Ibuprofen Contraindications You Have to Know

Introduction to Ibuprofen Contraindications

Nearly everyone experiences headache pain in their life. While some can be minor and go away after a while, there are cases when the pain is so intense to miss work or school. Pain relievers can help with some headaches, and ibuprofen is an effective one.

Yet, before taking the so-needed pill, have you asked yourself if you can use it safely?

For example, ibuprofen can cause an allergic reaction as any other medication, although available as an over-the-counter (OTC) medication. Moreover, if you have used ibuprofen safely before but recently had heart surgery, ibuprofen is not safe for you. (1)

There are medical reasons behind these contraindications, which could be life-threatening, and anyone should be aware of them.

Keep reading to find the reasons why ibuprofen is contraindicated in such cases.

Ibuprofen Contraindications – When to Use Ibuprofen?

Ibuprofen belongs to the non-steroidal anti-inflammatory drugs (NSAIDs) that inhibit two enzymes, cyclooxygenase-1 (COX-1) and cyclooxygenase-2 (COX-2). COX-1 and COX-2 are involved in the production of prostaglandins (hormone-like chemicals). (2-3)

After an injury, prostaglandins cause inflammation, pain, and fever during recovery, and they take part in the menstrual cycle and labor induction. The inhibition of the COX-1 and COX-2 enzymes reduces the production of prostaglandins and shows ibuprofen’s anti-inflammatory, analgesic, and antipyretic effects. (2-3)

Therefore, ibuprofen can be used as a drug prescribed by a doctor or OTC to reduce fever and relieve pain if you suffer from:

Ibuprofen Contraindications

Ibuprofen Contraindications – When to Use Ibuprofen?

● Headache;

● Toothache;

● Backache;

● Muscular aches;

● The common cold;

● Menstrual cramps;

● Minor pain of arthritis. (1)

When Shouldn’t You Use Ibuprofen?

Ibuprofen, like any other medication, is associated with side effects. In some cases, ibuprofen is contraindicated due to the severity of the symptoms.

Ibuprofen Contraindications: Allergic reaction to other pain relievers or fever reducers

When it comes in contact with a foreign substance, the body activates the immune system. It results in releasing chemicals that defend the body from that trigger. The process is the same if the trigger is a medication, including ibuprofen.

An allergic reaction does not necessarily happen at first. After the first contact, the body produces antibodies, but symptoms may occur the next time when the body gets in contact with the trigger. Then the body releases antibodies, and symptoms arise. Symptoms of the allergic reaction to ibuprofen are the following:

  • Hives;
  • Skin rash;
  • Itching;
  • Wheezing;
  • Swelling.

Symptoms can be severe, and more than one may happen simultaneously. That’s a potentially life-threatening reaction called anaphylaxis, requiring immediate medical care. If you experience any of the allergy symptoms, stop taking ibuprofen. In case of anaphylaxis, call 911 immediately. (4)

Don’t use ibuprofen if you have been allergic to aspirin or any other pain reliever/fever reducer. Ibuprofen is contraindicated in this situation. Instead, call your doctor and get advice on what medication to use. (1, 5)

Don’t take ibuprofen right before or after heart surgery

Another ibuprofen contraindication is in patients who have undergone heart surgery or right before (1). As a COX-1 inhibitor, ibuprofen affects blood clotting.

COX-1 enzyme is involved in the process of making prostaglandins and thromboxane, which are responsible for blood clot formation and vasoconstriction. Ibuprofen or other nonselective NSAIDs inhibits the COX-1 enzyme. This inhibition blocks thromboxane formation, and it results in disruption of the platelet aggregation process. Because of that, you may bleed longer. (6-8)

The good thing is that this COX-1 inhibition is reversible, so the effect of ibuprofen is short. (9) Yet, ibuprofen is contraindicated in patients who need to go for heart surgery or after the surgery. (1, 5)

Moreover, like other NSAIDs, ibuprofen increases the risk of heart attack and stroke. The potential risk of having a heart attack or stroke has been known since 2005 when FDA for the first time issued this warning. (10)

Don’t take OTC ibuprofen or combination products that contain ibuprofen if you have high blood pressure, heart disease, or you had a stroke. Instead, ask your doctor what painkiller is good for you. (1, 5)

Use Ibuprofen Safely Within the Recommended Doses

Dosage recommendations depend on the single dose of ibuprofen tablet. Ibuprofen is available as OTC and a prescription drug. The strength varies from 100 to 800 mg, and so do the recommendations. (11)

For example, if you get ibuprofen of 200 mg to relieve the pain or reduce fever, you can take 1 or 2 tablets every 4 to 6 hours. But, if you buy ibuprofen extended release of 600 mg, you can take 1 pill every 12 hours. (1)

Unless your doctor tells you differently, don’t take more than 1,200 mg daily.

