of interaction is not clear, use caution. Use Caution/Monitor.Minor (1)hydrochlorothiazide will increase the level or effect of ibuprofen by acidic (anionic) drug competition for renal tubular clearance. Minor/Significance Unknown.hydrocodoneMonitor Closely (1)diphenhydramine will increase the level or effect of hydrocodone by affecting hepatic enzyme CYP2D6 metabolism. Use Caution/Monitor. Hydromorphone (<3% of the circulating parent hydrocodone) is mainly formed by CYP2D6 mediated O-demethylation of hydrocodone. Hydromorphone may contribute to the total analgesic effect of hydrocodone.hydrocortisoneMonitor Closely (1)ibuprofen, hydrocortisone. Either increases toxicity of the other by pharmacodynamic synergism. Use Caution/Monitor. Increased risk of GI ulceration.hydromorphoneMonitor Closely (2)diphenhydramine will increase the level or effect of hydromorphone by affecting hepatic enzyme CYP2D6 metabolism. Use Caution/Monitor. diphenhydramine and hydromorphone both increase sedation. Use Caution/Monitor.hydroxyzineMonitor Closely (1)diphenhydramine and hydroxyzine both increase sedation. Use Caution/Monitor.hyoscyamineMonitor Closely (1)diphenhydramine and hyoscyamine both decrease cholinergic effects/transmission. Use Caution/Monitor.hyoscyamine sprayMonitor Closely (1)diphenhydramine and hyoscyamine spray both decrease cholinergic effects/transmission. Use Caution/Monitor.ibrutinibMonitor Closely (1)ibrutinib will increase the level or effect of ibuprofen by anticoagulation. Use Caution/Monitor. Ibrutinib may increase the risk of hemorrhage in patients receiving antiplatelet or anticoagulant therapies and monitor for signs of bleeding. iloperidoneMonitor Closely (5)diphenhydramine will increase the level or effect of iloperidone by affecting hepatic enzyme CYP2D6 metabolism. Use Caution/Monitor. diphenhydramine decreases levels of iloperidone by inhibition of GI absorption. Applies only to oral form of both agents. Use Caution/Monitor. diphenhydramine decreases levels of iloperidone by pharmacodynamic antagonism. Use Caution/Monitor. iloperidone increases effects of diphenhydramine by pharmacodynamic synergism. Use Caution/Monitor. Additive anticholinergic effects, possible hypoglycemia. diphenhydramine and iloperidone both increase sedation. Use Caution/Monitor.imatinibMonitor Closely (2)imatinib will increase the level or effect of ibuprofen by affecting hepatic enzyme CYP2C9/10 metabolism. Use Caution/Monitor. imatinib, ibuprofen. Either increases toxicity of the other by Other (see comment). Modify Therapy/Monitor Closely. Comment: Imatinib may cause thrombocytopenia; bleeding risk increased when imatinib is coadministered with anticoagulants, NSAIDs, platelet inhibitors, and thrombolytic agents.imidaprilMinor (1)ibuprofen decreases effects of imidapril by pharmacodynamic antagonism. Minor/Significance Unknown. NSAIDs decrease prostaglandin synthesis.imipramineMonitor Closely (3)diphenhydramine will increase the level or effect of imipramine by affecting hepatic enzyme CYP2D6 metabolism. Use Caution/Monitor. diphenhydramine and imipramine both decrease cholinergic effects/transmission. Use Caution/Monitor. diphenhydramine and imipramine both increase sedation. Use Caution/Monitor.indapamideMonitor Closely (1)ibuprofen increases and indapamide decreases serum potassium. Effect of interaction is not clear, use caution. Use Caution/Monitor.Minor (1)indapamide will increase the level or effect of ibuprofen by acidic (anionic) drug competition for renal tubular clearance. Minor/Significance Unknown.indomethacinMonitor Closely (2)ibuprofen and indomethacin both increase anticoagulation. Use Caution/Monitor. ibuprofen and indomethacin both increase serum potassium. Use Caution/Monitor.Minor (1)ibuprofen will increase the level or effect of indomethacin by acidic (anionic) drug competition for renal tubular clearance. Minor/Significance Unknown.ipratropiumMonitor Closely (1)diphenhydramine and ipratropium both decrease cholinergic effects/transmission. Use Caution/Monitor. Due to the poor systemic absorption of ipratropium, interaction unlikely at regularly recommended dosages.irbesartanMonitor Closely (3)irbesartan, ibuprofen. Either increases toxicity of the other by Other (see comment). Use Caution/Monitor. Comment: May result in renal function deterioration, particularly in elderly or volume depleted individuals. irbesartan and ibuprofen both increase serum potassium. Use Caution/Monitor. ibuprofen decreases effects of irbesartan by pharmacodynamic antagonism. Use Caution/Monitor. Antihypertensive effect of angiotensin receptor