ibuprofen

Ibuprofen is a nonsteroidal anti-inflammatory drug (NSAID). It works by reducing hormones that cause inflammation and pain in the body.

Ibuprofen is used to reduce fever and treat pain or inflammation caused by many conditions such as headache, toothache, back pain, arthritis, menstrual cramps, or minor injury.

Ibuprofen is used in adults and children who are at least 6 months old.

Important information

Ibuprofen may increase your risk of fatal heart attack or stroke, especially if you use it long term or have heart disease. Do not use this medicine just before or after heart bypass surgery (coronary artery bypass graft, or CABG).

Ibuprofen may also cause stomach or intestinal bleeding, which can be fatal. These conditions can occur without warning while you are using this medicine.

Do not take more than your recommended dose. An ibuprofen overdose can damage your stomach or intestines. Use only the smallest amount of medication needed to get relief from your pain, swelling, or fever.

Before taking this medicine

You should not use this medicine if you are allergic to ibuprofen, aspirin or other NSAIDs.

Ibuprofen may increase your risk of fatal heart attack or stroke, especially if you use it long term or have heart disease. Do not use this medicine just before or after heart bypass surgery (coronary artery bypass graft, or CABG).

Ibuprofen may also cause stomach or intestinal bleeding, which can be fatal. These conditions can occur without warning while you are using ibuprofen.

Ask a doctor or pharmacist if it is safe for you to take this medicine if you have:

• a history of heart attack, stroke, or blood clot;

• heart disease, congestive heart failure, high blood pressure;

• a history of stomach ulcers or bleeding;

• asthma;

• polyps in your nose;

• liver or kidney disease;

• systemic lupus erythematosus (SLE);

• a bleeding or blood clotting disorder; or

• if you smoke.

Taking ibuprofen during the last 3 months of pregnancy may harm the unborn baby. Tell your doctor if you are pregnant or plan to become pregnant while using ibuprofen.

It is not known whether ibuprofen passes into breast milk or if it could harm a nursing baby. Tell your doctor if you are breast-feeding a baby.

Do not give ibuprofen to a child younger than 2 years old without the advice of a doctor.

How should I take ibuprofen?

Use ibuprofen exactly as directed on the label, or as prescribed by your doctor. Do not use in larger or smaller amounts or for longer than recommended.

Do not take more than your recommended dose. An ibuprofen overdose can damage your stomach or intestines. The maximum dosage for adults is 800 milligrams per dose or 3200 mg per day (4 maximum doses). Use only the smallest amount of ibuprofen needed to get relief from your pain, swelling, or fever.

A child"s dose of ibuprofen is based on the age and weight of the child. Carefully follow the dosing instructions provided with children"s ibuprofen for the age and weight of your child. Ask a doctor or pharmacist if you have questions.

Take ibuprofen with food or milk to lessen stomach upset.

Shake the oral suspension (liquid) well just before you measure a dose. Measure liquid medicine with the dosing syringe provided, or with a special dose-measuring spoon or medicine cup. If you do not have a dose-measuring device, ask your pharmacist for one.

The chewable tablet must be chewed before you swallow it.

If you take ibuprofen for a long period of time, your doctor may want to check you on a regular basis to make sure this medicine is not causing harmful effects.

Store at room temperature away from moisture and heat. Do not allow the liquid medicine to freeze.

What happens if I miss a dose?

Since ibuprofen is used when needed, you may not be on a dosing schedule. If you are on a schedule, use the missed dose as soon as you remember. Skip the missed dose if it is almost time for your next scheduled dose. Do not use extra medicine to make up the missed dose.

What happens if I overdose?

Seek emergency medical attention or call the Poison Help line at 1-800-222-1222. Overdose symptoms may include nausea, vomiting, stomach pain, drowsiness, black or bloody stools, coughing up blood, shallow breathing, fainting, or coma.

What should I avoid while taking ibuprofen?

Avoid drinking alcohol. It may increase your risk of stomach bleeding.

Avoid taking ibuprofen if you are taking aspirin to prevent stroke or heart attack. Ibuprofen can make aspirin less effective in protecting your heart and blood vessels. If you must use both medications, take the ibuprofen at least 8 hours before or 30 minutes after you take the aspirin (non-enteric coated form).

Ask a doctor or pharmacist before using any cold, allergy, or pain medicine. Many medicines available over the counter contain aspirin or other medicines similar to ibuprofen. Taking certain products together can cause you to get too much of this type of medication. Check the label to see if a medicine contains aspirin, ibuprofen, ketoprofen, or naproxen.

Ibuprofen side effects

Get emergency medical help if you have signs of an allergic reaction to ibuprofen: hives; difficulty breathing; swelling of your face, lips, tongue, or throat.

Get emergency medical help if you have chest pain, weakness, shortness of breath, slurred speech, or problems with vision or balance.

Call your doctor at once if you have symptoms of stomach bleeding such as black, bloody, or tarry stools, or coughing up blood or vomit that looks like coffee grounds.

Stop taking ibuprofen and seek medical attention or call your doctor at once if you have:

• swelling or rapid weight gain;

• little or no urinating;

• nausea, upper stomach pain, itching, loss of appetite, dark urine, clay-colored stools, jaundice (yellowing of the skin or eyes);

• fever, sore throat, and headache with a severe blistering, peeling, and red skin rash;

• bruising, severe tingling, numbness, pain, muscle weakness; or

• severe headache, neck stiffness, chills, increased sensitivity to light, and/or seizure (convulsions).

