At a Glance
Generic/Biosimilar name: Ibuprofen.
Active ingredient: Ibuprofen.
Administration route: Oral.
Oral ibuprofen is approved to relieve mild to moderate pain, reduce fever, and treat signs and symptoms of juvenile and adult inflammatory conditions such as osteoarthritis and rheumatoid arthritis in adults and children 6 months and older (age limits vary by product).
Typical oral ibuprofen doses are 200–400 mg every 4–6 hours as needed in adults (maximum 1,200 mg/day OTC, up to 3,200 mg/day by prescription) and weight-based dosing in children 5–10 mg/kg every 6–8 hours (maximum 40 mg/kg/day).
How It Works
- Ibuprofen blocks enzymes called COX-1 and COX-2, which the body uses to make prostaglandins that cause pain, fever, and inflammation.
- By lowering prostaglandin levels, it reduces swelling and pain in joints, muscles, and other tissues.
- It also lowers fever by acting on the brain’s temperature-control center to help the body release heat.
Treatment and Efficacy
Approved indications: Oral ibuprofen is FDA-approved for relief of mild to moderate pain (such as headache, dental pain, menstrual cramps, muscle aches), reduction of fever, and treatment of signs and symptoms of inflammatory arthritis (e.g., osteoarthritis, rheumatoid arthritis, juvenile idiopathic arthritis).
Off-label uses and evidence: Clinicians may use ibuprofen off-label for conditions like acute migraine, postoperative pain in combination with other agents, and certain musculoskeletal or sports injuries; evidence generally supports short-term pain relief comparable to other nonsteroidal anti-inflammatory drugs (NSAIDs) when used at appropriate doses.
Efficacy expectations: Pain and fever relief usually begin within 30–60 minutes of an oral dose, with peak effect around 1–2 hours and duration of about 4–8 hours depending on formulation and dose.
Comparison to similar drugs: Compared with other NSAIDs such as naproxen or diclofenac, ibuprofen offers similar short-term pain and anti-inflammatory benefits, often with a somewhat lower risk of gastrointestinal side effects at over-the-counter doses but a similar risk profile at higher, chronic prescription doses.
Dosage and Administration
Typical adult dosing: For pain or fever, adults and adolescents usually take 200–400 mg by mouth every 4–6 hours as needed, not exceeding 1,200 mg per day without medical supervision and up to 3,200 mg per day in divided doses only under prescription guidance for inflammatory conditions.
Typical pediatric dosing: For children 6 months and older, typical doses are 5–10 mg/kg by mouth every 6–8 hours as needed for pain or fever, not exceeding 40 mg/kg per day or the maximum daily amount on the product label; an appropriate measuring device should be used for liquids.
How to take: Swallow tablets or capsules with a full glass of water; taking ibuprofen with food or milk can lessen stomach upset, though it may slightly delay onset; oral suspensions should be shaken well before use.
Special dosing instructions: Use the lowest effective dose for the shortest duration that controls symptoms; people with kidney, liver, or significant heart disease, those on blood thinners, or those with a history of ulcers should seek medical advice before use and may need dose adjustments or alternative therapies.
Missed dose guidance: For scheduled prescription dosing, take a missed dose as soon as remembered unless it is almost time for the next dose; if so, skip the missed dose and resume the regular schedule without doubling up.
Overdose: Taking more than the recommended amount can cause severe stomach pain, vomiting, drowsiness, dizziness, low blood pressure, kidney injury, or more serious symptoms; in case of suspected overdose, contact poison control or emergency services immediately and do not wait for symptoms to appear.
Safety and Side Effects
Common side effects: Common reactions include stomach upset, heartburn, nausea, mild abdominal pain, dizziness, and headache; these are usually mild, may appear within hours to days of starting the medicine, and often improve if taken with food or if the dose is lowered.
Serious or rare adverse effects: Seek immediate medical attention for signs of allergic reaction (rash, hives, swelling of face or throat, trouble breathing), chest pain, sudden weakness or difficulty speaking (possible heart attack or stroke), black or bloody stools, vomiting blood, severe stomach pain, unexplained bruising or bleeding, yellowing of skin or eyes, or a marked decrease in urine output.
