increase sedation. Use Caution/Monitor.amobarbitalMonitor Closely (1)diphenhydramine and amobarbital both increase sedation. Use Caution/Monitor.Minor (1)amobarbital will decrease the level or effect of ibuprofen by affecting hepatic enzyme CYP2C9/10 metabolism. Minor/Significance Unknown.amoxapineMonitor Closely (2)diphenhydramine and amoxapine both decrease cholinergic effects/transmission. Use Caution/Monitor. diphenhydramine and amoxapine both increase sedation. Use Caution/Monitor.anamuMinor (1)ibuprofen and anamu both increase anticoagulation. Minor/Significance Unknown.anticholinergic/sedative combosMonitor Closely (1)anticholinergic/sedative combos and diphenhydramine both decrease cholinergic effects/transmission. Use Caution/Monitor.antithrombin alfaMonitor Closely (1)antithrombin alfa and ibuprofen both increase anticoagulation. Modify Therapy/Monitor Closely.antithrombin IIIMonitor Closely (1)antithrombin III and ibuprofen both increase anticoagulation. Modify Therapy/Monitor Closely.apixabanSerious - Use Alternative (1)ibuprofen and apixaban both increase anticoagulation. Avoid or Use Alternate Drug.apomorphineMonitor Closely (1)diphenhydramine and apomorphine both increase sedation. Use Caution/Monitor.arformoterolMonitor Closely (2)diphenhydramine increases and arformoterol decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor. ibuprofen increases and arformoterol decreases serum potassium. Effect of interaction is not clear, use caution. Use Caution/Monitor.argatrobanMonitor Closely (1)argatroban and ibuprofen both increase anticoagulation. Modify Therapy/Monitor Closely.aripiprazoleMonitor Closely (4)diphenhydramine decreases levels of aripiprazole by inhibition of GI absorption. Applies only to oral form of both agents. Use Caution/Monitor. diphenhydramine decreases levels of aripiprazole by pharmacodynamic antagonism. Use Caution/Monitor. aripiprazole increases effects of diphenhydramine by pharmacodynamic synergism. Use Caution/Monitor. Additive anticholinergic effects, possible hypoglycemia. diphenhydramine and aripiprazole both increase sedation. Use Caution/Monitor.Minor (1)diphenhydramine will increase the level or effect of aripiprazole by affecting hepatic enzyme CYP2D6 metabolism. Minor/Significance Unknown.armodafinilMonitor Closely (1)diphenhydramine increases and armodafinil decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.asenapineMonitor Closely (2)asenapine and diphenhydramine both increase sedation. Use Caution/Monitor. ibuprofen decreases effects of asenapine by pharmacodynamic antagonism. Use Caution/Monitor. NSAIDs decrease prostaglandin synthesis.asenapine transdermalMonitor Closely (1)asenapine transdermal and diphenhydramine both increase sedation. Use Caution/Monitor.ashwagandhaMinor (1)ashwagandha increases effects of diphenhydramine by pharmacodynamic synergism. Minor/Significance Unknown. May enhance CNS depression.aspirinMonitor Closely (2)aspirin and ibuprofen both increase anticoagulation. Use Caution/Monitor. aspirin and ibuprofen both increase serum potassium. Use Caution/Monitor.Serious - Use Alternative (2)ibuprofen increases toxicity of aspirin by anticoagulation. Avoid or Use Alternate Drug. increases risk of bleeding. ibuprofen decreases effects of aspirin by Other (see comment). Avoid or Use Alternate Drug. Comment: Ibuprofen decreases the antiplatelet effects of low-dose aspirin by blocking the active site of platelet cyclooxygenase. Administer ibuprofen 8 h before aspirin or at least 2-4 h after aspirin. The effect of other NSAIDs on aspirin is not established.Minor (1)aspirin will increase the level or effect of ibuprofen by acidic (anionic) drug competition for renal tubular clearance. Minor/Significance Unknown.aspirin rectalMonitor Closely (2)aspirin rectal and ibuprofen both increase anticoagulation. Use Caution/Monitor. aspirin rectal and ibuprofen both increase serum potassium. Use Caution/Monitor.Serious - Use Alternative (1)ibuprofen decreases effects of aspirin rectal by Other (see comment). Avoid or Use Alternate Drug. Comment: Ibuprofen decreases the antiplatelet effects of aspirin by blocking the active site of platelet cyclooxygenase. The effect of other NSAIDs on aspirin is not established.Minor (1)aspirin rectal will increase the level or effect