conditions,” she said.
Dr Rupert Beale, group leader in cell biology of infection at the Francis Crick Institute, said ibuprofen could exacerbate acute kidney injury but said there was no widely accepted reason to avoid it for COVID-19. “Patients taking cortisone or other steroids should not stop them except on advice from their doctor,” he said.
Aspirin is also an anti-inflammatory drug although the NHS does not recommend taking this for mild symptoms of the disease.
Public Health England is quoted in the report as saying that there was currently not enough information on the effect of ibuprofen on the virus to change its advice.
[link url="https://www.reuters.com/article/us-reckittbenckiser-product/no-evidence-ibuprofen-bad-for-covid-19-patients-nurofen-maker-idUSKBN21327P"]Full Reuters Health report[/link]
[link url="https://www.theguardian.com/world/2020/mar/14/anti-inflammatory-drugs-may-aggravate-coronavirus-infection?CMP=Share_iOSApp_Other"]Full report in The Guardian[/link]
[link url="https://www.telegraph.co.uk/global-health/science-and-disease/experts-question-official-nhs-advice-ibuprofen-coronavirus/?WT.mc_id=e_DM1218948&WT.tsrc=email&etype=Edi_FAM_New_ES&utmsource=email&utm_medium=Edi_FAM_New_ES20200317&utm_campaign=DM1218948"]Full report in The Daily Telegraph[/link]