Ibuprofen is a nonsteroidal anti-inflammatory drug (NSAID) used to relieve many types of pain, including migraines and other headaches, muscle aches, arthritis, menstruation and many other conditions. It is usually taken in an over-the-counter formulation but is also available by prescription.
It is unknown exactly how ibuprofen works. However, it is believed that ibuprofen works by inhibiting prostaglandin production. Prostaglandins are hormone-like substances in the body that are involved in a wide range of physiological functions, including inflammation.
Ibuprofen helps reduce fever in addition to inflammation. It can be taken by tablet, capsule, suppository, liquid or drops. Although the drug is considered to be safe, it may not be advised for patients with some medical conditions or for certain populations.
The U.S. Food and Drug Administration (FDA) has warned that ibuprofen and other non-aspirin NSAIDs increase the risk of serious gastrointestinal bleeding and cardiovascular events such as heart attack and stroke. Patients are advised to consult their physician before taking ibuprofen, especially if they are also taking other medications, including aspirin, anticoagulants and diuretics.
Ibuprofen is a pain reliever (analgesic) that also reduces inflammation and fever. It belongs to a class of medications known as nonsteroidal anti-inflammatory drugs (NSAIDs). It is used to treat many types of pain, from headaches and muscle aches to arthritis, menstrual pain and many other causes of discomfort.
In most cases, people take ibuprofen as an over-the-counter drug. However, a physician can prescribe higher dosages of ibuprofen and combination products that include an opioid.
It is unknown exactly how ibuprofen works. However, it is believed that ibuprofen works by inhibiting prostaglandin production. Prostaglandins are hormone–like substances in the body that affect a wide range of physiological functions, including inflammation, blood pressure and contraction of smooth muscle.
In 1984, the U.S. Food and Drug Administration (FDA) approved ibuprofen for use in over-the-counter medications at lower dosage than in prescription medication.
Ibuprofen can be taken by standard tablet, chewable tablet, capsule, suppository, liquid and drops. Patients should always take ibuprofen as directed and are advised not to take the medication without first consulting a physician. Patients who take ibuprofen to relieve pain should call their physician if the painful area becomes red or swollen.
The FDA has warned that ibuprofen and other non-aspirin NSAIDs increase the risk of serious gastrointestinal bleeding and cardiovascular events such as heart attack and stroke.
The National Institutes of Health (NIH) cautions about two forms of kidney disease that can result from use of over-the-counter pain drugs including ibuprofen:
- Sudden-onset acute kidney failure can occur in people with risk factors including old age, chronic kidney disease, systemic lupus erythematosus or alcohol abuse.
- Chronic kidney damage (analgesic nephropathy) can develop in anyone taking these drugs daily over several years.
Some research has suggested that regular use of NSAIDs such as ibuprofen might help prevent conditions including cancer and benign prostatic hyperplasia. However, the scientists conducting such studies generally recommend against taking the medication for this purpose and emphasize that these were possible side benefits in patients who were prescribed the medication for conditions such as arthritis or heart disease.
Patients are advised to consult their physician before taking ibuprofen, especially if they have a condition of concern or are also taking other medications.
Recent research indicates that taking NSAIDs around the time of a vaccination may hinder the vaccine’s effectiveness. Patients scheduled for a flu shot or other vaccination are advised to ask their physician whether they should restrict use of NSAIDs around that time.
Types and differences of ibuprofen
Ibuprofen is available in various strengths. Brands include many store brands and:
Ibuprofen is also found in several combination drugs. These include products containing a sleep aid, a nasal decongestant for treating colds or an opioid for treating moderate to severe pain.
Conditions treated with ibuprofen
Ibuprofen is taken to relieve pain associated with a variety of conditions. These include:
- Headaches, including migraines
- Muscle aches
- Back pain
- Common colds and fever
- Arthritis, including osteoarthritis, rheumatoid arthritis, juvenile rheumatoid arthritis and gout
- Carpal tunnel syndrome
- Tennis elbow and other types of joint pain
- Surgical or dental pain
Conditions of concern with ibuprofen
Certain conditions may raise concerns for patients taking ibuprofen. Patients who have ulcers or who experience gastrointestinal upset when taking aspirin should not take ibuprofen. Patients should inform their physician if they are pregnant or have been diagnosed with any of the following conditions:
- Allergies to ibuprofen, aspirin or other pain medications
- Liver disease
- Heart disease
- Kidney disease, including that which is caused by lupus, sickle cell anemia, diabetes or other conditions
- High blood pressure
- History of gastrointestinal problems
Patients who are scheduled their surgery or have recently had surgery are advised to ask their physician about whether and when to use ibuprofen and other drugs. Physicians often prescribe anti-inflammatory drugs after arthroplasty to control pain and prevent abnormal formation of bone in soft tissues (ectopic ossification), but recent research suggests that routine prescription of ibuprofen or other anti-inflammatories after a hip replacement may cause complications including major bleeding.
