Pediatric Drug Interactions with Ibuprofen

• Anticoagulants/antiplatelets (warfarin, aspirin, clopidogrel): increased GI bleeding risk
• SSRIs/SNRIs: additive GI bleed risk; counsel on warning signs
• ACE inhibitors/ARBs + diuretics: renal perfusion risk ("triple whammy")—avoid combination when possible
• Methotrexate and Lithium: decreased clearance—monitor or avoid
• Other NSAIDs: avoid duplicate therapy