The maximal daily dose can be up to 3,200 mg when prescribed by a doctor. (12)

You may also find ibuprofen in combination with other medications, such as acetaminophen. In combination products, the dose of each active ingredient is adopted to reach the effect with a low as possible dose. (11)

Therefore, any time you buy OTC medication, read directions carefully and do not exceed recommended dose. Ask your doctor or pharmacist for additional advice.

Side Effects (Warnings)

The side effects of ibuprofen are well-known and always listed on the pack. Many of them are common and might happen to less than 10% of the patients using ibuprofen: heartburn, nausea, vomiting, flatulence, constipation, diarrhea, epigastric pain, rash, edema, fluid retention, headache, ringing in the ears, dizziness, and becoming nervous. (1, 13)

Be careful about the following conditions:

Allergy alert – Some people might be allergic to ibuprofen and have severe allergic reactions. Symptoms may include: hives, face swelling, wheezing, shock, skin reddening, rash, and blisters. (1, 13)

Stomach bleeding – NSAIDs, including ibuprofen, may cause ulcers and holes in the stomach and intestines that can result in bleeding. Bleeding can be severe and even cause death. You are at higher risk if you have an ulcer or bleeding problem. You can recognize stomach bleeding by any of the following signs: vomiting blood, feeling faint, having bloody or black stools, or having stomach pain that does not improve. (1, 5)

Heart attack or stroke warning – Ibuprofen increases the risk of heart attack, heart failure, and stroke. The risk is even higher when used in higher doses or longer than directed. Symptoms of heart problems or a stroke, may include pain in the chest, swelling of the legs, slurred speech, breathing troubles, or weakness in one part or side of the body. (1, 5, 13)

Read the label carefully to learn the symptoms of the possible side effects. Keep the cartoon for complete warning and information.

If you experience a serious side effect, call your doctor and consider sending a report to the Food and Drug Administration’s (FDA) MedWatch Adverse Event Reporting program online (https://www.fda.gov/safety/medwatch-fda-safety-information-and-adverse-event-reporting-program) or by phone (1-800-332-1088).

Final Notes

Ibuprofen is an effective painkiller that has been used for over 40 years. However, it is associated with allergic reactions, bleeding, heart attack, stroke, and other side effects.

Don’t use ibuprofen if you are allergic to aspirin or another painkiller or you need to go or already have heart surgery.

Ask a doctor or pharmacist before taking any other drug containing an NSAID, blood thinning (anticoagulant), steroid, or another drug. Use ibuprofen in recommended doses and treat your pain safely.

See Also:

Paxlovid Contraindications

Is Ibuprofen a Blood Thinner?

Acetaminophen Side Effects

Bupropion Side Effects

Trazodone Side Effects

Atorvastatin Side Effects

Metformin Side Effects

1. Food and Drug Administration, Advil, Drug Labeling and Warning, FDA Report


2. Mazaleuskaya L. L, Theken K. N, Gong L., Thorn C. F, FitzGerald G. A, Altman R. B, and Klein T. E. PharmGKB: Ibuprofen Pathway, Pharmacogenetics and genomics. 2015. https://www.pharmgkb.org/pathway/PA166121942

3. You and Your Hormones, Society of Endocrinology, Prostaglandins, 2019 Oct, https://www.yourhormones.info/hormones/prostaglandins/

4. The American College of Allergy, Asthma & Immunology, Drug Allergies, 2018 Feb, https://acaai.org/allergies/allergic-conditions/drug-allergies/

5. MedlinePlus, Ibuprofen, 2023 Feb,


6. L. A. Perry, C. Mosler, A. Atkins, and M. Minehart, Cardiovascular Risk Associated With NSAIDs and COX-2 Inhibitors, US Pharm. 2014;39(3):35-38.


7. A.I. Schafer, Effects of nonsteroidal anti-inflammatory drugs on platelet function and systemic hemostasis, J Clin Pharmacol 1995 Mar;35(3):209-19. https://pubmed.ncbi.nlm.nih.gov/7608308/#

8. Cleveland Clinic, COX-2 Inhibitors, 2022 May,


9. Gundu H. R. Rao, Gerhard G. Johnson, K. Ratnammal Reddy, and James G. White, Ibuprofen Protects Platelet Cyclooxygenase from Irreversible Inhibition by Aspirin, ARTERIOSCLEROSIS VOL 3, No 4, JULY/AUGUST 1983 https://www.ahajournals.org/doi/pdf/10.1161/01.ATV.3.4.383

10. FDA Drug Safety Communication: FDA strengthens warning that non-aspirin nonsteroidal anti-inflammatory drugs (NSAIDs) can cause heart attacks or strokes, 7-9-2015 https://www.fda.gov/media/92768/download

11. Drugbank online, Ibuprofen, 2023 Mar,


12. Medscape, Ibuprofen (Rx, OTC), https://reference.medscape.com/drug/advil-motrin-ibuprofen-343289

13. Food and drug administration, Ibuprofen Drug Facts Label, 2016 Apr, https://www.fda.gov/drugs/postmarket-drug-safety-information-patients-and-providers/ibuprofen-drug-facts-label


Follow us