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Co-administering Advil (ibuprofen) with tricyclic antidepressants (TCAs) might be problematic due to the potential increase in the risk of bleeding and gastrointestinal (GI) side effects. Ibuprofen, a nonsteroidal anti-inflammatory drug (NSAID), can already increase the risk of GI issues, and TCAs are known to have similar effects on the GI tract [1]. The combined use of these two types of medications may exacerbate these adverse effects.

Moreover, ibuprofen may affect the metabolism of TCAs. Ibuprofen is metabolized by cytochrome P450 (CYP) enzymes, specifically CYP2C9 and CYP2C8, which are also involved in the metabolism of some TCAs [2]. Consequently, the co-administration of ibuprofen and TCAs might lead to altered plasma concentrations of TCAs, potentially increasing the risk of adverse effects associated with TCA toxicity [3].

In summary, the potential problems with co-administering Advil (ibuprofen) with tricyclic antidepressants include an increased risk of gastrointestinal side effects and potential alterations in the metabolism of TCAs, leading to potential toxicity.

Sources:

1. Ibuprofen. (2021). In Mayo Clinic. Retrieved from https://www.mayoclinic.org/drugs-supplements/ibuprofen/side-effects/drg-20070754
2. Tricyclic antidepressants. (2021). In Drugs.com. Retrieved from https://www.drugs.com/drug-class/tricyclic-antidepressants.html
3. Cytochrome P450 Drug Interactions. (2016). In FDA. Retrieved from https://www.fda.gov/drugs/development-approval-process-drugs/cytochrome-p450-drug-interactions
4. Ibuprofen. (2021). In DrugPatentWatch. Retrieved from https://www.drugpatentwatch.com/drugs/ibuprofen
5. Tricyclic antidepressants. (2021). In DrugPatentWatch. Retrieved from https://www.drugpatentwatch.com/drugs/tricyclic-antidepressants