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**Short answer:**
Yes—you can typically take ibuprofen (the active ingredient in Motrin) while taking **metoprolol**, but you should do so with caution and under medical supervision, especially if you have any underlying health concerns or are on other medications.

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## Why they’re generally compatible

| Medication | Primary use | How it works | Typical side‑effects | Interaction notes |
|------------|-------------|--------------|----------------------|-------------------|
| **Ibuprofen (Motrin)** | Pain, inflammation, fever | Blocks COX enzymes → reduces prostaglandins | GI upset, ulcers, bleeding, kidney stress in high doses | Can increase blood pressure and impair kidney function at high doses or with certain antihypertensives. |
| **Lisinopril** | High blood pressure, heart failure, post‑MI protection | Inhibits ACE → less angiotensin II → vasodilation | Cough, dizziness, hyperkalemia | May cause mild rise in BP; usually safe with NSAIDs but monitor kidney function. |

- **Direct interactions:** None.
- **Indirect concerns:** NSAIDs can blunt antihypertensive effect and raise blood pressure; they also reduce the diuretic effect of ACE inhibitors on sodium excretion, possibly raising potassium.

Thus, *acetylsalicylic acid* is generally safe with lisinopril if taken at low doses (≤ 81 mg daily) for anti‑thrombotic or mild analgesic use. Higher doses (>100 mg) should be avoided unless a cardiologist prescribes them; otherwise the risk standard cycle of dianabol GI bleeding and impaired kidney function increases.

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## 2. Commonly prescribed drugs that *do* interact with acetylsalicylic acid

| Drug | Mechanism of interaction | Clinical relevance |
|------|--------------------------|--------------------|
| **Non‑steroidal anti‑inflammatory drugs (NSAIDs)** – ibuprofen, naproxen, diclofenac | Compete for COX inhibition; can diminish aspirin’s antiplatelet effect or add GI toxicity. | Use with caution in patients on low‑dose aspirin therapy. |
| **Warfarin** | Aspirin increases bleeding risk by inhibiting platelet aggregation and may enhance warfarin’s anticoagulant effect. | Monitor INR closely when starting/stopping aspirin. |
| **Clopidogrel** | Both drugs inhibit platelet function; concurrent use may increase bleeding risk. | Avoid unless necessary, consider alternatives. |
| **ACE inhibitors / ARBs** (e.g., lisinopril, losartan) | Aspirin can exacerbate renal dysfunction when combined with these agents. | Monitor kidney function in patients on both therapies. |
| **Non‑steroidal anti‑inflammatory drugs (NSAIDs)** (e.g., ibuprofen, naproxen) | NSAIDs and aspirin both affect gastric mucosa; combined use increases GI bleeding risk. | Use proton pump inhibitors if combination is unavoidable. |

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## 4. General Clinical Tips for Managing the Patient

| **Scenario** | **Key Points & Recommendations** |
|--------------|----------------------------------|
| **New patient with a history of chronic kidney disease (CKD)** | • Baseline serum creatinine and eGFR.
• Use lowest effective dose of aspirin if needed; consider alternatives like clopidogrel or statins for cardiovascular protection. |
| **Patient on ACE inhibitors/ARBs** | • Monitor potassium, especially if adding a second drug that raises it (e.g., spironolactone).
• Check creatinine before initiating therapy and periodically thereafter. |
| **Diabetes management with metformin** | • Exclude patients with eGFR < 30 ml/min/1.73 m².
• Dose adjustment for eGFR 30–45; consider discontinuation if renal function declines further. |
| **Use of NSAIDs in chronic pain** | • Prefer acetaminophen for patients with kidney disease to avoid additional nephrotoxicity.
• If NSAIDs are necessary, use the lowest effective dose for the shortest duration possible. |
| **Elderly polypharmacy** | • Review each medication for necessity; deprescribe when appropriate to reduce risk of drug interactions and adverse events.
• Monitor renal function and adjust doses accordingly. |

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## 4. Key Take‑Away Points (Bottom of Page)

- **Renal Function Matters:** Dose adjustments based on GFR/CrCl are essential for all medications with renal excretion or nephrotoxic potential.
- **Monitor Closely:** Regularly check kidney function, electrolytes, and drug levels when prescribing potentially nephrotoxic agents.
- **Avoid Drug–Drug Interactions:** Some combinations (e.g., aminoglycosides + vancomycin) greatly increase the risk of acute kidney injury; use alternatives or add renal protection strategies.
- **Use Non‑Nephrotoxic Alternatives When Possible:** Prefer agents like ceftriaxone over meropenem for mild infections when feasible.
- **Educate Patients:** Inform patients about signs of kidney dysfunction and the importance of adherence to monitoring schedules.

By integrating these evidence‑based practices into routine care, clinicians can minimize nephrotoxicity while effectively managing infections.