Ibuprofen – Tests & treatments

Ibuprofen is a painkiller available over the counter without a prescription.

It’s one of a group of painkillers called non-steroidal anti-inflammatory drugs (NSAIDs) and can be used to:

• ease mild to moderate pain – such as toothache, migraine and period pain
• control a fever (high temperature) – for example, when someone has the flu (influenza)
• ease pain and inflammation (redness and swelling) caused by conditions that affect the joints, bones and muscles – such as rheumatoid arthritis and osteoarthritis
• ease pain and swelling caused by sprains and strains – such as sports injuries

This topic covers:

Types of ibuprofen

Who can take ibuprofen

How to take ibuprofen

Interactions with medicines, food and alcohol

Side effects of ibuprofen

Overdoses of ibuprofen

Types of ibuprofen

You can buy most types of ibuprofen from supermarkets or pharmacies. Some types are only available on prescription.

Ibuprofen is available in many forms, including:

• tablets
• capsules
• liquids
• gels or creams
• sprays

In some products ibuprofen is combined with other ingredients. For example, it’s sometimes combined with medicine for a blocked nose (a decongestant) and sold as a cold and flu remedy.

Who can take ibuprofen

Some people should avoid using ibuprofen and others should use it with caution. If you have any queries about using ibuprofen or any other medicines, speak to your GP or pharmacist, or phone the NHS 24 111 service.

You shouldn’t take ibuprofen if you:

• have a history of a strong, unpleasant reaction (hypersensitivity) to aspirin or other NSAIDs
• have a current or recent stomach ulcer, or you have had one in the past
• have severe heart failure
• have severe liver disease
• are taking low-dose aspirin for the prevention of cardiovascular disease

You should use ibuprofen with caution if you’re aged 65 or over, breastfeeding, or have:

• asthma
• kidney or liver problems
• lupus
• Crohn’s disease or ulcerative colitis
• previously had any bleeding in your stomach
• high blood pressure (hypertension)
• narrowing of the arteries (peripheral arterial disease)
• any problems with your heart, such as angina, heart attacks, or mild or moderate heart failure
• had a stroke

Ibuprofen and pregnancy

Ideally, pregnant women shouldn’t take ibuprofen unless a doctor recommends it.

But ibuprofen appears in breast milk in small amounts, so it’s unlikely to cause any harm to your baby while you’re breastfeeding.

It’s best to tell your GP, pharmacist or health visitor about any medicines you’re taking.

Paracetamol is recommended as an alternative to ease short-term pain or reduce a high temperature.

Ibuprofen and children

Ibuprofen may be given to children aged 3 months or over who weigh at least 5kg (11lbs) to relieve pain, inflammation or fever.

Your GP or another healthcare professional may recommend ibuprofen for younger children in certain cases – for example, this may be to control a fever after a vaccination if paracetamol is unsuitable.

If your baby or child has a high temperature that doesn’t get better or they continue to experience pain, speak to your GP or phone the NHS 24 111 service.

How to take ibuprofen

Make sure you take ibuprofen as directed on the label or leaflet, or as instructed by a health professional.

How much you can take depends on your age, the type of ibuprofen you’re taking and how strong it is. For example:

• adults – can usually take 1 or 2 tablets (200mg) every 4 to 6 hours, but shouldn’t take more than 1,200mg (6 x 200mg) tablets in the space of 24 hours
• children under 16 – may need to take a lower dose, depending on their age; check the packet or leaflet, or ask a pharmacist or doctor for advice

The painkilling effect of ibuprofen begins soon after a dose is taken, but the anti-inflammatory effect can sometimes take up to 3 weeks to get the best results.

Ibuprofen shouldn’t be used to treat conditions that are mainly related to inflammation.

Don’t take more than the recommended dose if it isn’t relieving your symptoms.

Adults can take paracetamol at the same time if necessary, but this isn’t recommended for children.

Contact your GP or phone the NHS 24 111 service if your symptoms get worse or last more than 3 days despite taking ibuprofen.

Interactions with medicines, food and alcohol

Ibuprofen can react unpredictably with certain other medicines. This can affect how well either medicine works and increase the risk of side effects.

Check the leaflet that comes with your medicine to see if it can be taken with ibuprofen. Ask your GP or local pharmacist if you’re not sure. 

As ibuprofen is a type of NSAID, you shouldn’t take more than one of these at a time or you’ll have an increased risk of side effects. 

NSAIDs can also interact with many other medicines, including:

• some types of antidepressants – used to treat depression
• beta-blockers – used to treat high blood pressure (hypertension)
• diuretics – which reduce the amount of fluid in your body

Read more about medicines that interact with NSAIDs.