of ibuprofen by acidic (anionic) drug competition for renal tubular clearance. Minor/Significance Unknown.aspirin/citric acid/sodium bicarbonateMonitor Closely (2)aspirin/citric acid/sodium bicarbonate and ibuprofen both increase anticoagulation. Use Caution/Monitor. aspirin/citric acid/sodium bicarbonate and ibuprofen both increase serum potassium. Use Caution/Monitor.Serious - Use Alternative (1)ibuprofen decreases effects of aspirin/citric acid/sodium bicarbonate by Other (see comment). Avoid or Use Alternate Drug. Comment: Ibuprofen decreases the antiplatelet effects of aspirin by blocking the active site of platelet cyclooxygenase. The effect of other NSAIDs on aspirin is not established.Minor (1)aspirin/citric acid/sodium bicarbonate will increase the level or effect of ibuprofen by acidic (anionic) drug competition for renal tubular clearance. Minor/Significance Unknown.atenololMonitor Closely (2)ibuprofen decreases effects of atenolol by pharmacodynamic antagonism. Use Caution/Monitor. Long term (>1 wk) NSAID use. NSAIDs decrease prostaglandin synthesis. atenolol and ibuprofen both increase serum potassium. Use Caution/Monitor.atomoxetineMonitor Closely (1)diphenhydramine will increase the level or effect of atomoxetine by affecting hepatic enzyme CYP2D6 metabolism. Use Caution/Monitor.atracuriumMonitor Closely (1)atracurium and diphenhydramine both decrease cholinergic effects/transmission. Use Caution/Monitor.atropineMonitor Closely (1)atropine and diphenhydramine both decrease cholinergic effects/transmission. Use Caution/Monitor.atropine IV/IMMonitor Closely (1)atropine IV/IM and diphenhydramine both decrease cholinergic effects/transmission. Use Caution/Monitor.avapritinibMonitor Closely (1)avapritinib and diphenhydramine both increase sedation. Use Caution/Monitor.azelastineMonitor Closely (1)azelastine and diphenhydramine both increase sedation. Use Caution/Monitor.azficel-TMonitor Closely (1)azficel-T, ibuprofen. Other (see comment). Use Caution/Monitor. Comment: Patients taking NSAIDS may experience increased bruising or bleeding at biopsy and/or injection sites. Concomitant use of NSAIDs is not recommended.azilsartanMonitor Closely (2)ibuprofen, azilsartan. 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 azilsartan by pharmacodynamic antagonism. Modify Therapy/Monitor Closely. NSAIDs decrease synthesis of vasodilating renal prostaglandins, and thus affect fluid homeostasis and may diminish antihypertensive effect.baclofenMonitor Closely (1)diphenhydramine and baclofen both increase sedation. Use Caution/Monitor.balsalazideMinor (1)ibuprofen will increase the level or effect of balsalazide by acidic (anionic) drug competition for renal tubular clearance. Minor/Significance Unknown.belladonna alkaloidsMonitor Closely (1)belladonna alkaloids and diphenhydramine both decrease cholinergic effects/transmission. Use Caution/Monitor.belladonna and opiumMonitor Closely (2)diphenhydramine and belladonna and opium both decrease cholinergic effects/transmission. Use Caution/Monitor. diphenhydramine and belladonna and opium both increase sedation. Use Caution/Monitor.bemiparinMonitor Closely (1)bemiparin and ibuprofen both increase anticoagulation. Modify Therapy/Monitor Closely.benazeprilMonitor Closely (1)benazepril, 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, benazepril. 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.bendroflumethiazideMonitor Closely (1)ibuprofen increases and bendroflumethiazide decreases serum potassium. Effect of interaction is not clear, use caution. Use Caution/Monitor.Minor (1)bendroflumethiazide will increase the level or effect of ibuprofen by acidic (anionic) drug competition for renal tubular clearance. Minor/Significance Unknown.benperidolMonitor Closely (4)diphenhydramine decreases levels of benperidol by inhibition of GI absorption. Applies only to oral form of both agents. Use Caution/Monitor. diphenhydramine decreases levels of benperidol by pharmacodynamic antagonism. Use Caution/Monitor. benperidol increases effects of diphenhydramine by pharmacodynamic synergism. Use Caution/Monitor. Additive anticholinergic effects, possible hypoglycemia. diphenhydramine and benperidol both increase sedation. Use Caution/Monitor.benzhydrocodone/acetaminophenMonitor Closely (2)diphenhydramine will increase the level or effect of benzhydrocodone/acetaminophen by affecting hepatic enzyme CYP2D6 metabolism. Use Caution/Monitor. Hydromorphone (<3% of the circulating parent hydrocodone [benzhydrocodone is prodrug of hydrocodone]) is mainly formed by CYP2D6 mediated O-demethylation of hydrocodone. Hydromorphone may contribute to the total analgesic effect of hydrocodone. benzhydrocodone/acetaminophen and diphenhydramine both increase sedation. Use Caution/Monitor.benzphetamineMonitor Closely (1)diphenhydramine increases and benzphetamine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.benztropineMonitor Closely (1)benztropine and diphenhydramine both decrease cholinergic effects/transmission. Use Caution/Monitor. Additive anticholinergic adverse effects may be seen with concurrent use. betaxololMonitor Closely (2)ibuprofen decreases effects of betaxolol by pharmacodynamic antagonism. Use Caution/Monitor. Long term (>1 wk) NSAID use. NSAIDs decrease prostaglandin synthesis. betaxolol and ibuprofen both increase serum potassium. Use Caution/Monitor.bethanecholMonitor Closely (1)bethanechol increases and diphenhydramine decreases cholinergic effects/transmission. Effect of interaction is not clear, use caution. Use Caution/Monitor.betrixabanMonitor Closely (1)ibuprofen, betrixaban. Either increases levels of the other by anticoagulation. Use Caution/Monitor.bimatoprostMonitor Closely (1)bimatoprost, 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).bisoprololMonitor Closely (2)ibuprofen decreases effects of bisoprolol by pharmacodynamic antagonism. Use Caution/Monitor. Long term (>1 wk) NSAID use. NSAIDs decrease prostaglandin synthesis. bisoprolol and ibuprofen both increase serum potassium. Use Caution/Monitor.bivalirudinMonitor Closely (1)bivalirudin and ibuprofen both increase anticoagulation. Modify Therapy/Monitor Closely.bosentanMinor (1)bosentan will decrease the level or effect of ibuprofen by affecting hepatic enzyme CYP2C9/10 metabolism. Minor/Significance Unknown.brexanoloneMonitor Closely (1)brexanolone, diphenhydramine. Either increases toxicity of the other by sedation. Use Caution/Monitor.brexpiprazoleMonitor Closely (2)diphenhydramine will increase the level or effect of brexpiprazole by affecting hepatic enzyme CYP2D6 metabolism. Modify Therapy/Monitor Closely. Administer a quarter of brexpiprazole dose if coadministered with a moderate CYP2D6 inhibitor PLUS a strong/moderate CYP3A4 inhibitor. brexpiprazole and diphenhydramine both increase sedation. Use Caution/Monitor.brimonidineMonitor Closely (1)brimonidine and diphenhydramine both increase sedation. Use Caution/Monitor.Minor (1)brimonidine increases effects of diphenhydramine by pharmacodynamic synergism. Minor/Significance Unknown. Increased CNS depression.brivaracetamMonitor Closely (1)brivaracetam and diphenhydramine both increase sedation. Use Caution/Monitor.brompheniramineMonitor Closely (1)brompheniramine and diphenhydramine both increase sedation. Use Caution/Monitor.budesonideMonitor Closely (1)ibuprofen, budesonide. Either increases toxicity of the other by pharmacodynamic synergism. Use Caution/Monitor. Increased risk of GI ulceration.bumetanideMonitor Closely (2)ibuprofen decreases effects of bumetanide by pharmacodynamic antagonism. Use Caution/Monitor. NSAIDs decrease prostaglandin synthesis. ibuprofen increases and bumetanide decreases serum potassium. Effect of interaction is not clear, use caution. Use Caution/Monitor.buprenorphineMonitor Closely (1)diphenhydramine and buprenorphine both increase sedation. Use Caution/Monitor.buprenorphine buccalMonitor Closely (1)diphenhydramine and buprenorphine buccal both increase sedation. Use Caution/Monitor.buprenorphine subdermal implantMonitor Closely (1)buprenorphine subdermal implant and diphenhydramine both increase sedation. Use Caution/Monitor.buprenorphine transdermalMonitor Closely (1)buprenorphine transdermal and diphenhydramine both increase sedation. Use Caution/Monitor.buprenorphine, long-acting injectionMonitor Closely (1)buprenorphine, long-acting injection and diphenhydramine both increase sedation. Use Caution/Monitor.butabarbitalMonitor Closely (1)diphenhydramine and butabarbital both increase sedation. Use Caution/Monitor.Minor (1)butabarbital will