Xarelto and Ibuprofen

Is it safe to occasionally use Ibuprofen and take Xarelto? When I was in the Hospital in Austin, I was told I could use Ibuprofen and Xarelto for a few days to help with the pain from my Cather Ablation.

When I say occasionally I am talking about 400 mg of Ibuprofen 4-5 times a week. I need a inflammatory medication for my Interstitial Cystitis. I am taken Quercentin 500 mg 2x a day but it is limited to how much it helps.

I guess no one has crossed this issue. The drug interaction checker recommends against it;


Ibuprofen ↔ rivaroxaban

Applies to: ibuprofen, Xarelto (rivaroxaban)

Talk to your doctor before using rivaroxaban together with ibuprofen. Combining these medications can increase the risk of serious or life-threatening bleeding complications. If treatment with the combination is required, you may need a dose adjustment or more frequent monitoring by your doctor to safely use both medications. Call your doctor promptly if you experience any unusual bleeding or bruising, swelling, vomiting, blood in your urine or stools, headache, dizziness, or weakness during treatment with these medications. It is important to tell your doctor about all other medications you use, including vitamins and herbs. Do not stop using any medications without first talking to your doctor.

Smack, I'm avoiding ibuprofen until cleared to D/C Xarelto. I'm avoiding anything with blood-thinning properties until off Xarelto.

Late response here...

I asked my doctor about this a couple of weeks ago because Tylenol wasn't working on my neck pain. The general recommendation was against, but it wasn't a strong "no" and he basically conceded that I could take it once in a while. In your situation I would have given them a quick call to double-check the info.

Last summer while on warfarin I was regularly going to a specialized anticoagulant lab with a nurse who was very studied on anticoagulation and had been to conferences etc. He had an actual algorithm to check what your dose should be based on weight, medications, current INR and other factors, as opposed to in my experience most cardiologists who just kinda randomly pick numbers based on your labs.

For the most part he made warfarin seem much less delicate than we are led to believe. You're allowed to eat extra vegetables sometimes. You can drink sometimes. You can take ibuprofen sometimes. He explained that for the most part it's not like you're going to take a few ibuprofen pills and then hemorrhage that night. If you take a bunch of ibuprofen every day for a while and don't have your warfarin dose adjusted then yes it could become an issue. Even say five drinks every once in a while is fine (from the bleeding standpoint), whereas just 1-2 every day consistently would be a problem if medication was not adjusted. It's more the medium-term than the short-term.

All that being said, I know Xarelto does not work the same way and so it might be a different story. So this whole post may be irrelevant unless you take warfarin!