- Side Effects
- Drug Interactions
- Pregnancy & Breastfeeding
- What Else to Know
Generic Name: ibuprofen
Drug Class: NSAIDs, Patent Ductus Arteriosus Agents
What is ibuprofen, and what is it used for?
Ibuprofen is a non-steroidal anti-inflammatory drug (NSAID) used to treat inflammation, fever and mild to moderate pain from conditions such as common cold, headache, toothache, menstrual cramps, muscular pains, and joint pain and inflammation (arthritis).
Intravenous ibuprofen is used to treat patent ductus arteriosus (PDA), a condition in newborn babies in which a fetal connection between the aorta and pulmonary artery that normally closes at birth, remains open.
Ibuprofen works by blocking the activity of enzymes known as cyclooxygenases (COX-1 and COX-2), essential for biosynthesis of prostaglandin. Prostaglandins are fatty compounds that regulate many processes in the body including inflammation, blood flow and clotting processes, smooth muscle function, and female reproductive cycle.
By inhibiting prostaglandin synthesis, ibuprofen:
- Inhibits the movement and aggregation of inflammatory cells
- Inhibits the release of proinflammatory proteins (cytokines)
- Inhibits platelet aggregation, interfering with blood clotting function
- Promotes the closure of patent ductus arteriosus
Lower dosages of ibuprofen to treat minor pains are available over the counter, while dosages of 400 mg and above require prescription. Ibuprofen is used to treat the following:
- Pain and fever
- Painful menstruation (dysmenorrhea)
- Inflammatory disease
- Rheumatoid arthritis
- Do not take/administer ibuprofen if you/they have hypersensitivity to ibuprofen, aspirin or other NSAIDs
- Do not administer ibuprofen to preterm infants with:
- Untreated proven or suspected infection
- Bleeding with active intracranial hemorrhage or gastrointestinal (GI) bleed
- Low platelet count (thrombocytopenia)
- Coagulation defects
- Proven or suspected intestinal inflammation (necrotizing enterocolitis)
- Significant renal impairment
- Congenital heart disease where patency of the ductus arteriosus is necessary for pulmonary or systemic blood flow
- Do not use for perioperative pain in coronary artery bypass graft (CABG) surgery
- Ibuprofen may increase the risk of serious cardiovascular clotting (thrombotic) events, heart attack (myocardial infarction), and stroke, which can be fatal
- Risk for the above may increase with duration of use
- Do not use ibuprofen in patients with existing cardiovascular disease or risk factors for such disease, they may have greater cardiovascular risk
- Ibuprofen can lead to new onset or exacerbation of high blood pressure (hypertension)
- Ibuprofen can cause serious gastrointestinal (GI) adverse events, including bleeding, ulceration, and gastric or intestinal perforation, which can be fatal
- GI adverse events may occur at any time during use and without warning symptoms
- Elderly patients are at greater risk for serious GI events
What are the side effects of ibuprofen?
Common side effects of ibuprofen may include:
- Gastrointestinal effects such as:
- Ringing in the ears (tinnitus)
- Itching (pruritus)
- Reduced appetite
- Fluid retention
- Swelling (edema)
Less common side effects may include:
- Blood in stool
- Gastrointestinal inflammation (gastritis, hepatitis, pancreatitis)
- Hearing loss
- Vision disturbances
- Dry eyes
- Dry mouth and gum ulcers
- Nasal inflammation (rhinitis)
- Elevated blood pressure
- Blood disorders such as:
- Low red blood cell count due to reduced red cell production (aplastic anemia)
- Anemia from rapid destruction of red cells (hemolytic anemia)
- Low levels of neutrophil, a type of immune cell (neutropenia)
- Low levels of granulocytes, immune cells with granules (agranulocytosis)
- Low platelet count (thrombocytopenia)
- High level of eosinophils, a type of immune cell (eosinophilia)
- Reduced creatine clearance
- Bladder inflammation (cystitis)
- Increased urine output
- Blood in urine (hematuria)
- Elevated blood urea nitrogen (BUN)
Rare severe side effects may include:
- Gastrointestinal bleeding
- Gastrointestinal perforation
- Aseptic meningitis with fever and coma
- Acute renal failure
- Congestive heart failure
- Severe skin reactions including:
- Exfoliative dermatitis
- Stevens-Johnson syndrome
- Toxic epidermal necrolysis
- Severe allergic reaction (anaphylaxis)
This is not a complete list of all side effects or adverse reactions that may occur from the use of this drug. Call your doctor for medical advice about serious side effects or adverse reactions. You may also report side effects or health problems to the FDA at 1-800-FDA-1088.
