Is Ibuprofen a Blood Thinner?

Ibuprofen belongs to a group of medications called nonsteroidal anti-inflammatory drugs (NSAIDs). It is one of the most common pain relievers available over-the-counter (OTC) to treat minor aches, pains, fever, and inflammation. Ibuprofen is commonly referred to by its brand names Advil and Motrin. In addition to pain relief, ibuprofen is also widely used to reduce fever in adults and children. (Tylenol Vs. Advil: Which Is Better?)

Ibuprofen is considered to be a fairly safe drug for the majority of healthy people. However, it can also cause serious side effects such as high blood pressure and heart disease, including heart attack and stroke. Additionally, if you are already taking a blood thinner medication like warfarin, apixaban (Eliquis), dabigatran (Pradaxa), or rivaroxaban (Xarelto), taking ibuprofen can put you at a higher risk of bleeding (stomach and intestinal bleeding) and stomach ulcers. Ibuprofen should be used with caution in elderly patients. 

Please continue reading to learn more about how ibuprofen might increase your bleeding risk.

Definition of a Blood Thinner

A blood thinner is a medication that prevents blood clots from forming by interfering with the blood clotting process. It does not break up clots that have already formed. However, it can prevent existing blood clots from increasing in size. There are two types of blood thinners:

• Anticoagulants like heparin and warfarin that slow down the formation of blood clots. Learn about “Warfarin vs Heparin: Similarities and Differences.”

• Antiplatelet agents like aspirin and clopidogrel which prevent platelets from clumping together.

Is Ibuprofen a Blood Thinner: Yes or No?

No, ibuprofen is not a blood thinner. However, similar to other NSAIDs, ibuprofen can have a mild effect on the normal blood clotting process. To be more specific, ibuprofen increases the time your body takes to form blood clots. In other words, ibuprofen slows down the process of blood clot formation, making it harder for blood clotting to occur. Learn about exercises to help prevent blood clots.

Mechanism of Action: How Ibuprofen Affects the Body

Overview of How Ibuprofen Works: Does Ibuprofen Thicken or Thin Your Blood?

Ibuprofen does not technically “thin” your blood. Rather, it slows down the blood clotting time. As mentioned, ibuprofen is a nonsteroidal anti-inflammatory drug (NSAID). It works by blocking the cyclooxygenase (COX) enzyme in the body and preventing the formation of substances called prostaglandins. Prostaglandins are involved in inflammation and blood clot formation. By blocking the production of prostaglandins, ibuprofen reduces symptoms of pain and inflammation but also slows down the normal process of blood clotting. 

Effects Compared to Anticoagulants and Antiplatelet Drugs: Which Painkillers are Blood Thinners?

Anticoagulants and antiplatelet drugs are blood thinners. They are prescribed to people with heart and blood vessel diseases, including abnormal heart rhythms, artificial heart valves, and congenital heart defects. Blood thinners are also used to lower the risk of blood clots after surgery. 

In contrast, painkillers are not blood thinners. However, painkillers like ibuprofen (Advil, Motrin) and naproxen (Naprosyn, Aleve) have blood-thinning effects. These medications should be used with caution if you take blood thinners - antiplatelet drugs like aspirin or anticoagulants like warfarin (Coumadin) - because the additive effects can greatly increase your risk of bleeding.

Common Questions About Ibuprofen as a Blood Thinner

Is Baby Ibuprofen a Blood Thinner?

Ibuprofen dosing in babies and children is based on body weight. The drug can cause similar side effects in pediatric patients, including blood thinning effects.

Can Ibuprofen Cause Blood Clots?

Ibuprofen does not cause blood clots. Rather, it slows down blood clotting time. However, studies have shown that NSAID use can increase the risk of venous thromboembolism (deep vein thrombosis or DVT), which are blood clots in the leg veins, in women of reproductive age. Combined use of NSAIDs and hormonal contraception is associated with an even greater risk of DVT. 

What Clotting Factor Does Ibuprofen Affect?

Ibuprofen and other NSAIDs block the effects of the cyclooxygenase (COX) enzyme, preventing the formation of a substance called thromboxane which is necessary for platelet aggregation (clumping together of platelets to form a blood clot). As a result, these drugs slow down clotting and increase bleeding risk.