decrease the level or effect of ibuprofen by affecting hepatic enzyme CYP2C9/10 metabolism. Minor/Significance Unknown.butalbitalMonitor Closely (1)diphenhydramine and butalbital both increase sedation. Use Caution/Monitor.Minor (1)butalbital will decrease the level or effect of ibuprofen by affecting hepatic enzyme CYP2C9/10 metabolism. Minor/Significance Unknown.butorphanolMonitor Closely (1)diphenhydramine and butorphanol both increase sedation. Use Caution/Monitor.caffeineMonitor Closely (1)diphenhydramine increases and caffeine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.calcium/magnesium/potassium/sodium oxybatesSerious - Use Alternative (1)diphenhydramine, calcium/magnesium/potassium/sodium oxybates. Either increases effects of the other by pharmacodynamic synergism. Avoid or Use Alternate Drug. Profound sedation, respiratory depression, coma, and death may result if coadministered. Reserve concomitant prescribing of these drugs in patients for whom other treatment options are inadequate. Limit dosages and durations to the minimum required. Monitor closely for signs of respiratory depression and sedation.candesartanMonitor Closely (3)candesartan, 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 candesartan by pharmacodynamic antagonism. Modify Therapy/Monitor Closely. NSAIDs decrease synthesis of vasodilating renal prostaglandins, and thus affect fluid homeostasis and may diminish antihypertensive effect. candesartan and ibuprofen both increase serum potassium. Use Caution/Monitor.captoprilMonitor Closely (1)captopril, 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, captopril. 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.carbacholMonitor Closely (1)carbachol increases and diphenhydramine decreases cholinergic effects/transmission. Effect of interaction is not clear, use caution. Use Caution/Monitor.carbamazepineMonitor Closely (1)ibuprofen will increase the level or effect of carbamazepine by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor. Monitor plasma levels when used concomitantlyMinor (1)carbamazepine will decrease the level or effect of ibuprofen by affecting hepatic enzyme CYP2C9/10 metabolism. Minor/Significance Unknown.carbenoxoloneMonitor Closely (1)ibuprofen increases and carbenoxolone decreases serum potassium. Effect of interaction is not clear, use caution. Use Caution/Monitor.carbinoxamineMonitor Closely (1)carbinoxamine and diphenhydramine both increase sedation. Use Caution/Monitor.carisoprodolMonitor Closely (1)diphenhydramine and carisoprodol both increase sedation. Use Caution/Monitor.carvedilolMonitor Closely (3)carvedilol and ibuprofen both increase serum potassium. Use Caution/Monitor. ibuprofen decreases effects of carvedilol by pharmacodynamic antagonism. Use Caution/Monitor. Long term (>1 wk) NSAID use. NSAIDs decrease prostaglandin synthesis. diphenhydramine will increase the level or effect of carvedilol by affecting hepatic enzyme CYP2D6 metabolism. Use Caution/Monitor.cefadroxilMinor (1)cefadroxil will increase the level or effect of ibuprofen by acidic (anionic) drug competition for renal tubular clearance. Minor/Significance Unknown.cefamandoleMinor (1)cefamandole will increase the level or effect of ibuprofen by acidic (anionic) drug competition for renal tubular clearance. Minor/Significance Unknown.cefdinirMinor (1)cefdinir will increase the level or effect of ibuprofen by acidic (anionic) drug competition for renal tubular clearance. Minor/Significance Unknown.cefpiromeMinor (1)cefpirome will increase the level or effect of ibuprofen by acidic (anionic) drug competition for renal tubular clearance. Minor/Significance Unknown.ceftibutenMinor (1)ceftibuten will increase the level or effect of ibuprofen by acidic (anionic) drug competition for renal tubular clearance. Minor/Significance Unknown.celecoxibMonitor Closely (2)celecoxib and ibuprofen both increase anticoagulation. Use Caution/Monitor. celecoxib and ibuprofen both increase serum potassium. Use Caution/Monitor.Minor (1)celecoxib will increase the level or effect of ibuprofen by acidic (anionic) drug competition for renal tubular clearance. Minor/Significance Unknown.celiprololMonitor Closely (2)ibuprofen decreases effects of celiprolol by pharmacodynamic antagonism. Use Caution/Monitor. Long term