• COVID-19 and Avoiding Ibuprofen. How Good Is the Evidence?

      Kutti Sridharan, Gurusaravanan; Kotagiri, Rajesh; Chandiramani, Vijay H; Mohan, Babu P; Vegunta, Rathnamitreyee; Vegunta, Radhakrishna; Rokkam, Venkata R P; Univ Arizona, Banner Univ Med Ctr, Dept Internal Med (LIPPINCOTT WILLIAMS & WILKINS, 2020-07)
      Ibuprofen is an over-the-counter medication that is used widely for the treatment of pain and fever during COVID-19 pandemic. A concern was raised regarding the safety of ibuprofen use because of its role in increasing ACE2 levels within the Renin-Angiotensin-Aldosterone system. ACE2 is the coreceptor for the entry of SARS-CoV-2 into cells, and so, a potential increased risk of contracting COVID-19 disease and/or worsening of COVID-19 infection was feared with ibuprofen use. However, available data from limited studies show administration of recombinant ACE2 improves lung damage caused by respiratory viruses, suggesting ibuprofen use may be beneficial in COVID-19 disease. At this time, there is no supporting evidence to discourage the use of ibuprofen.
    • Ibuprofen Overuse Leading to Life-threatening Hypokalemia Associated with Renal Tubular Acidosis in Two Patients

      Thammineni, Nikhila; Kathi, Pradeep R; Sharma, Aditi; Jawed, Areeba; Univ Arizona, Internal Med Gastroenterol (CUREUS INC, 2019-12-17)
      Ibuprofen is a commonly used medication in the United States and is used both by prescription and over the counter, while hypokalemia is a life-threatening condition caused by various etiologies, one of which is the side effect of medications. Ibuprofen is well-known for its various nephrotoxic side effects, including hyperkalemia as a common electrolyte abnormality, however, renal tubular acidosis leading to hypokalemia with the use of ibuprofen has been reported rarely. We present here two cases of life-threatening hypokalemia due to over-thecounter use of large doses of ibuprofen and describe its management.