Are Ibuprofen or Tylenol Blood Thinners?

Ibuprofen and Tylenol (acetaminophen) are not blood thinners. Tylenol does not have blood thinning effects. Ibuprofen, on the other hand, can cause thinning of the blood, increasing bleeding risk. As a result, ibuprofen can cause intestinal or stomach bleeding as adverse effects, especially in patients who are on blood thinners and older adults. 

Does Ibuprofen Thin the Blood like Aspirin? 

Ibuprofen is not as strong as aspirin in thinning blood, but it can still slow down blood clotting time. Aspirin is an antiplatelet drug that stops platelets from clumping together to form blood clots. 

Can You Take Nonsteroidal Anti-Inflammatory Drugs to Prevent Blood Clotting? 

No, even though NSAIDs like ibuprofen have a blood thinning effect, you should not take ibuprofen or any other NSAIDs to prevent blood clotting. In other words, ibuprofen must not be used in place of prescription blood thinners like warfarin, Eliquis, Xarelto, or clopidogrel (Plavix). Find out “What Drugs Should Not Be Taken With Eliquis?”

Who Should Avoid Ibuprofen?

Health Conditions and Risks Associated with Ibuprofen

Clinical trials have shown that people who take ibuprofen have an increased risk of the following health conditions:

• Cardiovascular thrombotic events (blood clots in the heart or brain causing heart attacks and strokes)

• Hypertension (high blood pressure)

• Heart failure and edema (fluid retention)

• Gastrointestinal problems, including ulceration, bleeding, and perforation

• Kidney injury

• Severe allergic reactions

• Harm to the unborn baby if used during pregnancy

People with the following conditions should avoid ibuprofen or use it with caution:

• Allergic reaction to ibuprofen or other NSAIDs, or having an asthma attack after taking ibuprofen or aspirin in the past

• Active bleeding in the gastrointestinal tract or brain

• Recent heart attack

• Recent or upcoming coronary artery bypass grafting (CABG or heart bypass surgery)

• Uncontrolled hypertension (high blood pressure)

• Uncontrolled heart failure

• Kidney failure or advanced kidney disease

• Liver failure or advanced liver disease

• Pregnancy

Who Should Avoid Blood Thinners?

People who should avoid blood thinners include those with:

• Recent trauma 

• Recent major surgery

• Active bleeding

• History of brain bleeds, stroke, or aneurysm

• Advanced liver disease

• Blood clotting disorders

Safe Alternatives to Ibuprofen for Individuals at Risk

OTC Options for Pain Relief If You’re On a Blood Thinner

As mentioned above, taking ibuprofen and a blood thinner together can lead to an increased risk of bleeding. However, if you are on blood thinners and need to take something for short-term pain relief, you may be able to take over-the-counter painkillers like acetaminophen (Tylenol). Keep in mind that taking high doses of acetaminophen over an extended period can cause liver damage, leading to liver disease or even liver failure. Find out, “How much ibuprofen can I take safely?”

Long-Term Pain Relief While Taking a Blood Thinner

If you are taking blood thinners and have a health condition requiring long-term use of pain relievers, such as arthritis pain, consult your doctor for the most appropriate pain medicine along with the correct dosage and duration of therapy. Many pain medicines such as ibuprofen, Celebrex, and tramadol can interact with blood thinners and increase bleeding risk.

For arthritis and other medical conditions that require long-term treatment with pain relievers, your doctor may recommend medicines like acetaminophen (Tylenol) that do not have interactions with blood thinners. 

Consult a Health Care Provider

If Tylenol does not control your symptoms, there are other options for pain relief that you can discuss with your healthcare provider. Also, there are non-pharmacological modalities that can be very beneficial in the long run. Examples include physical therapy, aqua therapy, massage, acupuncture, and chiropractic therapy.

Doctors generally advise taking painkillers like ibuprofen at the lowest dose for the shortest time possible until your symptoms subside. However, if interactions between your blood thinner and ibuprofen are causing problems, you may need to stop taking ibuprofen completely.