What are the dosages of ibuprofen?
- 400mg (Rx)
- 600mg (Rx)
- 800mg (Rx)
- Over-the-counter (OTC): 200-400 mg taken orally once every 4-6 hours; not to exceed 1.2 g unless directed by a physician
- Prescription: 400-800 mg taken orally or intravenously (IV) once every 6 hours
- 400-800 mg taken orally once every 6-8 hours; not to exceed 3.2 g/day
- 300 mg, 400 mg, 600 mg, or 800 mg taken orally once every 6-8 hours; not to exceed 3.2 g/day
- Monitor for gastrointestinal (GI) risks
- 300 mg, 400 mg, 600 mg, or 800 mg taken orally once every 6-8 hours; not to exceed 3200 mg/day
- Monitor for GI risks
- Significantly impaired renal function: Monitor closely; consider reduced dosage if warranted
- Severe hepatic impairment: Avoid use
- Children 6 months to 12 years: 5-10 mg/kg/dose taken orally once every 6-8 hours; not to exceed 40 mg/kg/day
- 4-10 mg/kg/dose taken orally once every 6-8 hours; not to exceed 40 mg/kg/day
Juvenile Idiopathic Arthritis
- 30-50 mg/kg/24 hours taken orally once every 8 hours; not to exceed 2.4 g/day
Patent Ductus Arteriosus
- See ibuprofen IV (intravenous) drug monograph
Cystic Fibrosis (Off-label)
- Younger than 4 years: Safety and efficacy not established
- 4 years of age and older: taken orally once every 12 hours, adjusted to maintain serum levels of 50-100 mcg/mL; may slow disease progression in younger patients with mild lung disease
- The potential toxic dose in children younger than 6 years is 200 mg/kg
- Overdose must be treated with symptomatic and supportive care, such as administering activated charcoal and/or inducing vomiting (emesis).
- It may be beneficial to administer alkali and increase urine output because ibuprofen is acidic and is excreted in the urine.
What drugs interact with ibuprofen?
Inform your doctor of all medications you are currently taking, who can advise you on any possible drug interactions. Never begin taking, suddenly discontinue, or change the dosage of any medication without your doctor’s recommendation.
- Severe interactions of ibuprofen include: None
- Serious interactions of ibuprofen include:
- Ibuprofen has moderate interactions with at least 239 different drugs.
- Ibuprofen has mild interactions with at least 116 different drugs.
The drug interactions listed above are not all of the possible interactions or adverse effects. For more information on drug interactions, visit the RxList Drug Interaction Checker.
It is important to always tell your doctor, pharmacist, or health care provider of all prescription and over-the-counter medications you use, as well as the dosage for each, and keep a list of the information. Check with your doctor or health care provider if you have any questions about the medication.
Pregnancy and breastfeeding
- There are no adequate and well-controlled studies of ibuprofen in pregnancy, labor and delivery.
- Avoid using ibuprofen up to 20 weeks of gestation. Animal studies indicate an increased risk for loss of pregnancy in early stages because ibuprofen inhibits the synthesis of prostaglandin.
- Limit dose and duration of use between about 20 and 30 weeks of gestation.
- Avoid ibuprofen use at about 30 weeks of gestation and later in pregnancy, it may cause premature closure of ductus arteriosus and fetal renal dysfunction.
