Go to any pharmacy and there’s one product I can guarantee you’ll be able to buy — ibuprofen.
Packets of the painkiller and anti-inflammatory drug line the shelves, while paracetamol is difficult, if not impossible, to find. And it’s been like that for weeks — to be precise, since March 14, when French health minister Olivier Veran said ibuprofen could aggravate the coronavirus infection.
His comments appear to be based on four Covid-19 patients in France, who have no underlying health problems and who reportedly developed serious symptoms after taking ibuprofen.
The theory, published in a letter in The Lancet, is that the virus binds to a receptor in the body called ACE2, and ibuprofen may increase the production of this receptor. So taking the drug might raise the risk of getting the virus or make the infection worse.
There has recently been a U-turn on advice not to take ibuprofen following fears the drug could worsen coronavirus symptoms in sufferers (stock)
Despite no studies proving this theory, three days later, the NHS advised patients to avoid taking ibuprofen to treat their symptoms, and to use paracetamol instead.
But the Government’s Commission on Human Medicines (CHM), which advises on the safety, efficacy and quality of drugs, carried out a review and has now concluded that ibuprofen and paracetamol can be safely taken for Covid-19.
The review considered the available data, including that from studies in animals, clinical trials, evidence from observational studies (where patient outcomes are measured, but no treatment is given) and 16 studies which considered whether ibuprofen might increase the risk of an infection worsening.
‘There is currently insufficient evidence that ibuprofen can worsen the symptoms of Covid-19,’ says Dr Sarah Branch, director of vigilance and risk management of medicines at the Medicines and Healthcare products Regulatory Agency.
‘You can take paracetamol or ibuprofen to alleviate fever and headaches from Covid-19, if you follow the instructions that come with the medicine.’
Patients who have been prescribed ibuprofen or other non-steroidal anti-inflammatories (NSAIDs) as a treatment for a long-term condition, such as arthritis, ‘should keep taking these medicines as normal’, the CHM said last week.
The change has been welcomed by many who feared people had stopped taking prescriptions
The U-turn has been welcomed by experts who were concerned that the warning and subsequent shunning of ibuprofen had gone too far. ‘The advice was based, at best, on speculation and extrapolation from studies in other conditions,’ says Emma Baker, a professor of clinical pharmacology at St George’s, University of London and clinical vice president of the British Pharmacological Society.
‘The unfounded comments about avoiding ibuprofen went too far and led to nationwide shortages of paracetamol as people stockpiled the drug, which was unnecessary.
‘There are also concerns that people who take ibuprofen regularly for chronic arthritis, for example, may have stopped, and this could result in worsening symptoms, which could be painful and reduce mobility.’
A separate review of 13 studies by King’s College London recently also found no evidence that ibuprofen could be harmful for people who have the coronavirus.
Paracetamol and ibuprofen are both widely used to treat pain and fever. Ibuprofen is also an anti-inflammatory, so tends to be better for joint pain or inflammatory conditions such as arthritis.
‘Whenever you take a medicine of any sort, there is a risk and a benefit,’ says Professor Baker.
‘As long as paracetamol is taken at the recommended dose, it is safe for most people. Ibuprofen can irritate the stomach, and if you take it a lot you can develop stomach ulcers and kidney problems. If it’s a straight choice between the two, paracetamol is better.’
Indeed, the NHS website recommends patients with symptoms of the coronavirus ‘try paracetamol first’ as it has ‘fewer side-effects than ibuprofen’.
Previous studies have shown that people who take NSAIDs for coughs, colds and sore throats may be more likely to suffer severe illness or have a slower recovery than those who take paracetamol.