Combining Certain Medications With Ibuprofen Can Permanently Injure Kidneys

Taking the common pain reliever ibuprofen could cause acute kidney injury if you are also taking diuretics and RSA inhibitors, which is a common combination treatment for people with hypertension.

Commonly prescribed hypertension medications may be harmful in combination with ibuprofen.

People with high blood pressure are often treated with a combination of diuretics (sometimes called water pills) and RSA inhibitors. New research warns that taking ibuprofen, the over-the-counter medication often taken for pain, fever, or inflammation, on top of these two medications can be dangerous.

Specifically, the interaction of the three medications in people with certain medical profiles can cause acute kidney injury. In some cases, the damage caused by this “triple whammy” can be permanent.

Anyone who is taking a diuretic and a renin-angiotensin system (RSA) inhibitor for hypertension (high blood pressure) should be cautious about also taking the painkiller ibuprofen, according to new research.

Diuretics and RSA inhibitors are commonly prescribed together for people with hypertension and are available under various pharmaceutical brand names. Pain-relievers such as ibuprofen are available over-the-counter in most pharmacies and stores in popular brands including Advil and Motrin.

Researchers at the University of Waterloo used computer-simulated drug trials to model the interactions of the three drugs and the impact on the kidney. They found that in people with certain medical profiles, the combination can cause acute kidney injury, which in some cases can be permanent.

Ibuprofen is a medication in the nonsteroidal anti-inflammatory drug (NSAID) class that is used to treat pain, fever, and inflammation. This includes painful menstrual periods, migraines, and rheumatoid arthritis. Common brand names with ibuprofen as the active ingredient include Advil and Motrin.

“It’s not that everyone who happens to take this combination of drugs is going to have problems,” said Anita Layton, professor of applied mathematics at Waterloo and Canada 150 Research Chair in mathematical biology and medicine. “But the research shows it’s enough of a problem that you should exercise caution.”

Computer-simulated drug trials can quickly produce results that would take much longer in human clinical trials. Layton and her team use mathematics and computer science to give medical practitioners a head start with issues like drug complications.

The research, in this case, can also speak directly to the many people who are taking drugs for hypertension and may reach for a painkiller with ibuprofen without giving it much thought.

“Diuretics are a family of drugs that make the body hold less water,” Layton said. “Being dehydrated is a major factor in acute kidney injury, and then the RAS inhibitor and ibuprofen hit the kidney with this triple whammy. If you happen to be on these hypertension drugs and need a painkiller, consider acetaminophen instead.”

Layton’s new research paper, with co-authors Jessica Leete, Carolyn Wang, and Francisco J. López-Hernández, “Determining risk factors for triple whammy acute kidney injury,” appears in the journal Mathematical Biosciences.

Reference: “Determining risk factors for triple whammy acute kidney injury” by Jessica Leete, Carolyn Wang, Francisco J. López-Hernández and Anita T. Layton, 11 April 2022, Mathematical Biosciences.
DOI: 10.1016/j.mbs.2022.108809

KidneyPharmaceuticalsPopularToxicologyUniversity of Waterloo
Comments ( 8 )
Add Comment
  • S K Halstead

    We have known that NSAIDs can increase blood pressure so those of us over 65 have been warned to avoid them, but this is further “evidence” that they are not safe for those of us taking HCTZ (most likely) and either an ACE inhibitor or an angiotensin receptor blocker. Once past 65 we have to do all we can to protect our vital organs such as our kidneys.

  • Jean Kutzer

    I cannot take ibuprofen or tylenol and try not to end up in ER. The ambulance service administers Ketamine known as special k on the street. If you enjoy LSD fine but it was a nightmare for me. I’d rather be in pain. In the ER they treat your pain but when you leave they give nothing. Only thing left is vodka. Thanks to the DEA for creating the fake opioid crisis. Idiots.

  • David Barber

    I am a kidney transplant patient. I have from the beginning been told that acetaminophen is the only
    pain reliever safe to take, and I take that sparingly.
    It seems to me this should have been known decades ago.

  • Sekar

    Very Interesting. Sharing some initial Thoughts.

    1. Hypertension = Extremely High Blood Pressure. Probably due to high Psychological and Physiological stress that the Hypertensive Patient is under.

    2. Blood Pressure is due to malfunctioning of the flow of Blood . Blood flow is controlled by the muscle called Heart. Viscosity of blood may have a role to play.

    3. The Kidney (Two of them) are critical for the excretion of water waste from the human ecosystem. Linked to Blood Flow. The iquid system of network, carrying energy to cells in the human ecosystem.

    4. Inflammation is a signal that the body is trying to fight off unfriendly pathogens , bacteria and viruses attempting to invade the Human being.

    5. When we use medicines like a diuretic and RSA we are attempting to normalize the high blood pressure and bring it back to “normal”. Blood thinners and such….

    6. When we use a anti-inflammatory agent like Ibuprofen what we are doing is address a different problem. The side-effects of such a chemical on the kidney cells can be temporary or permanent.

    7. However, regenerative technologies do exist, which can regenerate cells impacted due to such chemicals. It may be a good idea for the Waterloo Scientists to touch base with the Scientists at Texas A&M working on regenerative technologies. Maybe, something could emerge!

    Views expressed are personal and not binding on anyone.

  • Mark the Pharmacist

    We learnt about this “triple whammy” combination (it was even know by the same name) at uni in the late 90’s… I’m not sure how they can call this new research?

  • M.Tanvir Khan

    Taking any over the counter medicatiion, check with the physcian or the pharmacist.
    Too much Tylenol can easily cause liver damage especially if mixed with Alcohol.
    Names of the drugs drugs that should have be mentioned in the article for the benefit of an average person ie; Cozaar (losartan), Diovan (Valsartan), Vasottec (Enalapril),

  • Lucille

    Thank you.

  • We R. One

    2 of my siblings were both taking both these drugs together! Both their kidneys failed and both died….