- No lactation studies have been conducted. Ibuprofen may be excreted in breast milk at extremely low levels. Ibuprofen has a short half-life and is considered safe in infants in doses much higher than those excreted in breast milk.
What else should I know about ibuprofen?
- Ibuprofen can cause fluid retention and edema and must be used with caution in patients with edema or congestive heart failure.
- Long-term administration of NSAIDs may result in kidney damage or injury; patients at the greatest risk include elderly individuals, those with impaired renal function, low blood volume (hypovolemia), heart failure, liver dysfunction, or salt depletion; and those taking medication such as diuretics, angiotensin-converting enzyme (ACE) inhibitors, or angiotensin receptor blockers.
- NSAIDS, except aspirin, increase risk of heart attack, heart failure, and stroke, which can be fatal; the risk is higher if patients use more than it was directed or for longer than needed.
- Use with caution in asthma (bronchial), cardiac disease, congestive heart failure (CHF), hepatic or renal impairment, hypertension, bleeding disorders, duodenal/gastric/peptic ulcer, stomatitis, systemic lupus erythematosus (SLE), ulcerative colitis, upper GI disease, late pregnancy (may cause premature closure of ductus arteriosus).
- Fever, rash, abdominal pain, nausea, liver dysfunction, and meningitis have occurred in patients with collagen-vascular disease, especially SLE.
- Ibuprofen (Junior Advil) for children may cause severe and persistent sore throat.
- Higher than recommended doses may cause stomach bleeding in children.
- Ibuprofen may increase the risk of elevated potassium in blood (hyperkalemia), especially in renal disease, patients with diabetes, the elderly, and when used simultaneously with other medications capable of inducing hyperkalemia.
- Ibuprofen can cause severe skin reactions such as Stevens-Johnson syndrome.
- Ibuprofen may cause drowsiness and dizziness; may impair ability to drive or operate heavy machinery.
- Ibuprofen may cause blurred vision, partial loss of vision/blind spot or changes in color vision.
- Drug reaction with eosinophilia and systemic symptoms (DRESS) has been reported in patients taking NSAIDs, some of which have been fatal or life-threatening. DRESS may present with fever, rash, swollen lymph nodes (lymphadenopathy), and/or facial swelling.
Ibuprofen is a non-steroidal anti-inflammatory drug (NSAID) used to treat inflammation, fever, and mild to moderate pain caused by the common cold, headache, toothache, menstrual cramps, muscular pains, and joint pain and inflammation (arthritis). Common side effects include nausea, vomiting, upper abdominal (epigastric) pain, heartburn, abdominal distress, diarrhea, indigestion (dyspepsia), constipation, abdominal cramps, bloating and flatulence, dizziness, headache, nervousness, and others. Consult your doctor before taking ibuprofen if pregnant or breastfeeding.
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Migraines typically last from four to 72 hours. The frequency of migraines differs for everyone, but usually, there would be two to four headaches per month. In some, the migraines may occur every few days, while others may get them once or twice a year.
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Learn these simple tips and tricks to help stop the progression of arthritis in your hands.
What Causes Migraines in Females?
Migraine is most commonly seen in women. Every three out of four women are affected by migraines. Some of the most common triggers affecting women are changes in hormonal levels or birth control pills, lack of sleep or too much sleep, and others
Early Signs of Arthritis in the Feet
There are more than 30 joints in the ankle and feet. Arthritis can affect one or multiple joints in the feet. Excess weight, hereditary tendencies, old injuries, and poor footwear are a few predisposing factors of arthritis.
Abdominal Migraines in Children and Adults
Abdominal migraine in adults and children is a variant of migraine headaches. Abdominal migraine in children generally occurs in children who have a family history of migraines. Causes of abdominal migraine is not known. Symptoms of abdominal migraine include acute, severe, midline abdominal pain, nausea, vomiting, paleness, and inability to eat. Abdominal migraine is diagnosed through patient history, family history, and ruling out other medical causes. Treatment of abdominal migraine include tricyclic antidepressants and triptans.
