Can I take Warfarin and Ibuprofen together?

Why this happens

This is a 'double whammy' effect. Warfarin works by slowing down the blood's ability to clot. Ibuprofen also thins the blood by affecting platelets, and it can irritate the lining of the stomach, making ulcers or bleeding more likely. Together, they make it much harder for your body to stop any bleeding that starts.

What you should do

You should avoid taking ibuprofen (or other similar anti-inflammatories like aspirin or naproxen) while taking warfarin unless specifically told to do so by your doctor. For pain relief, paracetamol is usually a much safer choice. If you have already taken them together and notice signs of bleeding—such as dark, tarry stools, bruising easily, or a nosebleed that won't stop—seek medical advice immediately.

Important precautions

Combined use (Drug-Drug Interaction)

Do not take ibuprofen while taking warfarin. Ibuprofen significantly increases the risk of severe internal bleeding and can interfere with how warfarin works. Use paracetamol for pain relief instead.

Asthma

Do not take ibuprofen if you have asthma, as it can trigger a life-threatening asthma attack or worsening of breathing difficulties in some people.

Pregnancy

Warfarin must not be taken during pregnancy as it can cause serious birth defects and fatal bleeding in the unborn baby. Use effective contraception while taking this medicine.

Pregnancy (third trimester)

Do not take ibuprofen if you are more than 6 months pregnant, as it can cause serious heart and kidney problems in the unborn baby and complications during birth.

Food and drink warnings

Alcohol

Avoid binge drinking. Regular, moderate consumption is usually fine, but sudden changes in alcohol intake can affect how warfarin works and increase the risk of bleeding.

It is best to avoid or strictly limit alcohol while taking ibuprofen. Combining alcohol with non-steroidal anti-inflammatory drugs (NSAIDs) like ibuprofen increases the risk of irritation to your stomach lining and can lead to stomach ulcers or bleeding.

Foods high in vitamin K (e.g. spinach, kale, broccoli, Brussels sprouts)

You do not need to avoid these, but you must keep your intake consistent. Vitamin K helps blood clot, which works against warfarin. A sudden increase or decrease in these foods can change your INR levels.

Cranberry juice and cranberry products

Avoid or limit cranberry juice. It can increase the effect of warfarin, making you more likely to bleed.

Grapefruit juice

It is best to avoid large amounts of grapefruit juice as it may increase the risk of bleeding, though the evidence is less consistent than with other foods.

Pomegranate juice

Avoid or limit pomegranate juice as it may increase the effect of warfarin and the risk of bleeding.

Food (General)

It is recommended to take ibuprofen with food or a glass of milk to reduce the risk of stomach upset or indigestion.

Using other medicines

Taking multiple medicines? Our Medicines Interaction Checker helps you check whether your prescriptions, over-the-counter medicines, and supplements are safe to take together. Simply search for your medicines to see potential interactions and what to do about them.

Disclaimer

This information is for general educational purposes only and should not be relied upon as a substitute for professional medical advice. Always consult your GP, pharmacist, or another qualified healthcare professional before making decisions about your medications. Individual circumstances may vary, and only a healthcare professional who knows your medical history can provide personalised guidance.