Nov 16, 2017
Darnol asked
What is the difference between ibuprofen and aspirin?
Answer
Ibuprofen (Advil, Motrin) and aspirin (ASA, or
acetylsalicylic acid) are both commonly used over-the-counter medications with
similar mechanisms of action. While aspirin is technically an NSAID
(non-steroidal anti-inflammatory drug) like ibuprofen, it does not fit as neatly
into this class due to differences in the mechanism of action. Because of this,
the reason to take aspirin versus ibuprofen is important to understand.
How Aspirin Works
Aspirin has been in use for thousands of years and
was first utilized by chewing the bark of a willow tree. This allowed for the
release of aspirin to help alleviate pain and reduce fever. Aspirin was first
marketed in the United States in 1899 and FDA approved in 1939. Aspirin works by inhibiting an enzyme known as
cyclooxygenase or COX. The COX enzymes play a significant role in prostaglandin
formation which are responsible for inflammation, platelet formation, and fever.
There are two types of COX, known as COX-1 and COX-2. COX-1 has a more
prominent role in platelet formation, as well as protecting the stomach lining.
COX-2 is primarily responsible for inflammation. Aspirin primarily impacts
COX-1 at low doses, which is the reason it has a more prominent impact on
platelet formation.When To Use Aspirin
While aspirin can be used as an anti-inflammatory, fever
reducer, and pain reliever, it is more often used for its benefit on the cardiovascular system. Due to platelet inhibition, aspirin helps protect against heart
attack, chest pain, and stroke. Aspirin can be used to prevent these
occurrences, known as primary prevention, or it can be used to protect cardiac
stents and valves and recurrent events, known as secondary prevention.
Generally, low-dose aspirin, 81 mg, is sufficient to provide the protective
effects without causing side effects like bleeding and GI irritation. Higher
doses of aspirin like the 325 mg tablet, are generally used for fever and pain,
similar to other NSAIDs like ibuprofen.
How Ibuprofen Works
Ibuprofen is a classic NSAID that non-selectively inhibits
both COX-1 and COX-2. This allows it to reduce pain, inflammation, and fever in
a similar way to aspirin. It does not have nearly the impact on platelet
formation like aspirin.
When To Use Ibuprofen
Ibuprofen is commonly used in a variety of ailments
including arthritis, cramping related to menstruation, general aches and pains,
fever, and headache. Unlike aspirin, it also has an IV formulation that can be
used in hospitals, although another NSAID, ketorolac (Toradol) is more commonly
used for hospitalized patients. Also
unlike aspirin, higher doses of ibuprofen (greater than 200 mg) requires a
prescription.
Side Effects Of Aspirin Versus Ibuprofen
Aspirin and ibuprofen have a similar side effect profile,
but there are some key differences. Aspirin can cause abdominal pain, nausea, tinnitus
(ringing of the ears) and heartburn. More severe side effects include bleeding,
especially GI bleeds. These side effects are dose dependent and the low-dose
aspirin is generally well tolerated in healthy adults. While ibuprofen and other NSAIDs like Naproxen (Aleve) and
Meloxicam (Mobic) may also cause GI irritation and bleeding, it is less common
than with aspirin. Ibuprofen can still cause upset stomach, including
constipation, diarrhea, and heartburn. NSAIDs can also cause fluid retention
and swelling. Unlike aspirin, ibuprofen can increase the risk of
heart attacks and stroke even during the first week of use.
Caution
is especially advised in patients with previous cardiac conditions, including
high blood pressure. Aspirin and ibuprofen generally should not be taken together
due to their similar mechanisms of action. This can lead to worsened side
effects like GI bleeding. Also, ibuprofen and other NSAIDs could decrease the
effectiveness of aspirin. Additionally, caution should be taken while taking
other blood thinners like warfarin, apixaban (Eliquis), clopidogrel (Plavix),
or heparin products.
It is important to note that it is no longer appropriate to
label 81 mg aspirin as “baby aspirin.” It is no longer recommended to give aspirin
to children under the age
of 19 years old during episodes of fever-causing or viral illnesses. This
type of usage has been associated with Reye’s syndrome, a rare, but potentially
fatal condition that most often affects children and teens during the flu or
chickenpox.