Potential side effects of ibuprofen
In 2005, the U.S. Food and Drug Administration (FDA) announced that it was asking all manufacturers of prescription nonsteroidal anti–inflammatory drugs (NSAIDs), including ibuprofen, to include new warnings on their labeling about certain dangers associated with these medications. These dangers include increased risk of cardiovascular events such as heart attack and stroke, and gastrointestinal bleeding that could be potentially life–threatening. The FDA also asked that the labeling state that patients who recently have undergone heart surgery should not take NSAIDs.
In addition, the FDA has asked manufacturers of over-the-counter NSAIDs to include the warnings about cardiovascular and gastrointestinal dangers, as well as a warning about the danger of skin reactions associated with these drugs. Patients should consult a physician if they have concerns about taking these medications in light of the FDA’s recommendations.
In general, ibuprofen is a safe drug that causes few side effects in most people. However, it sometimes causes upset stomach, although it is usually gentler on the stomach than aspirin. To avoid upsetting the stomach, ibuprofen can be taken with food or milk.
Patients should take ibuprofen only as instructed. Recent research shows that doubling the recommended daily dosage of 1,200 milligrams, such as may be done by some people with arthritis and other sources of chronic pain, can cause gastrointestinal bleeding.
Other side effects associated with ibuprofen include:
- Stomach pain or cramps
- Constipation, diarrhea or gas
Some side effects are more serious and require immediate medical attention. Patients are advised to consult a physician if any of the following symptoms occur:
- Bloody vomit
- Bloody diarrhea or black, tarry stools
- Ringing in the ears (tinnitus) or ear pain
- Blurred vision
- Swelling of the hands, feet, ankles or lower legs
- Skin rash or pruritus (itching)
Drug or other interactions with ibuprofen
Patients should consult their physician before taking any additional prescriptions, over-the-counter medications, nutritional supplements or herbal medications. Patients should not drink alcohol while taking ibuprofen, as it can cause increased risk of gastric bleeding and impaired liver function.
Patients should not take ibuprofen with acetaminophen with ibuprofen unless directed to do so by a physician or mix it with aspirin. For people who are instructed by their physician to take daily aspirin to lower their risk of heart attack, the U.S. Food and Drug Administration advises that they can still take ibuprofen but that they should consult their physician about when to take the drugs separately to maintain their effectiveness.
Patients should also inform their physician if they are taking any of the following medications:
- Certain blood pressure medications including beta blockers and diuretics
- Cyclosporine (an immunosuppresant antibiotic)
- Digoxin (an antiarrhythmic heart medication)
- Lithium (used to treat bipolar disorder and sometimes used to prevent cluster headaches)
- Medications for arthritis
- Medications for diabetes (antidiabetic agents)
- Methotrexate (an antimetabolite)
- Phenytoin (an anticonvulsant)
- Probenecid (a uricosuric, which promotes excretion of uric acid in urine)
Symptoms of ibuprofen overdose
Symptoms of overdose can be similar to the medication’s side effects, but are usually more severe. Patients exhibiting any of these symptoms should contact their physician immediately:
- Unsteadiness throughout the body
- Ringing in the ears (tinnitus) or ear pain
- Blurred vision
- Nausea or vomiting
- Stomach pain
- Incoherence and confusion
Overdose of ibuprofen can also lead to coma in some patients.
Patients who overdose on ibuprofen can usually be successfully treated with administration of a laxative or activated charcoal, a medication that neutralizes poisons that have been swallowed.
Pregnancy use issues with ibuprofen
Studies on whether or not ibuprofen causes birth defects in humans have not been performed. However, it is possible that ibuprofen may cause undesirable effects on the heart or blood flow of the fetus when taken by the mother during the last few months of pregnancy. Pregnant women should not take ibuprofen without doing so in close consultation with a physician.
It is not known whether ibuprofen passes into breast milk.
Child use issues with ibuprofen
Ibuprofen should be given only to children who are older than 6 months of age, and should not be given to children under age 12 without close supervision of a physician. It should not be given to children who are dehydrated or who are vomiting continuously.
Parents should consult with their child’s physician before giving ibuprofen to children diagnosed with kidney disease, asthma, ulcers or other chronic illnesses.
Elderly use issues with ibuprofen
Certain side effects associated with ibuprofen may be more likely to occur in older adults than in younger adults. These include:
- Swelling of the face, feet or lower legs
- Sudden decrease in urine output
Questions for your doctor regarding ibuprofen
Preparing questions in advance can help patients have more meaningful discussions with their physicians regarding their conditions. Patients may wish to ask their doctor the following questions about ibuprofen:
- Is ibuprofen safe for me to use?
- What kinds of pain can I treat with ibuprofen?
- Which other of my conditions can it treat?
- Is ibuprofen available to me in prescription dosages to treat more substantial pain?
- What should I do if I miss a dose or take too much?
- What side effects might I experience from taking ibuprofen?
- At what point should I inform you of side effects?
- Do I have any conditions that rule out use of ibuprofen?
- Can any of my other medications interact with ibuprofen?
- What are my other options if ibuprofen does not relieve my condition?