Ibuprofen side effects, safety, danger, caution and benefit NSAID medication by Ray Sahelian, M.D.
Feb 25 2014


Ibuprofen brand name: Advil, Children's Advil / Motrin, Medipren, Nuprin, Pediacare Fever etc.

Ibuprofen belongs to a class of drugs called non-steroidal anti-inflammatory drugs (NSAIDs). These drugs are used for the management of mild to moderate pain, fever, and inflammation. Prostaglandins are chemicals that are made by the body and are responsible for causing pain, fever and inflammation. Ibuprofen blocks the enzyme that makes prostaglandins (cyclooxygenase), resulting in lower levels of prostaglandins. As a consequence, inflammation, pain and fever are reduced. The FDA approved ibuprofen in 1974. Ibuprofen should be taken with meals.

Availability
Ibuprofen is available in tablets of 200, 400, 600, and 800 mg; Chewable tablets of 50 and 100 mg; Capsules of 200 mg; Suspension of 100 mg/2.5 ml and 100 mg/5 ml; Oral drops of 40 mg/ml.

What conditions is Ibuprofen used for?
Ibuprofen is used for the treatment of mild to moderate pain, inflammation and fever. Although both ibuprofen and acetaminophen reduce menstrual pain, ibuprofen appears to have more potent effects.

 

Comparison to dietary supplements
Summative interaction between astaxanthin, ginkgo biloba extract (EGb761) and vitamin C in suppression of respiratory inflammation: a comparison with ibuprofen.
Phytother Res. 2010. Department of Pharmacology, Faculty of Pharmacy, University of Debrecen, Debrecen, Hungary.
In this study, combinations of Ginkgo biloba leaf extract (EGb761) plus the carotenoid antioxidant astaxanthin (ASX) and vitamin C were evaluated for a summative dose effect in the inhibition of asthma-associated inflammation in asthmatic guinea-pigs. Ovalbumin-sensitized Hartley guinea-pigs challenged with ovalbumin aerosol to induce asthma, were administered EGb761, ASX, vitamin C or ibuprofen. Following killing, bronchoalveolar lavage (BAL) fluid was evaluated for inflammatory cell infiltrates and lung tissue cyclic nucleotide content. Each parameter measured was significantly altered to a greater degree by drug combinations, than by each component acting independently. An optimal combination was identified that included astaxanthin (10 mg/kg), vitamin C (200 mg/kg) and EGb761 (10 mg/kg), resulting in counts of eosinophils and neutrophils lower; macrophages lower, cAMP higher; and cGMP higher than levels in untreated, asthmatic animals. In conclusion, EGb761, ASX and vitamin C are shown here to interact summatively to suppress inflammation with efficacy equal to or better than ibuprofen, a widely used non-steroidal antiinflammatory drug (NSAID). Such combinations of non-toxic phytochemicals constitute powerful tools for the prevention of onset of acute and chronic inflammatory disease if consumed regularly by healthy individuals; and may also augment the effectiveness of therapy for those with established illness.

 

Ibuprofen dosage

For minor aches, mild to moderate pain, menstrual cramps and fever the usual adult dose is ibuprofen 200 or 400 mg every 4 to 6 hours. Arthritis is treated with 300 to 800 mg 3 or 4 times daily. When under the care of a physician, the maximum dose of ibuprofen is 2 to 3 grams daily. Individuals should not use ibuprofen for more than 10 days for the treatment of pain or more than 3 days for the treatment of a fever unless directed by a physician. Children 6 months to 12 years of age usually are given 5-10 mg/kg of ibuprofen every 6-8 hours for the treatment of fever and pain. The maximum dose is 40 mg/kg daily. Juvenile arthritis is treated with 20 to 40 mg/kg/day in 3-4 divided doses.

Ibuprofen Drug Interactions

Ibuprofen is associated with several suspected or probable interactions that can affect the action of other drugs. Ibuprofen may increase the blood levels of lithium (Eskalith) by reducing the excretion of lithium by the kidneys. Increased levels of lithium may lead to lithium toxicity. Ibuprofen may reduce the blood pressure-lowering effects of drugs that are given to reduce blood pressure. This may occur because prostaglandins play a role in the regulation of blood pressure. When ibuprofen is used in combination with aminoglycosides (e.g., gentamicin) the blood levels of the aminoglycoside may increase, presumably because the elimination of aminoglycosides from the body is reduced. This may lead to aminoglycoside-related side effects. Individuals taking oral blood thinners or anticoagulants (e.g., warfarin) should avoid ibuprofen because ibuprofen also thins the blood, and excessive blood thinning may lead to bleeding.