Common ibuprofen side effects may include:

• upset stomach, mild heartburn, nausea, vomiting;

• bloating, gas, diarrhea, constipation;

• dizziness, headache, nervousness;

• mild itching or rash; or

• ringing in your ears.

This is not a complete list of side effects and others may occur. Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.

See also: Side effects (in more detail)

Ibuprofen dosing information

Usual Adult Dose for Dysmenorrhea:

200 to 400 mg orally every 4 to 6 hours as needed.

Usual Adult Dose for Osteoarthritis:

Initial dose: 400 to 800 mg orally every 6 to 8 hours.
Maintenance dose: May be increased to a maximum daily dose of 3200 mg based on patient response and tolerance.

Usual Adult Dose for Rheumatoid Arthritis:

Initial dose: 400 to 800 mg orally every 6 to 8 hours.
Maintenance dose: May be increased to a maximum daily dose of 3200 mg based on patient response and tolerance.

Usual Adult Dose for Headache:

Study (n=34) - Prevention of Electroconvulsive therapy (ECT)-induced headache:
600 mg orally 90 minutes prior to the initial ECT session

Usual Adult Dose for Pain:

Oral: Mild to moderate pain:
200 to 400 mg orally every 4 to 6 hours as needed. Doses greater than 400 mg have not been proven to provide greater efficacy.

IV: (Patients should be well hydrated before IV ibuprofen administration):
Pain: 400 to 800 mg intravenously over 30 minutes every 6 hours as needed.

Usual Adult Dose for Fever:

Oral:
200 to 400 mg orally every 4 to 6 hours as needed.

IV: (Patients should be well hydrated before IV ibuprofen administration):
Fever: Initial: 400 mg intravenously over 30 minutes
Maintenance: 400 mg every 4 to 6 hours or 100 to 200 mg every 4 hours as needed.

Usual Pediatric Dose for Fever:

Greater than 6 months to 12 years:
5 mg/kg/dose for temperature less than 102.5 degrees F (39.2 degrees C) orally every 6 to 8 hours as needed.
10 mg/kg/dose for temperature greater than or equal to 102.5 degrees F (39.2 degrees C) orally every 6 to 8 hours as needed.

The recommended maximum daily dose is 40 mg/kg.

OTC pediatric labeling (analgesic, antipyretic): 6 months to 11 years: 7.5 mg/kg/dose every 6 to 8 hours; Maximum daily dose: 30 mg/kg

Usual Pediatric Dose for Pain:

Infants and Children: 4 to 10 mg/kg orally every 6 to 8 hours as needed.
The recommended maximum daily dose is 40 mg/kg.

OTC pediatric labeling (analgesic, antipyretic): 6 months to 11 years: 7.5 mg/kg/dose every 6 to 8 hours; Maximum daily dose: 30 mg/kg

Usual Pediatric Dose for Rheumatoid Arthritis:

6 months to 12 years:
Usual: 30 to 40 mg/kg/day in 3 to 4 divided doses; start at lower end of dosing range and titrate; patients with milder disease may be treated with 20 mg/kg/day; doses greater than 40 mg/kg/day may increase risk of serious adverse effects; doses greater than 50 mg/kg/day have not been studied and are not recommended.
Maximum dose: 2.4 g/day

Usual Pediatric Dose for Cystic Fibrosis:

Oral: Chronic (greater than 4 years) twice daily dosing adjusted to maintain serum concentration of 50 to 100 mcg/mL has been associated with slowing of disease progression in pediatric patients with mild lung disease.

Usual Pediatric Dose for Patent Ductus Arteriosus:

Ibuprofen lysine:
Gestational age 32 weeks or less, birth weight: 500 to 1500 g:
Initial dose: 10 mg/kg, followed by two doses of 5 mg/kg after 24 and 48 hours
Note: Use birth weight to calculate all doses. Hold second or third doses if urinary output is less than 0.6 mL/kg/hour; may give when laboratory studies indicate renal function is back to normal. A second course of treatment, alternative pharmacologic therapy, or surgery may be needed if the ductus arteriosus fails to close or reopens following the initial course of therapy.

What other drugs will affect ibuprofen?

Ask your doctor before using ibuprofen if you take an antidepressant such as citalopram, escitalopram, fluoxetine (Prozac), fluvoxamine, paroxetine, sertraline (Zoloft), trazodone, or vilazodone. Taking any of these medicines with an NSAID may cause you to bruise or bleed easily.

Ask a doctor or pharmacist if it is safe for you to use this medicine if you are also using any of the following drugs:

• lithium;

• methotrexate;

• a diuretic or "water pill";

• other NSAIDs--aspirin, naproxen (Aleve, Naprosyn, Treximet), celecoxib (Celebrex), diclofenac (Arthrotec, Cambia, Cataflam, Voltaren, Flector Patch, Pennsaid, Solareze), indomethacin (Indocin), meloxicam (Mobic), and others; or

• heart or blood pressure medicine--benazepril (Lotensin), enalapril (Vasotec), lisinopril (Prinivil, Zestril), quinapril (Accupril), ramipril (Altace), and others.

This list is not complete. Other drugs may interact with ibuprofen, including prescription and over-the-counter medicines, vitamins, and herbal products. Not all possible interactions are listed in this medication guide.