Ibuprofen: 7 things you should know
Medically reviewed by Carmen Fookes, BPharm. Last updated on Jan 28, 2019.
1. How it works
- Ibuprofen helps to relieve pain and inflammation by blocking the effects of cyclooxygenase (COX) enzymes. This prevents prostaglandin synthesis (prostaglandins elevate body temperature and make nerve endings more sensitive to pain transmission).
- Ibuprofen belongs to a group of medicines known as NSAIDs (nonsteroidal anti-inflammatory drugs).
- Effective for the relief of minor aches and pains due to arthritis, backache, the common cold, headache and migraine, menstruation, muscular aches, and toothache in adults.
- Relieves minor aches and pain in children aged 6 months or older.
- Temporarily relieves fever.
- Does not cause dependence and is readily available at a low cost.
- The incidence of stomach-related side effects is about half that seen with aspirin or indomethacin when ibuprofen is used at low dosages. However, this benefit is lost with higher dosages.
- Available as tablets, capsules, chewable tablets, suspension, and in an injectable form.
- Widely available over-the-counter.
- Generic ibuprofen is available.
If you are between the ages of 18 and 60, take no other medication or have no other medical conditions, side effects you are more likely to experience include:
- Stomach-related side effects including indigestion, heartburn, and bleeding. People of an older age, taking other medicines that affect the stomach, or who drink more than 3 glasses of alcohol per day may be more at risk. Ibuprofen has one of the lowest risks of stomach-related side effects compared with other NSAIDs.
- Most NSAIDs have been associated with an increased risk of stroke or heart attack. The risk may be higher in patients with pre-existing cardiovascular conditions and with dosages of ibuprofen greater than 1200mg per day.
- May require three to four times daily dosing because of short duration of acton.
- May not be suitable for some people including those with kidney disease, a history of stomach ulcers or other gastrointestinal disorders, with pre-existing cardiovascular disease, or following coronary artery bypass graft surgery.
- May interact with some other medicines such as warfarin, SSRIs, ACE inhibitors, and diuretics.
Notes: In general, seniors or children, people with certain medical conditions (such as liver or kidney problems, heart disease, diabetes, seizures) or people who take other medications are more at risk of developing a wider range of side effects. For a complete list of all side effects, click here.
- Take with food or milk if stomach disturbances (such as indigestion) occur with use. See a doctor if these persist.
- Always use the lowest effective dose for the shortest duration consistent with the condition being treated.
- If you are taking ibuprofen and find it is not working very well for you, you may like to try a different NSAID.
- Response to different NSAIDs can vary so switching types (for example, from ibuprofen to naproxen) may improve response.
- See a doctor immediately if you experience any difficulty with breathing, unexplained sickness or fatigue, loss of appetite, vision changes, fluid retention or abnormal bleeding.
- NSAIDs should not be used in the last 3 months of pregnancy; ask your doctor before using any medication during pregnancy.
- Avoid ibuprofen if you have a history of asthma or hives due to aspirin use or other NSAIDs, like naproxen.
- Do not use this medicine if you have just had heart bypass surgery (also called coronary artery bypass graft, or CABG).
6. Response and Effectiveness
- Peak levels of ibuprofen are reached 1-2 hours after administration.
- Equally effects COX-1 and COX-2 enzymes.
Medicines that interact with ibuprofen may either decrease its effect, affect how long it works for, increase side effects, or have less of an effect when taken with ibuprofen. An interaction between two medications does not always mean that you must stop taking one of the medications; however, sometimes it does. Speak to your doctor about how drug interactions should be managed.
Common medications that may interact with ibuprofen include:
- ACE inhibitors or ARBs, such as captopril, enalapril, or losartan
- antibiotics, such as ciprofloxacin or vancomycin
- anticoagulants (blood thinners) such as apixaban, dabigatran, fondaparinux, heparin, or warfarin
- antidepressants, such as citalopram, escitalopram, fluoxetine, or paroxetine
- antifungals, such as voriconazole
- antiplatelets, such as clopidogrel or ticagrelor
- beta-blockers, such as acebutolol, atenolol, bisoprolol, or carvedilol
- bisphosphonates, such as alendronate
- corticosteroids, such as dexamethasone or prednisone
- diuretics (water pills), such as chlorthalidone, chlorothiazide, hydrochlorothiazide (HCTZ), or furosemide
- HIV medications (eg, Stribild, tenofovir)
- other nonsteroidal anti-inflammatories (NSAIDs), such as celecoxib, diclofenac, etodolac, ketorolac, meloxicam, nabumetone, or naproxen
- sulfonylureas (a type of diabetes medication), such as glimepiride, glyburide, or glipizide
- supplements, such as glucosamine, omega-3 fatty acids, vitamin E
- others, such as cyclosporine, lithium, methotrexate, pemetrexed, pirfenidone, or tacrolimus.
Drinking alcohol while taking ibuprofen may increase the risk of gastrointestinal-related side effects or kidney damage.
Note that this list is not all-inclusive and includes only common medications that may interact with ibuprofen. You should refer to the prescribing information for ibuprofen for a complete list of interactions.
- Ibuprofen. Revised 02/2020. Drugs.com https://www.drugs.com/ppa/ibuprofen.html
Remember, keep this and all other medicines out of the reach of children, never share your medicines with others, and use ibuprofen only for the indication prescribed.
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Always consult your healthcare provider to ensure the information displayed on this page applies to your personal circumstances.
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