Ibuprofen Side Effects | When and How to Use Ibuprofen

Ibuprofen Side Effects Ibuprofen Side Effects

Ibuprofen Side Effects – Overview

You have an intense headache that doesn’t go away for hours or a fever, and you need immediate relief. The solution is simple, many over-the-counter (OTC) painkillers or fever relievers are available for you to buy. Ibuprofen is one of them; powerful and fast in pain or fever symptoms relief.

Before taking ibuprofen, how are you sure that ibuprofen is good for you? Aside from the positive and fast effects, have you heard that ibuprofen may cause bleeding in the stomach, stroke, or heart attack? Some side effects that might occur can be serious and even fatal if you take ibuprofen without caution. (1)

In this article, you can read about the possible side effects of ibuprofen. Although a proven OTC painkiller, still, ibuprofen may cause adverse events that need immediate medical care. Read below what the signs are that you should recognize and call a doctor right away.

When and how to use ibuprofen

Ibuprofen Side Effects

Ibuprofen Side Effects – How to use ibuprofen?

Ibuprofen is a nonsteroidal anti-inflammatory drug (NSAID) known as Brufen, Genpril, Nurofen, Advil, Motrin, etc., and for over 60 years has been used worldwide as an effective painkiller. Ibuprofen inhibits the synthesis of prostaglandins in the body by inhibiting two enzymes. Prostaglandins are hormone-like substances present in the body when there is an injury. Thanks to its way of working, ibuprofen has anti-inflammatory, antipyretic, and analgesic effects. (2)

Therefore, ibuprofen can temporarily reduce fever and relieve minor aches and pains if you have:

  • headache;
  • backache;
  • toothache;
  • menstrual cramps;
  • muscular aches;
  • the common cold;
  • minor pain of arthritis. (1)

When prescribed by a doctor and in higher doses, ibuprofen is used to relieve mild to moderate pain and menstrual pain, and in rheumatoid arthritis and osteoarthritis, to relieve pain, tenderness, swelling, and stiffness. (3-4)

You can take one tablet of 200 mg ibuprofen every four to six hours while you have pain. You should take at most 1.200 mg of ibuprofen in one day. The maximal daily dose should not exceed 3.200 mg and only if the doctor prescribes it. Take ibuprofen with food or 1-1.5 cups of water to avoid the gastrointestinal effect. (4)

Ibuprofen side effects

Even though ibuprofen has been marketed in the U.S. since 1974 and is available as an over-the-counter drug, it still has possible side effects that are well known. Therefore, ibuprofen should be used carefully, in the smallest dose that works and as short as possible.

Common side effects that might happen in a range of 1-10% of the patients using ibuprofen are dizziness, epigastric pain, heartburn, constipation, nausea, rash, ringing in the ears, edema, fluid retention, diarrhea, headache, vomiting, gasses, and becoming nervous. Call your doctor if some of these symptoms are severe and don’t go away. (1,3)

Dizziness, fast eye movements without control, slow breathing, short time without breathing, and becoming blue around the lips and nose are symptoms of overdose. If this happens to you, call the poison control helpline at 1-800-222-1222, or if the person taking ibuprofen has seizures, breathing problems, or can’t be awakened, call 911 immediately. (3)

Warnings you should know before using ibuprofen

In some cases, ibuprofen may cause serious side effects: severe allergic reaction, stomach bleeding, heart attack, or stroke that can be fatal. You can find a detailed warning in the drug cartoon; read it and keep the cartoon. (5)

Increased risk of heart attack, heart failure, and stroke – Ibuprofen and all other NSAIDs, excluding aspirin, increase the risk of heart failure, heart attack, and stroke, which can be fatal and without warning. This risk is higher when using ibuprofen in higher doses or longer than recommended. (1,5)

Don’t use ibuprofen right before or after heart surgery. If you have heart disease, high blood pressure, or you had a stroke, consult your doctor about what painkiller is good for you. (5) Also, tell your doctor if you smoke, had or now have cholesterol, or diabetes. Chest pain, shortness of breath, weakness in the arm, leg, or side of the body, and slurred speech are symptoms that require emergency medical help immediately. (3)

Allergic reaction – Some people, especially those allergic to aspirin, may have an allergic reaction to ibuprofen. If you know you have an allergic reaction to aspirin or another pain reliever or fever reducer, don’t use ibuprofen, even OTC. If your doctor or pharmacist recommends it, let them know about your allergic reaction. (1,5)

Stomach bleeding – Ibuprofen, like other NSAIDs, may cause ulcers or holes in the stomach and intestines (3) and severe stomach bleeding. (5) These consequences may develop during the ibuprofen treatment at any time and without warning. Stomach bleeding may cause death. (3)