blockers may be attenuated by NSAIDs; monitor renal function and blood pressure periodically.isocarboxazidSerious - Use Alternative (1)isocarboxazid increases effects of diphenhydramine by Other (see comment). Avoid or Use Alternate Drug. Comment: Isocarboxazid should not be administered in combination with antihistamines because of potential additive CNS depressant effects. MAO inhibitors also prolong and intensify anticholinergic effects of antihistamines. .isoproterenolMonitor Closely (2)diphenhydramine increases and isoproterenol decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor. ibuprofen increases and isoproterenol decreases serum potassium. Effect of interaction is not clear, use caution. Use Caution/Monitor.kavaMonitor Closely (1)kava increases effects of diphenhydramine by pharmacodynamic synergism. Use Caution/Monitor. May enhance CNS depression.ketamineMonitor Closely (1)ketamine and diphenhydramine both increase sedation. Use Caution/Monitor.ketoconazoleMinor (1)ketoconazole will increase the level or effect of ibuprofen by affecting hepatic enzyme CYP2C9/10 metabolism. Minor/Significance Unknown.ketoprofenMonitor Closely (2)ibuprofen and ketoprofen both increase anticoagulation. Use Caution/Monitor. ibuprofen and ketoprofen both increase serum potassium. Use Caution/Monitor.Minor (1)ibuprofen will increase the level or effect of ketoprofen by acidic (anionic) drug competition for renal tubular clearance. Minor/Significance Unknown.ketorolacMonitor Closely (2)ibuprofen and ketorolac both increase anticoagulation. Use Caution/Monitor. ibuprofen and ketorolac both increase serum potassium. Use Caution/Monitor.Serious - Use Alternative (1)ibuprofen, ketorolac. Either increases toxicity of the other by pharmacodynamic synergism. Contraindicated.Minor (1)ibuprofen will increase the level or effect of ketorolac by acidic (anionic) drug competition for renal tubular clearance. Minor/Significance Unknown.ketorolac intranasalMonitor Closely (2)ibuprofen and ketorolac intranasal both increase anticoagulation. Use Caution/Monitor. ibuprofen and ketorolac intranasal both increase serum potassium. Use Caution/Monitor.Serious - Use Alternative (1)ibuprofen, ketorolac intranasal. Either increases toxicity of the other by pharmacodynamic synergism. Contraindicated.Minor (1)ibuprofen will increase the level or effect of ketorolac intranasal by acidic (anionic) drug competition for renal tubular clearance. Minor/Significance Unknown.ketotifen, ophthalmicMonitor Closely (1)diphenhydramine and ketotifen, ophthalmic both increase sedation. Use Caution/Monitor.labetalolMonitor Closely (2)labetalol and ibuprofen both increase serum potassium. Use Caution/Monitor. ibuprofen decreases effects of labetalol by pharmacodynamic antagonism. Use Caution/Monitor. NSAIDs diminish antihypertensive effects of beta-blockers.lacosamideMonitor Closely (1)ibuprofen increases levels of lacosamide by affecting hepatic enzyme CYP2C9/10 metabolism. Modify Therapy/Monitor Closely. Consider decreasing lacosamide dose when coadministered with strong CYP2C9 inhibitors.lasmiditanMonitor Closely (1)lasmiditan, diphenhydramine. Either increases effects of the other by sedation. Use Caution/Monitor. Coadministration of lasmiditan and other CNS depressant drugs, including alcohol have not been evaluated in clinical studies. Lasmiditan may cause sedation, as well as other cognitive and/or neuropsychiatric adverse reactions.latanoprostMonitor Closely (1)latanoprost, ibuprofen. unspecified interaction mechanism. Use Caution/Monitor. There are conflicting reports from studies of either increased or decreased IOP when ophthalmic prostaglandins are coadministered with NSAIDs (either systemic or ophthalmic).latanoprostene bunod ophthalmicMonitor Closely (1)latanoprostene bunod ophthalmic, ibuprofen. unspecified interaction mechanism. Use Caution/Monitor. There are conflicting reports from studies of either increased or decreased IOP when ophthalmic prostaglandins are coadministered with NSAIDs (either systemic or ophthalmic).leflunomideMinor (1)leflunomide will increase the level or effect of ibuprofen by affecting hepatic enzyme CYP2C9/10 metabolism. Minor/Significance Unknown.lemborexantMonitor Closely (1)lemborexant, diphenhydramine. Either increases effects of the other by sedation. Modify Therapy/Monitor Closely. Dosage adjustment may be necessary if lemborexant is coadministered with other CNS depressants because of potentially additive effects.lesinuradMonitor Closely (1)ibuprofen will increase the level or effect of lesinurad by affecting hepatic enzyme