I listened to a podcast called Ibuprofen: Chemistry in its element. The podcast was by Brian Clegg on the topic of the over-counter drug ibuprofen that was developed by the British high-street pharmaceutical chain Boots.
Ever since the beginnings of the COVID-19 pandemic, there is been an increase of misleading information being spread on social platforms such as WhatsApp especially about the drug Ibuprofen. There have been claims made that Ibuprofen would worsen the symptoms of COVID-19 as it is an anti-inflammatory drug which means that it would delay primary healing mechanisms. The NHS also raised this concern and advised the use of paracetamol, another painkiller, instead of Ibuprofen. However, this claim may not be entirely true as there have been no studies conducted to prove the effect of ibuprofen on the virus.
In the modern day, the most commonly used compounds are paracetamol and ibuprofen whereas in the past, from the late 1890s, it used to be aspirin which is also an anti-inflammatory drug.
Ibuprofen is an NSAID (Non-steroidal anti-inflammatory drugs) which goes by other brand names; Neurofen, Brufen and Advil. It is good for muscle pains but not so much for the stomach and it has a lower overdose risk than paracetamol. Ibuprofen consists of iso butyl propanoic phenolic acid, which is a relatively simple aromatic acid with a single benzene ring at is centre, originally developed on from the simple organic fatty acid, propanoic acid (acetic acid with an added methyl group) which has been around since the 1840s.
Ibuprofen was developed in a Boots lab in Nottingham in 1961 by a team led by Stewart Adams and John Nicholson. The primary focus for this drug was to find an alternative treatment for rheumatoid arthritis which was treated at the time with steroids, which brought a lot of side effects. The original aim was to produce a non-steroidal anti-inflammatory drug with reduced side effects such as gastro-intestinal bleeding that accompanies the high dosages of aspirin which was the only option at the time. The team tested over 600 different compounds over a period of ten years and narrowed down the drug to Ibuprofen.
Ibuprofen was licensed in the UK in 1959 and in the US in 1974. Ten years later, it then became available as an over counter drug.
Ibuprofen works by cutting down the pain and swelling by attacking enzymes called cyclo-oxygenase which in turn reduces the body’s ability to produce prostaglandins. Prostaglandins are molecules used by the body to carry signals to cells to deal with the immune response.
Though ibuprofen is a readily available and commonly used drug, just like other medication, it also has its own side effects and risks. In 2017, the European society of cardiology announced that painkillers increase the chances of cardiac arrest which was also later supported by a study done in Denmark between the years 2001 to 2010 which showed a 31% increase of cardiac arrest risk. However, this study was not completely reliable as evidence as its was conducted for prescribed dosages which a much higher than that found over the counter. Therefore, it is not clear from the study that the there is a causal link between taking the drug and the increased risk of cardiac arrest as the study only provided relative risk which can be quite misleading.
In a blog post for the Winton Centre for Risk and Evidence communication at the University of Cambridge, Micheal Blastland, a writer and broadcaster, suggested that if the effect was causal then the impact of taking ibuprofen could lead to 1 in 32000 people getting cardiac arrest over a thirty-day period after the event.
On the other hand, there have been studies to shoe the possibility of using ibuprofen to treat prostrate cancer. Ibuprofen is a compound that demonstrates unique chirality. It comes as two similar looking mirror image variants.
An enzyme, AMACR, which catalyses the growth of tumour cells, also is able to convert one form of ibuprofen to another. This conversion can prevent the growth of the tumour cells. However due to its chirality and long- term health risks, they may not be introduced as potential treatments for the mentioned health problems.
Despite all of this, Ibuprofen is still regarded as one of the most used drugs and the core in medicine in the world, with more than twenty thousand tonnes of the compound being manufactured every year.