The risk is higher in those who have an ulcer or bleeding problems, are over 60 years, use other NSAIDs, blood thinners, or steroids, have three or more alcoholic drinks every day while using ibuprofen, or take ibuprofen in higher doses or longer than directed. (5)

Those who have stomach bleeding problems, previous stomach problems, (5) or heartburn (a painful burning feeling in the chest or throat due to stomach acid coming back into the esophagus), (6) should ask a doctor before using ibuprofen. (5)

If you experience any of the following symptoms, is a reason to stop using ibuprofen and ask your doctor:

  • Heart problems or stroke:
    • chest pain,
    • leg swelling,
    • slurred speech,
    • trouble breathing,
    • weakness in one part or side of the body,
  • Allergic reaction and ask for medical help right away:
    • rash,
    • blister,
    • whizzing,
    • facial swelling,
  • Stomach bleeding signs:
    • feel faint,
    • vomit blood,
    • have bloody or black stools,
    • have stomach pain that does not get better,
  • Pain that gets worse or lasts more than ten days,
  • Fever that gets worse or lasts more than three days,
  • Redness or swelling is present in the painful area,
  • Any new symptoms. (5)

Remember that you or your doctor can report the side effects that you experience by sending a report to the Food and Drug Administration’s (FDA) MedWatch Adverse Event Reporting program online (http://www.fda.gov/Safety/MedWatch) or by phone (1-800-332-1088).

Other special precautions you should follow

Talk to your doctor about the following before taking ibuprofen:

  • If you take medications, vitamins, supplements, or herbal products that you take; some may interact with ibuprofen, so your doctor will decide whether to keep ibuprofen treatment with dose adaption or to recommend other medication instead;
  • If you use aspirin for heart attack or stroke, ibuprofen may decrease aspirin benefit;
  • If you are pregnant, plan to become, or breast-feed, ibuprofen may be harmful to the fetus in the second half of the pregnancy;
  • If you have liver or kidney disease, asthma, swelling parts of the body (arm, leg, hand, etc.), or lupus (a condition when the body attacks its tissues and organs);
  • If you have phenylketonuria (PKU) due to aspartame, a sweetener used in ibuprofen. (3,5) Aspartame is transformed into phenylalanine, an amino acid that can lead to serious health problems and intellectual disability. The blood level of phenylalanine is increased in individuals with PKU. This increase is because the enzyme responsible for converting phenylalanine into other compounds is lower or absent. (7)

Final thoughts

Ibuprofen is a well-known effective painkiller, will make you feel better when you have a fever, and is generally well tolerated. In a small dose, ibuprofen is available as OTC, so you can use it without a prescription or medical advice. However, as with any other medication, you should know the possible side effects, even for the OTC formulation.

If you are allergic, just had or will have heart surgery, or are pregnant, don’t use ibuprofen and get medical advice on what painkiller to use. And, don’t underestimate stomach bleeding; if pain or fever gets worse, or you notice swelling while on ibuprofen, stop using it and call a doctor.

Ibuprofen is an effective and safe medication if you follow instructions for use, use it in a recommended dose, and not longer than necessary. Your doctor or pharmacist can give you all the answers so you know this medication will not harm you but help you.

References:

  1. 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
  2. Mazaleuskaya Liudmila L, Theken Katherine N, Gong Li, Thorn Caroline F, FitzGerald Garret A, Altman Russ B, and Klein Teri E. PharmGKB: Ibuprofen Pathway, Pharmacogenetics and genomics. 2015. https://www.pharmgkb.org/pathway/PA166121942
  3. MedlinePlus, Ibuprofen, 2022 Jan, https://medlineplus.gov/druginfo/meds/a682159.html
  4. Medscape, Ibuprofen (Rx, OTC), https://reference.medscape.com/drug/advil-motrin-ibuprofen-343289
  5. Report, ADVIL- ibuprofen tablet, coated Drug Labeling and Warnings, https://fda.report/DailyMed/1a665e64-9f30-be37-4a83-38789f1f1e89
  6. MedlinePlus, Heartburn, 2016 Mar, https://medlineplus.gov/heartburn.html
  7. MedlinePlus, Phenylketonuria, 2017 Oct, https://medlineplus.gov/genetics/condition/phenylketonuria/#causes

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About the Author

Biljana Srbinovska
Biljana is a Master of Pharmacy, with a Healthcare Management specialization. Over 20 years of professional engagement to enable access to innovative treatments for patients in need. Biljana is dedicated to upgrading health education evidence-based, promoting a healthy lifestyle, and embedding healthy habits.

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