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Drug Info

Can you take diclofenac with ibuprofen?

Combining diclofenac with ibuprofen can lead to unwanted side effects because of the interactions between these NSAIDs
Taneia Surles, MPH
By | Sep. 11, 2024 Medically reviewed by Chad Shaffer, MD
Two Rx tablets: Can you take diclofenac with ibuprofen?

Key takeaways

  • Diclofenac (Cataflam, Voltaren) and ibuprofen (Advil, Motrin) are nonsteroidal anti-inflammatory drugs (NSAIDs) that should not be taken together.

  • Mixing diclofenac with ibuprofen can cause several gastrointestinal side effects that cause stomach pain, as well as complications with your heart, liver, and kidney.

  • Certain factors, such as your age, the presence of other medical problems, consuming too much alcohol, and smoking, can increase your risk of adverse reactions from taking diclofenac and ibuprofen.

  • In some instances, acetaminophen can be a better alternative to ibuprofen if you’re taking diclofenac.

  • If you are considering taking diclofenac and ibuprofen together, check with your healthcare provider first.

In this article:

Diclofenac (Cataflam, Voltaren) and ibuprofen (Advil, Motrin) are nonsteroidal anti-inflammatory drugs (NSAIDs) approved by the U.S. Food and Drug Administration (FDA) to reduce pain and inflammation in certain situations. These drugs may help with rheumatoid arthritis, period pain, muscle aches, and other conditions. Because they fall into the same class of drugs, they shouldn’t be taken together, as they can increase your risk of side effects. Continue reading to learn more about the risks of taking diclofenac with ibuprofen.

Can you take diclofenac with ibuprofen?

According to Kubanych Takyrbashev, MD, Ph.D., a Health and Wellness adviser at NAO based in Minneapolis, Minnesota, since diclofenac and ibuprofen are both NSAIDs, taking them together can increase your risk of serious side effects. In addition, doubling up on multiple NSAIDs is not effective. “Evidence shows that combining NSAIDs generally does not result in significantly more pain relief than giving a single NSAID in an adequate dosage,” Dr. Takyrbashev says.

While diclofenac is available as an oral or topical NSAID, neither form may be completely safe when combined with oral ibuprofen. You can still experience health risks with either form of diclofenac, although the systemic drug levels are significantly lower with topical application compared to oral administration, according to a 2010 study.

Can you take with diclofenac with Tylenol?

Tylenol (acetaminophen) is another pain relief medication that provides some similar benefits as ibuprofen but has no known drug interactions with diclofenac. Acetaminophen is a non-opioid analgesic and antipyretic agent that can treat pain and fever. It does not reduce inflammation in the way that NSAIDs do.

A 2024 literature review of 11 randomized controlled trials (RCTs) revealed that combining oral acetaminophen with topical diclofenac significantly reduced pain for patients with osteoarthritis.

An older study also supports the combination of diclofenac and acetaminophen for postoperative pain. The researchers discovered that combining oral diclofenac with oral acetaminophen offered extended relief for patients with moderate to severe pain after wisdom teeth removal.

Before combining diclofenac with acetaminophen, speak with your healthcare provider to ensure that this combination of drugs is safe for you.

Benefits of taking diclofenac with ibuprofen together

There are no benefits to taking diclofenac with ibuprofen or other NSAIDs like aspirin and naproxen. Suppose you need to take a secondary pain medication with diclofenac. In that case, your healthcare provider may recommend other over-the-counter or prescription drugs, such as acetaminophen or codeine, in place of ibuprofen.

Risks of taking diclofenac with ibuprofen?

According to Hadva Barenholtz Levy, Pharm.D., BCPS, BCGP, a senior pharmacist and the author of Maybe It’s Your Medications of St. Louis, Missouri, mixing the oral formulations of diclofenac and ibuprofen may cause the following symptoms:

  • Gastrointestinal upset, such as heartburn
  • Stomach ulcers
  • Bleeding in the stomach
  • Kidney problems
  • Heart attack and stroke

Dr. Takyrbashev says that taking diclofenac with ibuprofen may cause other cardiovascular issues. “Both drugs increase blood pressure,” he says. 

In rare cases, NSAIDs may also cause allergic reactions, such as rhinoconjunctivitis, bronchospasm, urticaria/angioedema, and anaphylaxis. 

If you’re experiencing any of these side effects, please seek immediate medical help. 

In addition to the potential health complications that can arise from taking diclofenac and ibuprofen together, other precautions should be considered before mixing these medications.

According to Dr. Levy, the following factors can lead to a higher risk of experiencing serious side effects from diclofenac and ibuprofen:

  • Being 65 and older
  • Having kidney or liver impairment
  • Having heart disease
  • Having a history of stomach ulcers or stomach bleeding
  • Heavy alcohol use
  • Being a smoker
  • Using other medications, such as anticoagulants, aspirin, and other antiplatelet drugs

Dr. Levy also adds that if you have high blood pressure (hypertension) or heart failure, taking these medications together can worsen these conditions.

How long after taking diclofenac can you take ibuprofen? 

Because most healthcare providers advise against combining diclofenac with ibuprofen, there are no guidelines on dosage schedules. However, if your healthcare provider decides that taking both drugs can improve your health, they can give you personalized medical advice on how you should take them.

If you’re taking diclofenac or ibuprofen tablets individually, here are Dr. Levy‘s recommendations for a safe dosing schedule:

  • Oral diclofenac tablets (prescription): Take as needed two to four times daily (depending on formulation) with food to minimize stomach side effects.
  • Diclofenac gel (over-the-counter): Apply the gel as needed every six hours up to four times daily on the affected area. “The amount depends on whether you’re treating the upper or lower extremities (i.e., arms, legs, hands, and feet), “ Dr. Levy says. 
  • Ibuprofen tablets (over-the-counter): Take 200 to 400 milligrams (mg) every four to six hours with food to prevent stomach upset. “The maximum is 1,200 mg per day unless otherwise instructed by a healthcare provider,” Dr. Levy says.

Depending on your health conditions, medications like diclofenac and ibuprofen may be further adjusted. “Dosage should be reduced, or possibly avoided if a person has liver impairment or decreased kidney function,” Dr. Levy says.

Overall, mixing diclofenac with ibuprofen can cause unwanted side effects due to the drug interactions between these NSAIDs. “Patients should only mix their medications under the supervision of their doctor,” Dr. Takyrbashev says. “An alternative pain management technique, the use of one NSAID, is most often safer.”