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Debate over ibuprofen use amid coronavirus confusion

French health minister Olivier Veran suggested that anti-inflammatory drugs could worsen the infection.

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Ibuprofen (Lauren Hurley/PA)

Ibuprofen (Lauren Hurley/PA)

Ibuprofen (Lauren Hurley/PA)

There is not enough information on ibuprofen use and Covid-19 to advise people to stop using ibuprofen, health officials in England have said.

Public Health England (PHE) said there is no published scientific evidence that ibuprofen increases the risk of catching Covid-19 or makes the illness worse.

It comes after French health minister Olivier Veran suggested that anti-inflammatory drugs could worsen the infection.

In a tweet, Mr Veran wrote: “Taking anti-inflammatory drugs (ibuprofen, cortisone, etc.) may be a factor in worsening the infection. If you have a fever, take paracetamol. If you are already on anti-inflammatory drugs or if in doubt, ask your doctor for advice.”

In the UK, paracetamol would generally be preferred over non-steroidal anti-inflammatory drugs (NSAIDS), such as ibuprofen, to relieve symptoms caused by infection such as feverDr Tom Wingfield

PHE said that most people with Covid-19 will have a mild illness and some people may need to take medicines, such as paracetamol or ibuprofen, to help with raised temperature, headache and other pains.

But other experts in Britain have said that people should use paracetamol to relieve symptoms caused by infection such as fever.

Dr Tom Wingfield, senior clinical lecturer and honorary consultant physician at the Liverpool School of Tropical Medicine, said: “In the UK, paracetamol would generally be preferred over non-steroidal anti-inflammatory drugs (NSAIDS), such as ibuprofen, to relieve symptoms caused by infection such as fever.

“This is because, when taken according to the manufacturer’s and/or a health professional’s instructions in terms of timing and maximum dosage, it is less likely to cause side effects.

“Side effects associated with NSAIDs such as ibuprofen, especially if taken regularly for a prolonged period, are stomach irritation and stress on the kidneys, which can be more severe in people who already have stomach or kidney issues.

“It is not clear from the French minister’s comments whether the advice given is generic ‘good practice’ guidance or specifically related to data emerging from cases of Covid-19, but this might become clear in due course.

“It should also be noted that, in the UK, we would not commonly use cortisone to relieve infection-related symptoms such as fever.”

Dr Charlotte Warren-Gash, associate professor of epidemiology at London School of Hygiene and Tropical Medicine, added: “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.”

Professor Ian Jones, virologist at the University of Reading, added: “The advice relates to ibuprofen’s anti-inflammatory properties, that is, it dampens down the immune system, which may slow the recovery process.

“In addition, it is likely, based on the substantial literature around Sars I and the similarities this new virus (Sars-CoV-2) has to Sars I, that the virus reduces a key enzyme which part-regulates the water and salt concentration in the blood and could be part of the pneumonia seen in extreme cases.

“Ibuprofen aggravates this while paracetamol does not. It is recommended that people use paracetamol to reduce temperature if you are feverish.”

PHE said that there is no conclusive evidence that taking ibuprofen is harmful for other respiratory infections.

It added that patients who have been prescribed NSAIDs for long-term health problems should continue to take them as directed by their healthcare professional.

PA