What Is Happening in the Brain During a Migraine?
During a migraine, some chemicals in the brain become more active, which send out confusing signals that result in headaches.
How Long Does Headache Last After Thunderclap?
Thunderclap headache is an extremely painful headache that begins suddenly and peaks with intensity within seconds. These headaches can last for at least 5 minutes.
What Foods Trigger Arthritis Attacks?
Exercising regularly and eating a healthy diet can help you manage arthritis. Learn which foods to avoid and which foods to eat with arthritis.
Early Signs of Arthritis in the Fingers
The earliest signs of arthritis are pain, swelling and stiffness. If these symptoms are experienced in the fingers, it is likely because of rheumatoid arthritis. The signs and symptoms of arthritis in the fingers include popping sounds, joint deformity, warmth, mucus cysts and bone spurs.
Migraine vs. Headache: Differences and Similarities
Headaches are the most common reason why a person goes to the doctor or other healthcare professional for treatment. There are different types of headaches, for example, migraine, tension, and cluster headaches. The most common type of headache is tension headache. Migraine is much less common. There are few similarities between migraine and other headaches, for example, the severity of the pain can be the same, mild, moderate, or severe; and they can occur on one side or both sides of the head. However, there are many differences between migraine and other types of headaches. Migraine headaches also have different names, for example, migraine with aura and menstrual migraine. Symptoms of migraine that usually aren't experienced by a person with another type of headache include nausea, vomiting, worsens with mild exercise, debilitating pain, eye pain, throbbing head pain. Migraine trigger include light, mild exercise, strong smells, certain foods like red wine, aged cheese, smoked meats, artificial sweeteners, chocolate, alcohol, and dairy products, menstrual period, stress, oversleeping, and changes in barometric pressure. Untreated migraine attacks usually last from 4 to 72 hours, but may last for weeks. Most headaches resolve within 24-48 hours. Doctors don't know exactly what causes migraine headaches; however, other headaches like tension headaches have more specific triggers and causes. Additional tests usually are required to diagnose migraine from other types of headaches, diseases, or other medical problems. Most headaches can be treated and cured with home remedies like essential oils, massage, and over-the-counter pain medication like acetaminophen (Tylenol) and NSAIDs (nonsteroidal anti-inflammatory drugs) like naproxen (Aleve, Anaprox, Naprosyn) or ibuprofen (Advil, Midol, Motrin). Most headaches resolve with OTC and home remedy treatment, while your doctor may need to prescribe medication to treat your migraines. If you have the "worst headache of your life," seek medical care immediately.
How Can You Live With Arthritis in Your Back?
Arthritis in the back can be extremely painful and in some cases debilitating. However, effective ways to manage and live with the condition.
How Serious Is Rheumatoid Arthritis?
Rheumatoid arthritis (RA) is a chronic inflammatory disorder that typically affects the joints and other body parts. If not diagnosed early and appropriately treated, RA can lead to permanent deformities, disabilities, and serious systemic complications.
What Does a Pseudotumor Cerebri Headache Feel Like?
Pseudotumor cerebri headaches usually feel like a headache that occurs at the back of the head or behind the eyes. The pain starts as a dull, aching pain that worsens at night or in the morning. They may be associated with vomiting as well. Patients may also eventually develop visual problems and blindness due to inflammation of the optic nerve.
Breastfeeding With Rheumatoid Arthritis
You can breastfeed your baby even if you have rheumatoid arthritis (RA). However, you must always consult your doctor before you start the process.
Is Crohn's Disease Related to Rheumatoid Arthritis?
Since Crohn’s disease causes inflammation of the body, including the joints, sufferers are at a greater risk of developing rheumatoid arthritis.
How Do You Get Rid of a Migraine Fast?
Migraine is a neurological condition that is characterized by recurrent episodes of intense headaches. It may be associated with symptoms such as nausea, vomiting, and other clinical features.
