The claim: Using ibuprofen when you have coronavirus can make symptoms worse
A French public health official tweeted a warning for coronavirus patients using ibuprofen over the weekend, helping spark alarm among many who fear the common pain and fever treatment could prove harmful as people around the world increasingly become sick during the COVID-19 pandemic.
Anecdotal stories about people's experiences have received international attention, as guidance from health experts has been at times unclear. Publications have cited professors and medical doctors offering seemingly conflicting takes on the matter.
One professor told the BBC that previous studies have linked ibuprofen to the worsening of respiratory infections, although there isn't strong data on COVID-19 specifically. Other experts essentially dismissed the concerns about ibuprofen in interviews with The New York Times, while noting that avoiding painkillers may help the immune system fight the virus.
For those following the issue from the U.S., the topic can be even more difficult to understand because one of the alternatives to ibuprofen goes by a different name in Europe.
What's known in the U.S. as acetaminophen – sold under brand names including Tylenol – is called paracetamol in Europe.
Also some confusing vocabulary: Ibuprofen is a part of a broader class of drugs called nonsteroidal anti-inflammatory drugs, or NSAIDs.
Both acetaminophen and ibuprofen can be used to treat fever and pain associated with COVID-19, according to the European Medicines Agency.
What experts say: Little evidence, but some suggest caution
There's consensus among experts about the lack of evidence: There's no widely accepted data about ibuprofen and COVID-19. However, many credible organizations have advised caution on the matter and often suggest acetaminophen as a possibly preferable treatment.
A clear and updated guidance came Wednesday from a major health organization, when from England's National Health Service drew attention to the following recommendation:
There is currently no strong evidence that ibuprofen can make coronavirus (COVID-19) worse.
But until we have more information, take paracetamol to treat the symptoms of coronavirus, unless your doctor has told you paracetamol is not suitable for you.
If you are already taking ibuprofen or another non-steroidal anti-inflammatory (NSAID) on the advice of a doctor, do not stop taking it without checking first.
Another NHS document about treating COVID-19 in children admitted to the hospital describes paracetamol as the "first line" of fever treatment.
Also on Wednesday, a World Health Organization spokesperson confirmed to USA TODAY that while the organization was aware of concerns about the use of NSAIDs in the treatment of COVID-19, WHO has not yet issued any new guidance.
"WHO is gathering further evidence on this issue before making a formal recommendation, but after a rapid review of the literature, is not aware of published clinical or population-based data on this topic," reads an emailed statement from Christian Lindmeier.
Previously, Lindmeier recommended people self-treating a COVID-19 infection use paracetamol, or acetaminophen, according to AFP.
Other experts have focused their statements on the lack of evidence surrounding the issue.
Anthony Fauci, director of the National Institute of Allergy and Infectious Diseases, took this position in a Wednesday JAMA Network question and answer video.
“I have not seen any firm data to indicate there is a problem or prove there is not a problem," he said.
He also said physicians widely believe Tylenol is best for reducing a fever, if that is the primary goal of the treatment.
The lack of evidence on this issue was also highlighted in a European Medicines Agency release Wednesday, acknowledging reports claiming ibuprofen can make coronavirus symptoms worse.
"There is currently no scientific evidence establishing a link between ibuprofen and worsening of COVID‑19. EMA is monitoring the situation closely and will review any new information that becomes available on this issue in the context of the pandemic," the statement reads.
Our ruling: Not enough information
There's not enough information to say for sure whether ibuprofen does or does not make coronavirus symptoms worse.
Until there is better data and a widespread consensus among health professionals, you should be skeptical of reports making blanket claims on the matter.
Because there are potential side effects with both acetaminophen and ibuprofen, patients may need to call a doctor to discuss their treatment options.
Fevers help the body fight infections, so a doctor can provide advice about which medication you should take or whether you should take medication at all.
Our fact-check sources:European Medicines Agency: EMA gives advice on the use of non-steroidal anti-inflammatories for COVID-19 National Health Service: Guidance for the clinical management of children admitted to hospital with proven COVID-19 National Health Service: Stay at home advice-Coronavirus (COVID-19) Interview: Coronavirus Update with Anthony Fauci, MD – March 18, 2020 #JAMALive AFP: Avoid taking ibuprofen for COVID-19 symptoms: WHO Twitter: @olivierveran on Twitter March 14, 2020