Ewa Obońska, Mariusz Zapadka

COVID-19: Should you be concerned about the use of ibuprofen?
2021-11-30

The disease caused by the SARS-COV-2 virus poses several challenges for patients, doctors, and healthcare systems worldwide. According to the recommendations for managing SARS-CoV-2 infections, in the case of mild disease without signs of respiratory failure, symptomatic treatment is recommended, in which non-steroidal anti-inflammatory drugs (NSAIDs) with anti-inflammatory, analgesic and antipyretic effects are used. Concern over the role of these drugs, particularly ibuprofen, in the course of COVID-19 has led to much speculation. Concerns about the use of non-steroidal anti-inflammatory drugs (NSAIDs) were mainly related to their pharmacological properties and the effects of inhibition of prostaglandin release on the immune system. The safety of ibuprofen to control fever and pain in COVID-19 has been openly questioned. It has been debated whether ibuprofen increases or decreases the levels of ACE2 (angiotensin-converting enzyme 2) in tissues, especially in the lungs, and whether it could exacerbate or reduce symptoms of COVID-19. It has also been suggested that by reducing fever, ibuprofen masks its beneficial effects in the natural course of the disease.

To date, studies have not provided sufficient evidence to establish a causal relationship between ibuprofen use and susceptibility to SARS-CoV-2 infection or exacerbation of COVID-19. In turn, the latest reports suggest using non-steroidal anti-inflammatory drugs (NSAIDs), including ibuprofen, which may have a beneficial effect in the early stage of COVID-19 treatment. Moreover, an alternative to traditional forms of ibuprofen may be administering a hypertonic sodium ibuprofenate solution using modern nebulizers. Nebulization allows the drug to deliver micro- or nanometer particles to the lung and allows the dose to be reduced to achieve a therapeutic effect.

According to the WHO, EMA, and FDA recommendations, all drugs used in the treatment of COVID-19 should be used with caution after the balance of benefits and risks has been established.

Keywords: Ibuprofen, COVID-19, NSAIDs.

© Farm Pol, 2021, 77 (9): 554–558