Ibuprofen can also interact with ginkgo biloba, a controversial dietary supplement some people claim can treat memory problems and dementia.

There are no known problems caused by taking ibuprofen with any specific foods or by drinking a moderate amount of alcohol.

Side effects of ibuprofen

Ibuprofen can cause a number of side effects. You should take the lowest possible dose for the shortest possible time needed to control your symptoms.

See the patient information leaflet that comes with your medicine for a full list of side effects.

Common side effects of ibuprofen include:

• nausea or vomiting
• constipation or diarrhoea
• indigestion (dyspepsia) or abdominal pain

Less common side effects include:

• headache or dizziness
• bloating (fluid retention)
• raised blood pressure
• inflammation of the stomach (gastritis)
• a stomach ulcer
• allergic reactions – such as a rash
• worsening of asthma symptoms by causing narrowing of the airways (bronchospasm)
• kidney failure
• black stools and blood in your vomit – this can indicate bleeding in your stomach

If you feel unwell after taking ibuprofen or have concerns, speak to your GP or pharmacist, or phone the NHS 24 111 service.

You can also report suspected side effects using the Yellow Card Scheme.

High doses

Taking high doses of ibuprofen over long periods of time can increase your risk of:

• stroke – when the blood supply to the brain is disturbed
• heart attacks – when the blood supply to the heart is blocked

In women, long-term use of ibuprofen might be associated with reduced fertility. This is usually reversible when you stop taking ibuprofen.

Overdoses of ibuprofen

Taking too much ibuprofen, known as an overdose, can be very dangerous.

If you’ve taken more than the recommended maximum dose, go to your nearest accident and emergency (A&E) department as soon as possible.

It can be helpful to take any remaining medicine and the box or leaflet with you to A&E if you can.

Some people feel sick, vomit, have abdominal pain or ringing in their ears (tinnitus) after taking too much ibuprofen, but often there are no symptoms at first. Go to A&E even if you’re feeling well.

Can You Overdose on Ibuprofen? Symptoms, Treatment, and More

Taking too much ibuprofen can result in an overdose. This can cause dangerous side effects such as damage to your stomach or intestines. In rare cases, an overdose can be fatal.

You should always take ibuprofen exactly as directed on the label or as recommended by your doctor.

If you think that you or someone you know has overdosed on ibuprofen, contact your local poison center or your local emergency services. In the United States, you can reach the poison center by calling 1-800-222-1222.

Ibuprofen is an over-the-counter nonsteroidal anti-inflammatory drug (OTC NSAID) used to relieve inflammation, fever, and mild pain.

People take this medication to treat:

• headaches
• back pain
• toothaches
• arthritis
• menstrual cramps
• fevers

Some brand names for ibuprofen are:

• Motrin
• Advil

Read on to learn how to safely use this medication as well as the signs of an overdose.

Your recommended dose of ibuprofen depends on your age.

For adults

The recommended dosage for adults is one or two 200-milligram (mg) tablets every 4 to 6 hours. Adults should not exceed 800 mg at once or 3,200 mg per day.

Adults over 60 years old should take as little ibuprofen as possible to manage their symptoms. Older adults have a higher risk of kidney and gastrointestinal side effects.

For children

To determine the safe dosage for children, you need to know the child’s weight and the formulation of ibuprofen you’re using.

Ibuprofen for children is available in:

• infant drops
• liquids
• chewable tablets

Liquid measurements are given in milliliters (mL). Make sure to read the label and measure carefully.

Never give your child more than four doses in one day. The following chart shows how much ibuprofen a child can consume depending on their weight.

Weight	50-mg/1. 25-mL infant drops dosage	100-mg/5-mL liquid dosage	50-mg/1 chewable tablet dosage
12 to 17 pounds	1.25 mL (50 mg)	Ask your doctor	Ask your doctor
18 to 23 pounds	1.875 mL (75 mg)	Ask your doctor	Ask your doctor
24 to 35 pounds	2.5 mL (100 mg)	5 mL (100 mg)	2 tablets (100 mg)
36 to 47 pounds	3.75 mL (150 mg)	7.5 mL (150 mg)	3 tablets (150 mg)
48 to 59 pounds	5 mL (200 mg)	10 mL (200 mg)	4 tablets (200 mg)
60 to 71 pounds	n/a	12.5 mL (250 mg)	5 tablets (250 mg)
72 to 95 pounds	n/a	15 mL (300 mg)	6 tablets (300 mg)
over 95 pounds	n/a	20 mL (400 mg)	8 tablets (400 mg)

For babies

Do not give ibuprofen to children under 6 months old.

For infants ages 6 months to 1 year, the safe dose of the infant formulation depends on their weight.

Drug interactions

Certain medications can increase your risk of having an overdose of ibuprofen.