What Gets Rid of Toothache Instantly?
Here are 19 simple methods to ease toothache pain; however, many of these only provide short-term comfort while you seek further help from a dentist.
Early Signs of Arthritis in the Knee
Arthritis refers to the redness and swelling of the joints. It usually develops slowly over 10 to 15 years, interfering with daily life activities. Knowing the early signs of arthritis can help you take appropriate treatment and incorporate modifications in your diet and lifestyle.
Why Is ibuprofen Bad for You? 25 Side Effects
Learn the 25 potential side effects of ibuprofen here.
Early Signs of Arthritis in Shoulder
Early signs and symptoms of arthritis in the shoulder include pain in the shoulder joint that's worse when lifting heavy objects, pain that radiates down the arm and shoulder joint sounds like grinding, clicking, and crackling.
What Can I Give My Child for a Toothache?
Here are 6 tips to relieve toothache in your child, which include saltwater rinse, over-the-counter medication, and changing their diet.
What Is the Most Common Type of Migraine?
The most common type of migraine is migraine without aura (common migraine). 70-90% of people with migraine experience this type. The frequency of this type of migraine may range from once a year to several times per week.
What Is the Difference Between Primary and Secondary Headaches?
Depending on their cause, headaches are categorized into two categories, primary and secondary headaches. Learn their differences below.
Does New Daily Persistent Headache Ever Go Away?
New daily persistent headache (NDPH) does not have a specific treatment, however, certain medication, behavioral therapy and stress management may help patients get better.
Are Migraine Auras Serious?
Migraine with aura (also called classic migraine) is repeated episodes of headache that occur during or after sensory disturbances (aura or migraine aura). These disturbances may include symptoms such as flashes of light, blind spots, and other vision changes or tingling over the hand or face.
Does Rheumatoid Arthritis Run in Families?
Rheumatoid arthritis (RA) is an autoimmune disease that tends to run in families. Your likelihood of getting RA, however, is not determined by family history of the disease alone. It is also influenced by environmental factors such as age, obesity and smoking.
Osteoarthritis vs. Rheumatoid Arthritis
Osteoarthritis (OA) and rheumatoid arthritis (RA) are chronic joint disorders. RA is also an autoimmune disease. OA and RA symptoms and signs include joint pain, warmth, and tenderness. Over-the-counter pain relievers treat both diseases. There are several prescription medications that treat RA.
How Do You Stop a Toothache At Home?
What causes a toothache? Learn how to take care of a toothache at home and the signs that there may be a more serious underlying condition from that toothache.
What Kind of Headache Comes With COVID?
COVID-19 headache is described as a really tight, squeezing sensation that gets worse with coughing and physical activity.
What Causes Migraines?
A migraine is a complex disorder that involves episodes of recurrent and severe headaches. An episode of a migraine can be very painful, lasting for hours, making day-to-day activities difficult until the episode is resolved. The frequency and severity of migraine attacks tend to decline with age. And women are more likely to suffer from migraines than men.
Are Migraines a Symptom of COVID-19?
Although the main symptoms of COVID-19 are fever, cough, and shortness of breath, migraines are also a common symptom that may persist during or after infection.
What Are the First Signs of a Migraine?
The first sign of a migraine is severe eye pain associated with a dull headache. Migraines gradually worsen with physical activity.
Early Signs of Arthritis in the Wrist
Wrist arthritis is inflammation (swelling) of one or more joints of the wrist. Wrist arthritis is long-lasting or permanent and eventually causes severe joint damage. The early signs of arthritis in the wrist include morning stiffness, redness, tenderness, pain, swelling, weakness, warmth and other symptoms.
Do Steroids Help With Arthritis?
Arthritis is the inflammation of one or more joints in the body. The disease is one of the most common chronic health conditions in the United States. Steroids are a class of drugs that reduce inflammation and have a suppressing effect on the immune system.