Warnings and precautions: Long-term or high-dose use can increase the risk of stomach ulcers and bleeding, kidney injury, and cardiovascular events, especially in people with existing heart disease, high blood pressure, kidney disease, or those taking diuretics, ACE inhibitors, or ARBs.
Pregnancy and breastfeeding: Ibuprofen is generally avoided in the third trimester because it can harm the unborn baby’s heart and reduce amniotic fluid; limited short-term use in early pregnancy may be considered only if clearly needed, while short-term use in breastfeeding is usually considered compatible as only small amounts pass into breast milk.
Age limits and special populations: Use in infants under 6 months is generally not recommended without specific medical direction; older adults have higher risks of gastrointestinal bleeding, kidney problems, and cardiovascular events and often require the lowest effective dose for the shortest duration.
Relative safety: At nonprescription doses for short periods, ibuprofen is considered relatively safe for many people, but at higher doses or with prolonged use its safety is similar to other NSAIDs, requiring careful assessment of cardiovascular, gastrointestinal, and kidney risks.
Reporting side effects and safety updates: Patients in the United States can report side effects to the FDA’s MedWatch program and check federal or manufacturer communications for new safety warnings or recalls related to ibuprofen products.
Interactions and Precautions
Drug interactions: Ibuprofen can interact with anticoagulants (e.g., warfarin), antiplatelet drugs (e.g., aspirin, clopidogrel), other NSAIDs, certain blood pressure medicines (ACE inhibitors, ARBs, beta-blockers, and diuretics), some antidepressants that affect bleeding risk (such as SSRIs and SNRIs), and specific drugs like lithium or methotrexate by altering their effects or increasing toxicity.
OTC medicines, supplements, foods, and alcohol: Combining ibuprofen with other OTC pain relievers or cold medicines that contain NSAIDs raises the risk of side effects; herbal supplements that affect clotting (such as ginkgo, garlic, or high-dose fish oil) and regular alcohol use increase the chance of stomach bleeding and should be used cautiously.
Precautions and conditions: People with a history of stomach ulcers or gastrointestinal bleeding, chronic kidney disease, severe liver disease, uncontrolled high blood pressure, heart failure, or established cardiovascular disease should generally avoid ibuprofen or use it only under close medical supervision.
Procedures and imaging: Before surgery or certain procedures with bleeding risk, clinicians may advise stopping ibuprofen in advance to lower bleeding risk, typically several days before the procedure depending on the situation.
Monitoring needs: Long-term or high-dose ibuprofen therapy may require periodic checks of kidney function, liver enzymes, blood pressure, and signs of gastrointestinal bleeding, especially in older adults or those with comorbid conditions.
Disposal Guidance
Storage: Keep ibuprofen tablets, capsules, and liquids at room temperature away from excess heat and moisture; store in a tightly closed container and keep out of reach of children and pets.
Disposal: Do not flush ibuprofen down the toilet unless instructed; use take-back programs when available or mix unused tablets or liquid with an unappealing substance (like coffee grounds or cat litter), seal in a bag or container, and place in household trash according to local guidance.
Common Questions and Answers
Q: How long does it take for ibuprofen to start working?
A: Most people begin to feel pain or fever relief within 30–60 minutes after an oral dose, with peak effect around 1–2 hours.
Q: Can I take ibuprofen on an empty stomach?
A: You can take ibuprofen with or without food, but taking it with food or milk can help reduce stomach upset, especially if you are sensitive to NSAIDs.
Q: Is it safe to take ibuprofen every day?
A: Short-term daily use at recommended doses is usually acceptable for many otherwise healthy adults, but long-term or high-dose daily use increases risks to the stomach, kidneys, and heart and should only be done under medical supervision.
Q: Can I take ibuprofen with acetaminophen?
A: Ibuprofen and acetaminophen work differently and can sometimes be used together or alternated for short periods under dosing guidance, but you should follow product instructions and avoid exceeding the maximum daily dose of either medicine.
Q: Can I drink alcohol while taking ibuprofen?
A: Occasional light alcohol use may be tolerated, but drinking alcohol while taking ibuprofen, especially in higher amounts or for long periods, increases the risk of stomach irritation and bleeding and should be minimized or avoided.