According to research, do not take any of the following medications with ibuprofen without first talking with your doctor:

• Selective serotonin reuptake inhibitors (SSRIs), which can interfere with the metabolism of NSAIDs while also increasing pain and bleeding
• antihypertensives, which are medications for high blood pressure that may increase the risk of kidney damage
• aspirin, which may increase the risk of serious side effects
• diuretics (water pills), which increase the risk of kidney failure when combined with ibuprofen
• lithium, which increases the risk of toxicity
• methotrexate, which increases the risk of toxicity
• anticoagulants (blood thinners), such as warfarin, because they can increase your risk of serious gastrointestinal bleeding

Mixing ibuprofen with alcohol can also increase your risk of having serious side effects, like stomach or intestinal bleeding.

Not everyone will experience symptoms of an ibuprofen overdose right away. Some people won’t have any visible symptoms at all.

If you do experience symptoms of an ibuprofen overdose, they’re usually mild. Mild symptoms may include:

• tinnitus (ringing in the ears)
• heartburn
• nausea
• vomiting
• stomach pain
• diarrhea
• dizziness
• blurred vision
• rash
• sweating

Severe symptoms can include:

• difficult or slow breathing
• convulsions
• hypotension (low blood pressure)
• seizures
• little to no urine production
• severe headache
• coma

If you or someone you know has taken more than the maximum recommended dose of ibuprofen, contact your local poison center. In the United States, you can reach the poison center by calling 1-800-222-1222. You can call this number 24 hours a day. Stay on the line for further instructions.

If possible, have the following information ready:

• the person’s age, height, weight, and gender
• how much ibuprofen was ingested
• when the last dose was taken
• whether the person also took other drugs, supplements, or had any alcohol

You can also receive guidance by using the poison center’s webPOISONCONTROL online tool.

TIP

1. Text “POISON” to 202-677-7600 to save the contact information for poison control to your smartphone.

If you can’t access a phone or computer, go to the nearest emergency room immediately. Do not wait until symptoms start. Some people who overdose on ibuprofen will not show symptoms right away.

At the hospital, doctors will monitor breathing, heart rate, and other vital signs. A doctor may insert a tube through the mouth to look for internal bleeding.

You may also receive the following treatments:

• medications that make you throw up
• decontamination of the stomach with activated charcoal
• benzodiazepines to control seizures
• breathing support, such as oxygen or a breathing machine (ventilator)
• intravenous fluids
• antihypertensive medications to reduce blood pressure

Children who consume more than 400 mg/kilogram (kg) of ibuprofen are at a higher risk of overdose and will likely require hospitalization. If they consume 100 mg/kg or less, they may be monitored at home.

An overdose of ibuprofen can cause severe problems in the gastrointestinal tract. These include:

• inflammation
• bleeding
• ulcers
• stomach or intestinal perforation, which can be fatal
• liver or kidney failure

Taking high doses of ibuprofen over long periods of time can also increase your risk of having a stroke or heart attack.

With prompt medical treatment, you’re likely to recover from an ibuprofen overdose. However, some people develop liver, kidney, or stomach issues. People with a prior history of ulcers or gastrointestinal bleeding should not take NSAIDS like ibuprofen.

Always read product labels carefully and take the smallest amount of ibuprofen possible that will help relieve your symptoms.

An adult should not take more than 3,200 mg of ibuprofen per day. A safe dose for children is much less than that. If you or someone you know has taken more than the recommended dose, call your local poison center or your local emergency services.

If you experience symptoms of an ulcer after taking ibuprofen, stop taking ibuprofen and call your doctor.

Paracetamol and ibuprofen: what from what?

BBC News, Russian Service

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22 May 2015

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Image copyright, Thinkstock

Image caption,

Paracetamol has been at the service of mankind since the 19th century, ibuprofen was synthesized in the middle of the 20th century

Pregnant women should avoid taking not only ibuprofen, but also paracetamol, a study by Scottish scientists suggests. Long-term use of the latter, they argue, can lead to reproductive disorders in male children.

Scientists from the University of Edinburgh have found that the use of paracetamol by pregnant women for seven days blocks the production of testosterone in the fetus, which can have a detrimental effect on the formation of male reproductive organs.

Until now it has been thought that paracetamol during pregnancy, although undesirable, can be used for a short time – these are the recommendations of the British National Health Service.

It turns out that both ibuprofen (the most famous drug based on it is Nurofen) and paracetamol are both quite harmful for pregnant women.

But what about everyone else? Could the findings of Scottish scientists in any way influence our daily choice between these two most popular painkillers?

We have compiled a small memo where we tried to weigh all the “pros” and “cons” of the use of each of the analgesics.