Early Signs and Symptoms of Arthritis in Thumb
The earliest sign and symptom of thumb arthritis is pain, swelling, and tenderness with activities that involve pinching action. The pain may be dull, achy, or sharp at the base of the thumb. The pain can occur when we grip, grasp, or pinch an object or use the thumb to apply force.
What Triggers Tension Headaches?
A tension headache is the most common type of headache seen in adults. A tension headache is also called a tension-type headache (TTH) or stress headaches. It is usually associated with muscle tightness in the head, scalp or neck. A tension headache is so common that we often consider it a normal occurrence. There are two types of tension headaches: Episodic tension headaches and chronic tension headaches.
What Are the 3 Common Types of Arthritis?
The 3 most common types of arthritis include osteoarthritis, rheumatoid arthritis, and gout.
What Is the Main Cause of Osteoarthritis?
Osteoarthritis (OA) is a chronic degenerative disease of the joints affecting middle-aged and elderly people. It involves the breakdown of cartilage and associated inflammatory changes in the adjacent bone. It is a leading cause of chronic disability, affecting 30 million people in the United States alone.
Which Are the Pressure Points to Relieve Migraines?
Migraines are complex disorders involving episodes of recurrent and severe headaches. They generally present as a headache on one side and may be associated with visual or sensory symptoms (such as seeing flashes of light, colorful or bright shapes, or hearing sounds of various types) collectively called “aura.”
Can NMO Cause Headaches?
Neuromyelitis optica (NMO) also known as Devic disease is a rare yet severe disease. In this condition, antibodies (proteins) are produced against the cells in the central nervous system. It specifically affects the myelin, which is the insulation sheath around the nerves.
What Is the Best Essential Oil for Headaches?
Using essential oils to help relieve pain from headaches depends on the type, such as peppermint and lavender oil is best for migraine relief.
Osteoarthritis and Treatment
Painful swelling of the joints due to wear and tear over many years is called osteoarthritis. Osteoarthritis may develop in any joint that includes the fingers, hips, and knees. There are many treatment options available to curb the complications of arthritis.
What Foods Trigger Migraines?
Migraine is a chronic neurological disorder that features intense headaches on one or both sides of the head. Migraine attacks may resolve in few hours or may take as long as several days.
What Does the Start of a Migraine Feel Like?
Warning signs that a migraine is coming on may include increased urination, constipation, food cravings, mood changes, tiredness, and sensitivity to light or sound.
What Is the Best Cure for Migraine?
The best cure for migraine involves preventive medications and lifestyle changes. Some newer medications and therapies are effective in controlling the symptoms of migraine. Avoiding or controlling triggers may provide considerable benefit. Migraine can be prevented mainly by using medications, avoiding triggers and implementing lifestyle changes.
Do Anti-Inflammatories Help Rheumatoid Arthritis?
Rheumatoid arthritis is a chronic inflammatory disorder. Anti-inflammatory medications can help address symptoms of rheumatoid arthritis.
A spinal tap or an epidural block can cause a spinal headache. In these procedures, a needle is placed within the fluid-filled space surrounding the spinal cord. This creates a passage for the spinal fluid to leak out, changing the fluid pressure around the brain and spinal cord. A spinal headache may occur up to five days after the procedure is performed. Such a headache may be prevented with bed rest after a procedure.
When to Call the Doctor for Your Headache?
Almost everyone must have experienced a headache at some point in their life. The most common reasons for your headache are migraines, tension headaches, cluster headaches, and sinus headaches. Headache is also most often experienced in some common viral infections such as the flu or even in something as simple as the cold.
Headaches in Children
Kids get headaches and migraines too. Many adults with headaches started having them as kids, in fact, 20% of adult headache sufferers say their headaches started before age 10, and 50% report their headaches started before age 20.
What Could Headache Be a Sign of?
Medically, headache is not a sign; it is a symptom. It can occur as a separate entity (primary headache) or as a symptom of various underlying conditions (secondary headache).
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