Experts question official NHS advice over ibuprofen and coronavirus

Experts have questioned official government advice that people with mild symptoms of coronavirus should take ibuprofen over fears that it can make symptoms worse.

The concerns grew after the French health minister, Olivier Veran, a neurologist, tweeted that taking anti-inflammatory drugs such as ibuprofen “could be a factor in aggravating the infection. In cases of fever, take paracetamol. If you are already taking anti-inflammatory drugs ask your doctor's advice.”

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 Dr 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.

“It is recommended that people use paracetamol to reduce temperature if they are feverish,” he said.

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.

She added that a 2017 study showed a higher risk of a patient suffering a heart attack when treated with an anti-inflammatory drug for a respiratory infection.

“For Covid-19, research is needed into the effects of specific [non-steroidal anti inflammatory drugs] 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,” said Dr Warren-Gash.

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 said there was currently not enough information on the effect of ibuprofen on the virus to change its advice

PHE said in a statement: “Currently there is no published scientific evidence that ibuprofen increases the risk of catching covid-19 or makes the illness worse. There is also no conclusive evidence that taking ibuprofen is harmful for other respiratory infections.”

Patients who have been prescribed anti-inflammatories should continue to take them, PHE said.

Irish health authorities were also forced to scotch rumours circulating on social media that four young people were seriously ill in hospital in Cork with the coronavirus and all had been taking anti-inflammatory medication.

Dr Colm Henry, chief clinical officer for Ireland’s Health Service Executive, said the message, which was being forwarded among parents’ groups on WhatsApp, had “no basis in fact”.

“It is complete lies and totally untrue,” he told Ireland’s Journal newspaper.

He added in a statement: “It is okay to take paracetamol and an anti-inflammatory like ibuprofen at the same time. There is no evidence to stop any medication at this time.”

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