Ibuprofen Debate Continues During Coronavirus Outbreak

COVID-19 disease treatment options include OTC and prescribed medication products

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According to the BMJ, the debate over the safety of non-steroidal anti-inflammatory drugs (NSAIDs) in treating COVID-19 disease has continued with the European Medicines Agency (EMA) saying that the drugs could be considered for treating the emerging viral illness in some cases.

The EMA's comments published on March 24, 2020, were prompted by claims from France’s health minister Oliver Veran that people showing COVID-19 symptoms 'should use paracetamol rather than ibuprofen because the latter might worsen the condition.' 

His comments seem to have stemmed in part from remarks attributed to an infectious disease doctor in France. 

In addition, Jean-Louis Montastruc, a professor of medical and clinical pharmacology at the Central University Hospital in Toulouse, said that such deleterious effects from NSAIDs would not be a surprise given that since 2019, on the advice of the National Agency for the Safety of Medicines and Health Products, French health workers have been told not to treat fever or infections with ibuprofen.

Experts in the UK have also backed this sentiment. 

Paul Little, a professor of primary care research at the University of Southampton, said that there was good evidence “that prolonged illness or the complications of respiratory infections may be more common when NSAIDs are used—both respiratory or septic complications and cardiovascular complications.”

He added, “The finding in two randomized trials that advice to use ibuprofen results in more severe illness or complications helps confirm that the association seen in observational studies is indeed likely to be causal.” 

“Advice to use paracetamol is also less likely to result in complications.”

Ian Jones, a professor of virology at the University of Reading, said that ibuprofen’s anti-inflammatory properties could “dampen down” the immune system, which could slow the recovery process. 

He added that it was likely, based on similarities between the new virus (SARS-CoV-2) and SARS, that COVID-19 reduces a key enzyme that part regulates the water and salt concentration in the blood and could contribute to pneumonia seen in extreme cases. 

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“Ibuprofen aggravates this, while paracetamol does not,” he said.

On March 17, 2020, Charlotte Warren-Gash, associate professor of epidemiology at the London School of Hygiene and Tropical Medicine, said: “For COVID-19, research is needed into the effects of specific NSAIDs among people with different underlying health conditions. In the meantime, for treating symptoms such as fever and sore throat, it seems sensible to stick to paracetamol as the first choice.”

Rupert Beale, an infectious diseases researcher at the Francis Crick Institute, had a warning on cortisone, however. “Patients taking cortisone or other steroids should not stop them except on advice from their doctor,” he said.

The complex role that the immune system might play in COVID-19 disease has been underscored by reports that Swiss drug company Roche has secured approval from China for its anti-inflammation drug Actemra (tocilizumab) to treat patients developing severe complications from COVID-19.

Some doctors in Italy, including Paolo Ascierto of the Pascale Hospital in Naples, claim that they have had success treating severely ill patients with the drug, which blocks the key inflammatory molecule interleukin-6.

There is speculation that the drug might prevent fatal “cytokine storms,” in which the immune system of seriously ill patients can cause organ failure.

The US Food and Drug Administration (FDA) advises the public to read the full Drug Facts Label on OTC medications prior to use.

And, patients who use prescription drugs should take these medications as directed by your healthcare professional and in accordance with instructions on the label.

The FDA encourages healthcare professionals and patients to report adverse events or quality problems experienced with the use of any medication to the FDA’s MedWatch Adverse Event Reporting program.

SARS-CoV-2 coronavirus vaccine and medication development news published by Precision Vaccinations.