PARACETAMOL

Image copyright Thinkstock

Image caption

Paracetamol relieves pain and can bring down fever

Benefits:

• Most commonly used to relieve headaches, toothaches, minor bruises, sunburn and high fever.
• Paracetamol works by blocking enzymes secreted in the body in response to illness and injury, thereby making pain less noticeable to the central nervous system.
• It can be taken by adults and children – with the correct dosage, side effects are minimized.
• An article on AskDrSear.com indicates that the average patient only experiences negative effects at eight times the recommended dose.
• Paracetamol can be used in combination with many other cold medicines.

Disadvantages:

• Unlike ibuprofen, which begins to act half an hour after taking, the effect of paracetamol must be waited for about 45-60 minutes.
• The duration of the drug is usually limited to four hours, and not six, as is the case with ibuprofen.
• Paracetamol lacks an anti-inflammatory effect and is therefore less suitable for situations where pain is caused by inflammatory processes in the body or bodily injury.
• Although it is almost safe for the stomach, if the recommended dose is exceeded, it can adversely affect the functioning of the liver.

IBUPROFEN

Image credit: Thinkstock

Image caption

Like paracetamol, ibuprofen is a pain reliever but also an anti-inflammatory

Benefits: 9 0016

• Reduces fever, relieves pain and inflammation.
• Reduces inflammation at the site of an injury or wound, so it is suitable for relieving muscle pain, like any other, caused by trauma, overexertion and ruptures (microtears) of tissues.
• Begins to work faster than paracetamol and lasts longer – up to six hours.

Disadvantages:

• May have a number of unpleasant side effects such as nausea, vomiting, diarrhea, abdominal pain and digestive upset.
• It is not recommended to use it for a long time for those who have stomach problems: ibuprofen can aggravate peptic ulcers and lesions of the gastric mucosa. If you take ibuprofen with or after food, this risk can be reduced.
• Internal bleeding is possible, although this is extremely rare.
• May cause impaired blood clotting, which is dangerous if the patient has a serious wound or bleeding. Then it is better to use paracetamol to relieve pain.

VERDICT

Photo credit, EyeWire Inc

Image caption,

If the pain is tolerable, British doctors recommend not taking painkillers

• Both analgesics are effective painkillers that can also bring down the heat.
• Ibuprofen starts working faster and lasts longer. In addition, it has anti-inflammatory properties.
• Paracetamol has fewer side effects: in particular, it is relatively harmless to the stomach.
• Both drugs can be used simultaneously for a short time. For longer use, a doctor’s consultation is necessary.
• The UK National Health Service does not recommend either drug during pregnancy. For minor colds and tolerable headaches, it is better not to take medicine at all.
• British doctors do not recommend that pregnant women take ibuprofen without a doctor’s order.
• During pregnancy and lactation, if the patient still needs an analgesic for a short period (to bring down the fever or relieve sharp and short-term pain), paracetamol is usually recommended.

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When to use ibuprofen and how quickly it starts to work

Ibuprofen has proven to be a popular and effective remedy for even severe pain. Does ibuprofen bring down the temperature – yes, and very effectively. In addition to the antipyretic and analgesic effect, it has a good anti-inflammatory effect. The drug is used to treat acute respiratory infections, chronic pain and inflammation of the joints, spine and other diseases.

Indications for use

According to the instructions, the drug is used as a symptomatic treatment for the following pathologies:

• rheumatism, arthritis, sciatica, trauma, neuritis, myalgia;
• otitis, SARS, influenza;
• infectious diseases and hyperthermia after vaccination in a child;
• adnexitis, painful menses;
• dental pain, migraine.

Ibuprofen belongs to the group of NSAIDs (non-steroidal anti-inflammatory drugs), like Paracetamol. But it is more effective, it is not metabolized into side toxic substances.

Does ibuprofen help with fever

The drug has a good antipyretic effect, but does not affect the etiology of fever itself.

How long does it take for adults

Adults and children over 6 years of age are prescribed 200 mg tablets 3-4 times a day after meals. The medicine in the form of a cream or ointment is applied topically to the diseased area of ​​​​the body with a thin layer 3-4 times a day. How long does ibuprofen work: the effect begins half an hour after ingestion, and the maximum amount of the drug in plasma is detected 2 hours after ingestion.

When does it start to work in children?

A child from the age of three months is prescribed the drug in syrup, after ingestion, how quickly Ibuprofen acts – the effect appears within 15 minutes. The tablet after taking it does not act so quickly – after 30-60 minutes, the maximum amount of the substance in the blood appears after 2-4 hours. The dosage for a child under 6 years of age is calculated at 30 mg per kilogram of weight. How long ibuprofen acts is within 6-8 hours, so the frequency of use is 3-4 times a day.