Aspirin vs. Aleve

If you take both a baby aspirin and an anti-inflammatory drug like Naproxyn or Ibuprofen every day, did you know that there is a potential drug interaction?

I was playing and talking with a cardiologist, Dan Silverstein and asked him the pros and cons of taking some Aleve every day for minor aches and pains. He said that he takes two Naproxen one to two hours before playing tennis; and finds it eases the aches and helps him play better.

But he did caution that Aleve (naproxen) is a nonsteroidal anti-inflammatory drug (NSAID) that may interfere with the anti-platelet effect of aspirin, the mechanism by which aspirin affects its heart-protective effect. He told me that the drug interaction is clearer for ibuprofen but still possible for naproxen.

If you take ibuprofen at the same time you take aspirin, the anti-platelet effect of aspirin is blocked. Since naproxen has some anti-platelet effects of its own, the interaction with aspirin is less clear, with some studies showing an adverse effect, and others showing none.

If you must take both drugs, there may be a way to minimize the interaction. The aspirin anti-platelet effect is relatively irreversible. It takes about 48 hours for the effect to diminish, the time it takes for the body to produce enough new platelets.

The ibuprofen and naproxyn effects wear off after about 8-12 hours. Therefore, if you start by taking a baby aspirin at bedtime, your morning dose of “non-steroidal” should have minimal effect on the already “blocked” platelets. Also, since Naproxyn has some anti-platelet effects of its own, it might be the preferable drug.

Why Take Aspirin?

He also cautioned that someone “in as great physical shape as I am” probably doesn’t need to take a daily dosage of aspirin. If you have no risk factors for cardiovascular disease such as prior cardiovascular event, high blood pressure, diabetes, high cholesterol or low HDL cholesterol, strong family history, cigarette smoking, or others, the potential risks of a daily aspirin, even a baby aspirin, such as the increased risk of serious gastrointestinal bleeding might outweigh the small benefit of giving it to a perfectly healthy individual with a tiny risk of heart attack or stroke.

So take these words for what they are, understanding I am not a doctor (“Although I once played one in a movie”!); and consult yours with any real medical questions you may have.
Dr. Silverstein also cautioned me that he has been retired for about 10 years, so his free advice might not be worth much more than I paid for it!

The Pelican Bay Doubles Tournament

By the way, John Berry and I had a great match on Sunday’s 8.5 Combined finals vs. The Twin Towers of Mike Griner and Jack Moter (average height of 6’ 4”). In front of about 50 people (half watching, half drinking), they won the first set easy… we won the second set in a tie breaker … and they took the 10-point Champion’s Tie Breaker. It was a good format for fun tennis.

6 thoughts on “Aspirin vs. Aleve

  1. Recent news stories in the NYTimes indicate aspirin may have more benefits than we thought. Studies show that aspirin may also reduce the risk of cancer. Also take the aspirin with a hot liquid like herbal tea to help dissolve it in your stomach.

  2. The anti-platelet effects of aspirin may last longer than 48 hours. In our office, we wouldn’t perform any surgery unless the patient was off aspirin for at least one week.
    Interestingly, the anti-platelet effects of one baby aspirin are as strong as a regular aspirin.

  3. George, I have been taking voltaren(NSAID) daily and advil for tennis for many years now. I also take Plavix and aspirin for heart disease. Anecdotally, when I bleed, it is very hard to stop the bleeding. Yesterday, my cardiologist did say that there is a small increased risk of a blood clot for some people when taking the NSAIDs with the blood thinning meds. He emphasized taking the aspirin first, but if I’m taking both kinds of meds daily, which one is really “first”?

    George – as i understand from Dr. Silverstein, separating them by 12 hours helps. (But i only “played a doctor in the movies”!). geo

  4. I have been playing with triangular fibrocartilage, a tear in my wrist, for a couple of years. At least 1 hour before playing I take two Aleve for the arthritis and two Tylenol for the pain and shock to the wrist from hitting and I am able to play pain free.

    Doug – sounds like a lot of pills to me! geo

  5. If the aspirin effect lasts 48 hours and the naproxen / ibuprofen effect lasts 12 to 18 hours I don’t see why it’s better to take the aspirin at night instead of in the morning?

    Ted – i guess the Doc is saying you “minimize” the overlap because the ibuprofen lasts 8-12 hours and then you take your aspirin. geo

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