Harvard Heart Letter

Heart Beat: Take aspirin before ibuprofen, not after

Heart Beat

Take aspirin before ibuprofen, not after

If you take aspirin for your heart and ibuprofen for your aches and pains, try to take the aspirin first each day. That's what the FDA is recommending in a warning to consumers and health care professionals.

In 2003 we highlighted research suggesting that ibuprofen (Motrin, Advil, others) could block the heart-protecting action of aspirin. Subsequent work supporting this idea prompted the FDA to issue its warning in mid-September 2006.

Aspirin helps prevent heart attacks and the most common form of stroke by making platelets in the bloodstream less sticky and thus less likely to clump and form artery-blocking blood clots. It does this by sliding into the pocket of an enzyme called cyclooxygenase and handing over a few atoms of carbon, hydrogen, and oxygen. This transfer stops cyclooxygenase from making prostaglandin. Without prostaglandin, platelets can't make thromboxane A2, the substance that makes them sticky.

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