The NHS has issued guidance cautioning against combining naproxen and aspirin with a widely-used medication. Mixing these pain relievers could lead to some unpleasant side effects.

Non-prescription painkillers can prove invaluable for countless people experiencing routine discomfort and ailments. Conditions including headaches, back discomfort and common colds can frequently be alleviated through standard pain relief options.

Amongst the painkillers commonly relied on across Britain is ibuprofen, one of the most widely-purchased medicines available without requiring a doctor's prescription. Also marketed under the brand names Nurofen, Calprofen and Ibuleve, it belongs to a class of medications called nonsteroidal anti-inflammatory drugs - commonly referred to as NSAIDs.

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The medication functions by suppressing hormones responsible for inflammation and discomfort throughout the body, and is utilised for various ailments, from back discomfort and menstrual pain to dental ache and managing symptoms of colds, influenza or even COVID-19.

However, as with any pharmaceutical product, it's essential to understand the correct usage of ibuprofen to prevent any potentially dangerous adverse reactions. Part of this involves being cautious about combining ibuprofen with other medications, as they may interact negatively.

The NHScautioned: "Ibuprofen does not mix well with some medicines." Consequently, the health service has advised people to refrain from taking ibuprofen simultaneously with other NSAIDs.

This category includes aspirin and naproxen, which when used in combination with ibuprofen, could heighten the likelihood of complications such as gastric bleeding or renal difficulties. "Common" side effects of ibuprofen encompass:

• Indigestion and stomach discomfort


• Nausea and vomiting


• Headaches


• Skin rashes


• Dizziness


• Diarrhoea or constipation

However, more severe but less frequent side effects can include:

• Stomach ulcers or internal stomach bleeding – manifesting symptoms such as abdominal pain, breathlessness, pallor, vomiting blood or excreting black, sticky, tar-like faeces


• An allergic reaction (anaphylaxis) – exhibiting symptoms like a swollen throat or tongue, an elevated, itchy rash or difficulty in breathing


• Kidney issues – presenting symptoms such as shortness of breath, blood in urine or swelling in your ankles, feet or hands

The NHS has warned: "The risk of serious side effects is higher if you're taking a high dose of ibuprofen or taking it for a long time."

It's also crucial to be cautious with medications that might not be obvious as NSAIDs. "NSAIDs are also used in medicines you can buy from pharmacies, such as cough and cold remedies," the NHS advised.

"Before taking any other medicines, check the label to see if they contain aspirin, ibuprofen or other NSAIDs." For your safety, it's recommended to inform your doctor if you're consuming any of the following medicines before you commence taking any form of ibuprofen:

• Medications that help prevent blood clots, such as warfarin


• Treatments for hypertension


• Corticosteroid medications including betamethasone, dexamethasone, hydrocortisone or prednisolone


• Antibiotic treatments such as ciprofloxacin, levofloxacin, moxifloxacin, norfloxacin or ofloxacin


• Antidepressant medications including citalopram, fluoxetine, fluvoxamine, venlafaxine, paroxetine or sertraline


• Diabetic medications such as gliclazide, glimepiride, glipizide or tolbutamide

Additionally, combining ibuprofen with gingko biloba supplements should be avoided as it can "increase the chance of bleeding". The NHS advises seeking immediate medical attention or ringing 111 if you've been using ibuprofen and notice:

• Dark-coloured stools or blood present in vomit – potential indicators of stomach bleeding


• Puffy ankles, blood in urine or complete absence of urination – possible signs of kidney complications

Other NSAIDs include diclofenac, celecoxib, mefenamic acid, etoricoxib, and indomethacin.