Drug Information
Common brand names:
Reprexain, VicoprofenSummary of Interactions with Vitamins, Herbs, & Foods
Types of interactions:BeneficialAdverseCheck
Replenish Depleted Nutrients
- Iron
NSAIDs cause gastrointestinal (GI) irritation, bleeding, and iron loss. Iron supplements can cause GI irritation. However, iron supplementation is sometimes needed in people taking NSAIDs if those drugs have caused enough blood loss to lead to iron deficiency. If both iron and nabumetone are prescribed, they should be taken with food to reduce GI irritation and bleeding risk.
Reduce Side Effects
- Fiber
Propoxyphene may cause gastrointestinal (GI) upset. Propoxyphene-containing products may be taken with food to reduce or prevent GI upset. A common side effect of narcotic analgesics is constipation. Increasing dietary fiber (especially vegetables and whole-grain foods) and water intake can ease constipation.
- Licorice
The flavonoids found in the extract of licorice (Glycyrrhiza glabra) known as DGL (deglycyrrhizinated licorice) are helpful for avoiding the irritating actions NSAIDs have on the stomach and intestines. One study found that 350 mg of chewable DGL taken together with each dose of aspirin reduced gastrointestinal bleeding caused by the aspirin. DGL has been shown in controlled human research to be as effective as drug therapy (cimetidine) in healing stomach ulcers.
- Milk Thistle
Silymarin is a collection of complex flavonoids found in milk thistle (Silybum marianum) that has been shown to elevate liver glutathione levels in rats.Acetaminophen can cause liver damage, which is believed to involve glutathione depletion. In one study involving rats, silymarin protected against acetaminophen-induced glutathione depletion. While studies to confirm this action in humans have not been conducted, some doctors recommend silymarin supplementation with 200 mg milk thistle extract, containing 70–80% silymarin, three times per day for people taking acetaminophen in large amounts for more than one year and/or with other risk factors for liver problems.
The interaction is supported by preliminary, weak, fragmentary, and/or contradictory scientific evidence.
Support Medicine
In a controlled human study, people who took stinging nettle with diclofenac obtained similar pain relief compared to people taking twice as much diclofenac with no stinging nettle. More research is needed to determine whether people taking diclofenac might benefit from also taking stinging nettle.
Potential Negative Interaction
- Ginkgo
It has been argued that ginkgo has a blood-thinning effect and might therefore further increase the risk of bleeing when taken in combination with drugs (including ibuprofen) that thin the blood. However, the bulk of the evidence suggests that ginkgo does not, in fact, have a blood-thinning effect.
The interaction is supported by preliminary, weak, fragmentary, and/or contradictory scientific evidence.
Ibuprofen may cause sodium and water retention. It is healthful to reduce dietary salt intake by eliminating table salt and heavily salted foods.
The interaction is supported by preliminary, weak, fragmentary, and/or contradictory scientific evidence.
- White Willow
White willow bark (Salix alba) contains salicin, which is related to aspirin. Both salicin and aspirin produce anti-inflammatory effects after they have been converted to salicylic acid in the body. The administration of salicylates like aspirin to individuals taking oral NSAIDs may result in reduced blood levels of NSAIDs. Though no studies have investigated interactions between white willow bark and NSAIDs, people taking NSAIDs should avoid the herb until more information is available.
The interaction is supported by preliminary, weak, fragmentary, and/or contradictory scientific evidence.
Explanation Required
- Potassium
Ibuprofen has caused kidney dysfunction and increased blood potassium levels, especially in older people. People taking ibuprofen should not supplement potassium without consulting with their doctor.
- Copper
Supplementation may enhance the anti-inflammatory effects of NSAIDs while reducing their ulcerogenic effects. One study found that when various anti-inflammatory drugs were chelated with copper, the anti-inflammatory activity was increased. Animal models of inflammation have found that the copper chelate of aspirin was active at one-eighth the effective amount of aspirin. These copper complexes are less toxic than the parent compounds as well.
The interaction is supported by preliminary, weak, fragmentary, and/or contradictory scientific evidence.
- Vitamin C
Taking 3 grams vitamin C with acetaminophen has been shown to prolong the amount of time acetaminophen stays in the body. This theoretically might allow people to use less acetaminophen, thereby reducing the risk of side effects. Consult with a doctor about this potential before reducing the amount of acetaminophen. However, increasing the time acetaminophen is in the body might also theoretically increase its toxicity. Consult with a doctor before taking vitamin C along with acetaminophen.
The interaction is supported by preliminary, weak, fragmentary, and/or contradictory scientific evidence.
The Drug-Nutrient Interactions table may not include every possible interaction. Taking medicines with meals, on an empty stomach, or with alcohol may influence their effects. For details, refer to the manufacturers’ package information as these are not covered in this table. If you take medications, always discuss the potential risks and benefits of adding a new supplement with your doctor or pharmacist.
