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Current Drug Safety

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ISSN (Print): 1574-8863
ISSN (Online): 2212-3911

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Short Communication

Lack of Evidence for Blood Pressure Effects of Caffeine Added to Ibuprofen

Author(s): Anette Lampert, Robert Lange and Thomas Weiser*

Volume 18, Issue 1, 2023

Published on: 25 May, 2022

Page: [97 - 102] Pages: 6

DOI: 10.2174/1574886317666220414125027

open access plus

Abstract

Background: Caffeine enhances the efficacy of non-opioid analgesics. Data on the cardiovascular health effects of caffeine intake are controversial, and studies on the cardiovascular effects of medical caffeine use are lacking.

Objective: The study aims to explore the cardiovascular effects of an ibuprofen/caffeine combination in comparison to ibuprofen alone.

Methods: Secondary analysis of a previously reported bioequivalence study of a single dose of a fixed dose ibuprofen/caffeine combination (400/100 mg) vs. ibuprofen alone in a randomized, cross-over design in 36 healthy volunteers. Plasma catecholamines were analyzed to enhance mechanistic interpretation of the data.

Results: After exclusion of 10 protocol violators (pre-dosing intake of caffeine), vital signs were comparable over a 24-h period in the absence and presence of caffeine. Plasma catecholamine levels were also comparable.

Conclusion: These data do not support the hypothesis that occasional intake of a small dose of caffeine as part of pain medication imposes a health risk due to vital sign changes. Based on the proven increase in efficacy, the addition of caffeine to non-opioid analgesics such as IBU has a favorable risk/benefit profile for occasional use.

Keywords: Caffeine, ibuprofen, blood pressure, heart rate, adverse effects, drug metabolism.

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Graphical Abstract

[1]
Lipton RB, Diener H-C, Robbins MS, Garas SY, Patel K. Caffeine in the management of patients with headache. J Headache Pain 2017; 18(1): 107.
[http://dx.doi.org/10.1186/s10194-017-0806-2] [PMID: 29067618]
[2]
Derry CJ, Derry S, Moore RA. Caffeine as an analgesic adjuvant for acute pain in adults Cochrane Database of Systematic Reviews 2014; (12).
[http://dx.doi.org/10.1002/14651858.CD009281.pub3]
[3]
Mesas AE, Leon-Muñoz LM, Rodriguez-Artalejo F, Lopez-Garcia E. The effect of coffee on blood pressure and cardiovascular disease in hypertensive individuals: A systematic review and meta-analysis. Am J Clin Nutr 2011; 94(4): 1113-26.
[http://dx.doi.org/10.3945/ajcn.111.016667] [PMID: 21880846]
[4]
De Giuseppe R, Di Napoli I, Granata F, Mottolese A, Cena H. Caffeine and blood pressure: A critical review perspective. Nutr Res Rev 2019; 32(2): 169-75.
[http://dx.doi.org/10.1017/S0954422419000015] [PMID: 30947761]
[5]
Derry S, Wiffen PJ, Moore RA. Single dose oral ibuprofen plus caffeine for acute postoperative pain in adults Cochrane Database of Systematic Reviews 2015; (7).
[http://dx.doi.org/10.1002/14651858.CD011509]
[6]
Weiser T, Schepers C, Mück T, Lange R. Pharmacokinetic properties of ibuprofen (IBU) from the fixed-dose combination IBU/caffeine (400/100 mg; FDC) in comparison with 400 mg IBU as acid or lysinate under fasted and fed conditions—data from 2 single-center, single-dose, randomized crossover studies in healthy volunteers. Clin Pharmacol Drug Dev 2019; 8(6): 742-53.
[http://dx.doi.org/10.1002/cpdd.672] [PMID: 30897305]
[7]
European Food Safety Authority. Scientific opinion on the safety of caffeine. EFSA J 2015; 13(5): 4102.
[8]
White JR Jr, Padowski JM, Zhong Y, et al. Pharmacokinetic analysis and comparison of caffeine administered rapidly or slowly in coffee chilled or hot versus chilled energy drink in healthy young adults. Clin Toxicol (Phila) 2016; 54(4): 308-12.
[http://dx.doi.org/10.3109/15563650.2016.1146740] [PMID: 27100333]
[9]
Zhou A, Hyppönen E. Long-term coffee consumption, caffeine metabolism genetics, and risk of cardiovascular disease: A prospective analysis of up to 347,077 individuals and 8368 cases. Am J Clin Nutr 2019; 109(3): 509-16.
[http://dx.doi.org/10.1093/ajcn/nqy297] [PMID: 30838377]
[10]
Papakonstantinou E, Kechribari I. Sotirakoglou Κ, et al. Acute effects of coffee consumption on self-reported gastrointestinal symptoms, blood pressure and stress indices in healthy individuals. Nutr J 2016; 15: 26.
[http://dx.doi.org/10.1186/s12937-016-0146-0] [PMID: 26979712]
[11]
MacDonald TM, Richard D, Lheritier K, Krammer G. The effects of lumiracoxib 100 mg once daily vs. ibuprofen 600 mg three times daily on the blood pressure profiles of hypertensive osteoarthritis patients taking different classes of antihypertensive agents. Int J Clin Pract 2010; 64(6): 746-55.
[http://dx.doi.org/10.1111/j.1742-1241.2010.02346.x] [PMID: 20518950]
[12]
Ruschitzka F, Borer JS, Krum H, et al. Differential blood pressure effects of ibuprofen, naproxen, and celecoxib in patients with arthritis: The PRECISION-ABPM (Prospective Randomized Evaluation of Celecoxib Integrated Safety Versus Ibuprofen or Naproxen Ambulatory Blood Pressure Measurement) Trial. Eur Heart J 2017; 38(44): 3282-92.
[http://dx.doi.org/10.1093/eurheartj/ehx508] [PMID: 29020251]
[13]
Zimmermann-Viehoff F, Thayer J, Koenig J, Herrmann C, Weber CS, Deter HC. Short-term effects of espresso coffee on heart rate variability and blood pressure in habitual and non-habitual coffee consumers--a randomized crossover study. Nutr Neurosci 2016; 19(4): 169-75.
[http://dx.doi.org/10.1179/1476830515Y.0000000018] [PMID: 25850440]
[14]
Lopez-Garcia E, Orozco-Arbeláez E, Leon-Muñoz LM, et al. Habitual coffee consumption and 24-h blood pressure control in older adults with hypertension. Clin Nutr 2016; 35(6): 1457-63.
[http://dx.doi.org/10.1016/j.clnu.2016.03.021] [PMID: 27075317]
[15]
Weiser T, Richter E, Hegewisch A, Muse DD, Lange R. Efficacy and safety of a fixed-dose combination of ibuprofen and caffeine in the management of moderate to severe dental pain after third molar extraction. Eur J Pain 2018; 22(1): 28-38.
[http://dx.doi.org/10.1002/ejp.1068] [PMID: 28805281]
[16]
Predel HG, Ebel-Bitoun C, Lange R, Weiser T. A randomized, placebo- and active-controlled, multi-country, multi-center parallel group trial to evaluate the efficacy and safety of a fixed-dose combination of 400 mg ibuprofen and 100 mg caffeine compared with ibuprofen 400 mg and placebo in patients with acute lower back or neck pain. J Pain Res 2019; 12: 2771-83.
[http://dx.doi.org/10.2147/JPR.S217045] [PMID: 31576162]

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