Does ibuprofen impair the metabolism of ethanol?/nThe questioner has recently had a couple of patie

Fråga: Does ibuprofen impair the metabolism of ethanol?

The questioner has recently had a couple of patients who have stated that they have used therapeutic or higher doses of ibuprofen in connection to alcohol intake. The ethanol concentrations, as measured by breath analysis, did not decrease as expected in these patients. Faulty equipment is also suspected.

Sammanfattning: Ibuprofen administered once or twice in therapeutic doses does not appear to substantially affect the elimination of ethanol.

Svar: There is no obvious theoretical reason to suspect a pharmacokinetic interaction between ibuprofen and ethanol. However, three studies addressing this question have been identified.

In one study, six healthy volunteers were randomly assigned to ethanol alone or ibuprofen followed by ethanol and served as their own controls. The subjects were fasting and the ibuprofen dose was 400 mg at 12 h and 1.5 h before ethanol intake. The ethanol was dosed to reach a serum concentration of approximately 125 mg/dl (equals 1.25 promille). The ethanol concentrations were measured by breath analysis. A ten percent decrease in the ethanol elimination was found after ibuprofen intake (1).

Another study investigated the effect of a single-dose ibuprofen, ingested one hour prior to alcohol consumption, on the single-dose kinetics of ethanol in twelve healthy volunteers who served as their own controls. The ibuprofen dose was 800 mg and was administered at the end of a standardized breakfast. The ethanol dose was 0.3 g pure ethanol per kg body weight, corresponding to 40-50 ml hard liquor. Plasma concentrations of ethanol were measured by gas chromatography. Ibuprofen did not change the peak concentration, the time to peak concentration or the area under the concentration curve of ethanol (2).

One study of 19 subjects who were randomly assigned to two groups received either placebo or ibuprofen followed by ethanol. The ethanol was dosed to reach a serum concentration of approximately 100 mg/dl (equals 1.0 promille). Each subject served as his/her own control. The ibuprofen dose was 400 mg and was administered 5.5 h and 1 h before the ethanol consumption. Blood ethanol was estimated every 30 to 60 minutes by breath analysis, and measured at 4 hours by gas chromatography. There was no difference between the groups at the various time intervals.

All studies are small and they reach somewhat different conclusions. But the ten percent decrease found in the smallest study is a modest change, and breath analysis was used to measure ethanol concentrations. However, it is of course possible that ibuprofen can affect ethanol eliminations differently in some individuals compared to the participants of these studies. All studies used therapeutic doses of ibuprofen. No data on the effects of higher doses of ibuprofen was found. Minocha A, Herold DA, Barth JT, Gideon DA, Spyker DA. Activated charcoal in oral ethanol absorption: lack of effect in humans. J Toxicol Clin Toxicol 1986;24(3):225-234 Melander O, Liden A, Melander A. Pharmacokinetic interactions of alcohol and acetylsalicylic acid. Eur J Clin Pharmacol 1995;48(2):151-153 Barron SE, Perry JR, Ferslew KE. The effect of ibuprofen on ethanol concentration and elimination rate. J Forensic Sci 1992;37(2):432-435