FDA: No Scientific Evidence That NSAID Use Worsens COVID-19 Symptoms

Despite emerging reports that the use of non-steroidal anti-inflammatory drugs (NSAIDs) could exacerbate coronavirus disease (COVID-19), officials with the FDA have said that there is currently no available scientific evidence backing these reports at this time.¹

In a published statement, the agency did indicate that it is investigating the issue and will communicate publicly when more information is available. However, as of now, the agency “is not aware of scientific evidence connecting the use of NSAIDs, like ibuprofen, with worsening COVID-19 symptoms.”

Last week, France’s health ministry urged individuals to avoid taking OTC NSAIDs, including ibuprofen, aspirin, and naproxen, suggesting that these drugs may increase the severity of COVID-19. As an alternative, those infected with the virus were advised to take acetaminophen, such as Tylenol, instead.²

A commentary previously published in The Lancet suggested that taking ibuprofen might increase the number of angiotensin-converting enzyme 2 (ACE2) receptors on a cell, which could make an individual more vulnerable to infection.²

However, there is no published or peer-reviewed data to substantiate a potential interaction between NSAID use and COVID-19 symptoms.

In a tweet published on its official Twitter account on March 18, the World Health Organization (WHO) said that, based on currently available information, it does not recommend against the use of ibuprofen.

“We are also consulting with physicians treating COVID-19 patients and are not aware of reports of any negative effects of ibuprofen, beyond the usual known side effects that limit its use in certain populations,” the WHO added.

However, the FDA maintained that, “all prescription NSAID labels warn that ‘the pharmacological activity of NSAIDs in reducing inflammation, and possibly fever, may diminish the utility of diagnostic signs in detecting infections.’”

References:

1. FDA advises patients on use of non-steroidal anti-inflammatory drugs (NSAIDs) for COVID-19 [news release]. https://www.fda.gov/drugs/drug-safety-and-availability/fda-advises-patients-use-non-steroidal-anti-inflammatory-drugs-nsaids-covid-19. Accessed March 20, 2020.

2. Snyder B. Ibuprofen and COVID-19: a doctor’s guidance [VUMC Reporter]. Vanderbilt University Medical Center’s website. https://news.vumc.org/2020/03/18/ibuprofen-and-covid-19%E2%80%88a-doctors-guidance/. Accessed March 20, 2020.