CYP2C9/10 metabolism. Modify Therapy/Monitor Closely.levalbuterolMonitor Closely (2)ibuprofen increases and levalbuterol decreases serum potassium. Effect of interaction is not clear, use caution. Use Caution/Monitor. diphenhydramine increases and levalbuterol decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.levodopaMonitor Closely (1)diphenhydramine, levodopa. Other (see comment). Use Caution/Monitor. Comment: Anticholinergic agents may enhance the therapeutic effects of levodopa; however, anticholinergic agents can exacerbate tardive dyskinesia. In high dosage, anticholinergics may decrease the effects of levodopa by delaying its GI absorption. .levofloxacinMonitor Closely (1)levofloxacin, ibuprofen. Other (see comment). Modify Therapy/Monitor Closely. Comment: Risk of CNS stimulation/seizure. Mechanism: Displacement of GABA from receptors in brain.levoketoconazoleMinor (1)levoketoconazole will increase the level or effect of ibuprofen by affecting hepatic enzyme CYP2C9/10 metabolism. Minor/Significance Unknown.levomilnacipranMonitor Closely (1)levomilnacipran, ibuprofen. Either increases toxicity of the other by pharmacodynamic synergism. Use Caution/Monitor. SNRIs may further impair platelet activity in patients taking antiplatelet or anticoagulant drugs.levorphanolMonitor Closely (1)diphenhydramine and levorphanol both increase sedation. Use Caution/Monitor.lisdexamfetamineMonitor Closely (1)diphenhydramine increases and lisdexamfetamine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.lisinoprilMonitor Closely (1)lisinopril, ibuprofen. Either increases toxicity of the other by Other (see comment). Use Caution/Monitor. Comment: May result in renal function deterioration, particularly in elderly or volume depleted individuals.Serious - Use Alternative (1)ibuprofen, lisinopril. pharmacodynamic antagonism. Avoid or Use Alternate Drug. Coadministration may result in a significant decrease in renal function. NSAIDs may diminish the antihypertensive effect of ACE inhibitors. The mechanism of these interactions is likely related to the ability of NSAIDs to reduce the synthesis of vasodilating renal prostaglandins.lithiumMonitor Closely (1)ibuprofen increases levels of lithium by decreasing renal clearance. Use Caution/Monitor.lofepramineMonitor Closely (3)diphenhydramine will increase the level or effect of lofepramine by affecting hepatic enzyme CYP2D6 metabolism. Use Caution/Monitor. diphenhydramine and lofepramine both decrease cholinergic effects/transmission. Use Caution/Monitor. diphenhydramine and lofepramine both increase sedation. Use Caution/Monitor.lofexidineMonitor Closely (1)diphenhydramine and lofexidine both increase sedation. Use Caution/Monitor.loprazolamMonitor Closely (1)diphenhydramine and loprazolam both increase sedation. Use Caution/Monitor.loratadineMinor (1)diphenhydramine will increase the level or effect of loratadine by affecting hepatic enzyme CYP2D6 metabolism. Minor/Significance Unknown.lorazepamMonitor Closely (1)diphenhydramine and lorazepam both increase sedation. Use Caution/Monitor.lormetazepamMonitor Closely (1)diphenhydramine and lormetazepam both increase sedation. Use Caution/Monitor.lornoxicamMonitor Closely (2)ibuprofen and lornoxicam both increase anticoagulation. Use Caution/Monitor. ibuprofen and lornoxicam both increase serum potassium. Use Caution/Monitor.Minor (1)ibuprofen will increase the level or effect of lornoxicam by acidic (anionic) drug competition for renal tubular clearance. Minor/Significance Unknown.losartanMonitor Closely (3)losartan, ibuprofen. Either increases toxicity of the other by Other (see comment). Use Caution/Monitor. Comment: May result in renal function deterioration, particularly in elderly or volume depleted individuals. ibuprofen decreases effects of losartan by pharmacodynamic antagonism. Modify Therapy/Monitor Closely. NSAIDs decrease synthesis of vasodilating renal prostaglandins, and thus affect fluid homeostasis and may diminish antihypertensive effect. losartan and ibuprofen both increase serum potassium. Use Caution/Monitor.loxapineMonitor Closely (4)diphenhydramine decreases levels of loxapine by inhibition of GI absorption. Applies only to oral form of both agents. Use Caution/Monitor. diphenhydramine decreases levels of loxapine by pharmacodynamic antagonism. Use Caution/Monitor. loxapine increases effects of diphenhydramine by pharmacodynamic synergism. Use Caution/Monitor. Additive anticholinergic effects, possible hypoglycemia. diphenhydramine and loxapine both increase sedation. Use Caution/Monitor.loxapine inhaledMonitor Closely (3)loxapine inhaled increases effects of diphenhydramine by pharmacodynamic synergism. Use Caution/Monitor. Additive anticholinergic effects, possible hypoglycemia. diphenhydramine decreases levels of loxapine inhaled by pharmacodynamic antagonism. Use Caution/Monitor. diphenhydramine and loxapine inhaled both increase sedation. Use Caution/Monitor.lumacaftor/ivacaftorMonitor Closely (1)lumacaftor/ivacaftor will decrease the level or effect of ibuprofen by affecting hepatic enzyme CYP2C9/10 metabolism. Use Caution/Monitor. Ibuprofen it a substrate of CYP2C9. Lumacaftor has the potential to induce CYP2C9 substrates.lurasidoneMonitor Closely (1)lurasidone, diphenhydramine. Either increases toxicity of the other by Other (see comment). Use Caution/Monitor. Comment: Potential for increased CNS depressant effects when used concurrently; monitor for increased adverse effects and toxicity.maprotilineMonitor Closely (2)diphenhydramine and maprotiline both decrease cholinergic effects/transmission. Use Caution/Monitor. diphenhydramine and maprotiline both increase sedation. Use Caution/Monitor.marijuanaMonitor Closely (1)diphenhydramine and marijuana both increase sedation. Use Caution/Monitor.meclizineMonitor Closely (1)diphenhydramine and meclizine both decrease cholinergic effects/transmission. Use Caution/Monitor.meclofenamateMonitor Closely (2)meclofenamate and ibuprofen both increase anticoagulation. Use Caution/Monitor. meclofenamate and ibuprofen both increase serum potassium. Use Caution/Monitor.Minor (1)meclofenamate will increase the level or effect of ibuprofen by acidic (anionic) drug competition for renal tubular clearance. Minor/Significance Unknown.mefenamic acidMonitor Closely (2)ibuprofen and mefenamic acid both increase anticoagulation. Use Caution/Monitor. ibuprofen and mefenamic acid both increase serum potassium. Use Caution/Monitor.Minor (1)ibuprofen will increase the level or effect of mefenamic acid by acidic (anionic) drug competition for renal tubular clearance. Minor/Significance Unknown.mefloquineSerious - Use Alternative (1)mefloquine increases toxicity of diphenhydramine by QTc interval. Avoid or Use Alternate Drug. Mefloquine may enhance the QTc prolonging effect of high risk QTc prolonging agents.melatoninMonitor Closely (2)melatonin increases effects of ibuprofen by anticoagulation. Use Caution/Monitor. Melatonin may decrease prothrombin time. diphenhydramine and melatonin both increase sedation. Use Caution/Monitor.meloxicamMonitor Closely (2)ibuprofen and meloxicam both increase anticoagulation. Use Caution/Monitor. ibuprofen and meloxicam both increase serum potassium. Use Caution/Monitor.Minor (1)ibuprofen will increase the level or effect of meloxicam by acidic (anionic) drug competition for renal tubular clearance. Minor/Significance Unknown.meperidineMonitor Closely (1)diphenhydramine and meperidine both increase sedation. Use Caution/Monitor.meprobamateMonitor Closely (1)diphenhydramine and meprobamate both increase sedation. Use Caution/Monitor.mesalamineMonitor Closely (1)mesalamine, ibuprofen. Either increases toxicity of the other by pharmacodynamic synergism. Use Caution/Monitor. Additive nephrotoxicity.Minor (1)ibuprofen will increase the level or effect of mesalamine by acidic (anionic) drug competition for renal tubular clearance. Minor/Significance Unknown.metaproterenolMonitor Closely (2)ibuprofen increases and metaproterenol decreases serum potassium. Effect of interaction is not clear, use caution. Use Caution/Monitor. diphenhydramine increases and metaproterenol decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.metaxaloneMonitor Closely (1)diphenhydramine and metaxalone both increase sedation. Use Caution/Monitor.methadoneMonitor Closely (1)diphenhydramine and methadone both increase sedation. Use Caution/Monitor.methamphetamineMonitor Closely (2)diphenhydramine will increase the level or effect of methamphetamine by affecting hepatic enzyme CYP2D6 metabolism. Use Caution/Monitor. diphenhydramine increases and methamphetamine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.methocarbamolMonitor Closely (1)diphenhydramine and methocarbamol both increase sedation. Use Caution/Monitor.methotrexateSerious - Use Alternative (1)ibuprofen increases levels of methotrexate by decreasing renal clearance. Avoid or Use Alternate Drug. Concomitant administration of NSAIDs with high dose methotrexate has been reported to elevate and prolong serum methotrexate levels, resulting in deaths from severe hematologic and GI toxicity. NSAIDs may reduce tubular secretion of methotrexate and enhance