The NHS has updated its advice for people who are at home with symptoms of the Covid-19 virus, saying people should take paracetamol as the painkiller of first choice.
The new advice comes after France’s Health Minister, Olivier Veran, tweeted that “taking anti-inflammatory drugs (ibuprofen, cortisone…) could be an aggravating factor of the infection”.
The NHS says there is “currently no strong evidence that ibuprofen can make coronavirus worse” but recommends paracetamol “until we have more information” – unless a doctor has said you shouldn’t take it.
Symptoms and treatment advice
The NHS says the symptoms to watch out for are a high temperature – where you feel hot to touch on the chest or back – and a new, continuous cough.
The advice says people with symptoms should drink plenty of water and take paracetamol.
Public Health England goes into more detail, saying: “You should drink enough during the day so your urine (pee) is a pale clear colour.”
It says people using paracetamol should follow the instructions on the packet or label and not exceed the recommended dose.
Change of advice
Official advice for patients in the UK was to use paracetamol or ibuprofen, but this has been updated after criticism from clinical experts.
The NHS now says: “There is currently no strong evidence that ibuprofen can make coronavirus (COVID-19) worse.
“But until we have more information, take paracetamol to treat the symptoms of coronavirus, unless your doctor has told you paracetamol is not suitable for you.
“If you are already taking ibuprofen or another non-steroidal anti-inflammatory (NSAID) on the advice of a doctor, do not stop taking it without checking first.”
Experts have broadly welcomed the change.
Professor Sir Munir Pirmohamed, president of the British Pharmacological Society, said: “There is no consistent evidence to suggest that ibuprofen worsens the disease, but we support the cautious approach as more evidence is collected.”
He added: “Stopping or changing medicines for chronic health conditions without appropriate advice can be harmful. Now more than ever, people can look after their own health and support the NHS by following both official guidance and that of their doctor.”
Drawbacks of ibuprofen
Experts point out that prolonged use of non-steroidal anti-inflammatory drugs – the class of medicine ibuprofen belongs to – can prolong some illnesses, make respiratory and other complications more likely and cause other side effects like stomach irritation and kidney problems.
Dr Tom Wingfield, Senior Clinical Lecturer and Honorary Consultant Physician at Liverpool School of Tropical Medicine, said: “In the UK, paracetamol would generally be preferred over non-steroidal anti-inflammatory drugs (“NSAIDS”) such as ibuprofen to relieve symptoms caused by infection such as fever.
“This is because, when taken according to the manufacturer’s and/or a health professional’s instructions in terms of timing and maximum dosage, it is less likely to cause side effects.”
Dr Rupert Beale, Group Leader in Cell Biology of Infection at The Francis Crick Institute, said: “There is a good reason to avoid ibuprofen as it may exacerbate acute kidney injury brought on by any severe illness, including severe COVID-19 disease. There isn’t yet any widely accepted additional reason to avoid it for COVID-19.
“Patients taking cortisone or other steroids should not stop them except on advice from their doctor. The Society for Endocrinology has issued advice for patients who are taking hydrocortisone or other steroids for pituitary or adrenal deficiency.”
FactCheck has seen a number of fabricated stories about the dangers of ibuprofen being circulated on various messaging platforms.
One purported to originate from Cork University Hospital and claimed that young people were being treated in intensive care because anti-inflammatory drugs made their symptoms worse.
The hospital has confirmed that the story is completely false. The BBC has reported on other variations from France and Italy – all fabrications.
We’ve seen lurid fake messages circulating about the supposed dangers of people with coronavirus symptoms taking anti-inflammatory drugs like ibuprofen.
While these scare stories are not true, doctors say there are good reasons to prefer paracetamol to ibuprofen.
The latest NHS advice says there is “no strong evidence” that ibuprofen worsens symptoms of Covid-19 but recommends that people take paracetamol until more is known.
Experts have broadly welcomed this change of advice but stress that people should follow instructions from doctors about the medication they are taking.