 

Ibuprofen for children
The first head-to-head study of three common painkillers found that ibuprofen works best, at least for kids with broken bones, bruises and sprains. Available generically and under the brand names Advil and Motrin, ibuprofen beat generic acetaminophen and codeine in an emergency room study of 300 children treated at a Canadian hospital. The youngsters, aged 6 to 17, were randomly assigned to receive standard doses of one of the three medicines. They then periodically rated their pain. Half an hour later, ratings were similar in the three groups. But starting an hour after taking the medicine, children who got ibuprofen reported substantially greater pain relief than the other two groups.

Ibuprofen and Pregnancy

There are no adequate studies of ibuprofen in pregnant women. Therefore, ibuprofen is not recommended during pregnancy.

Breastfeeding

Most NSAIDs are excreted in breast milk. In general, mothers who breast feed should avoid the use of NSAIDs because of possible effects on the fetus.

Ibuprofen side effects, reports

The most common ibuprofen side effects are rash, ringing in the ears, headaches, dizziness, drowsiness, abdominal pain, nausea, diarrhea, constipation and heartburn. Serious Ibuprofen side effect is ulceration of the stomach or intestine, and the ulcers may bleed. Sometimes, ulceration and bleeding can occur without abdominal pain, and black tarry stools, weakness, and dizziness upon standing (orthostatic hypotension) may be the only signs of a problem. Renal ibuprofen side effects include reduction of blood flow to the kidneys and impaired function of the kidneys. The impairment is most likely to occur in patients with preexisting impairment of kidney function or congestive heart failure, and use of ibuprofen in these patients should be done cautiously. People who are allergic to other NSAIDs, including aspirin, should not use ibuprofen. Individuals with asthma are more likely to experience allergic reactions to ibuprofen and other NSAIDs.
   A serious ibuprofen side effect when used daily for prolonged periods is ringing in the ear which could lead to hearing loss.

Ibuprofen may raise the risk of heart attacks and other fatal and serious problems when elderly people take it daily for arthritis.

 

Med Sci Sports Exerc. 2012. Aggravation of exercise-induced intestinal injury by Ibuprofen in athletes.

 

Ibuprofen, aspirin, and stroke
There is a drug-drug interaction between ibuprofen and aspirin, with ibuprofen affecting aspirin's ability to inhibit platelet clumping or aggregation that can lead to fatal blood clots. Researchers compared the extent and duration of platelet clumping with aspirin 325 mg alone, with ibuprofen alone and with aspirin 325 mg given two hours after ibuprofen 400 mg in 12 healthy subjects. Duration of inhibition of platelet aggregation with aspirin alone was 72 to 96 hours. This was significantly longer than the inhibition of only 4 to 6 hours with aspirin followed by ibuprofen, and with ibuprofen alone. Thus, it appears the presence of ibuprofen prevents the irreversible inhibition of platelet clumping produced by aspirin needed for secondary prevention of stroke.

 

Patient report
I sprained my ankle approximately 6-8 weeks ago. I took nothing for a couple of weeks. Then I was advised by everyone to take some advil to reduce the swelling. This has been working. I have been taking 2-4 tablets per day for around a month. Yesterday at work my hearing on my left side went numb.

 

Questions
At times, not always, my testicles become very small and my libido becomes shot. I have a varicocele on each testicle and doctors have told me that varicoceles only effect fertility and not testosterone or libido. But I disagree. varicoceles are not always that apparent but sometimes I think when they do become very apparent is when my testicles shrink and my testosterone production or sperm production hinders and my libido suffers. this is just my theory but recently i started taking about 600 mg of ibuprofen for my sore throat and hat did i notice, my varicoceles not only became very unapparent but my testicles became fuller as well, returning my libido. Then when I went about 4 days without ibuprofen the same problems came back. when i then took another high dose of ibuprofen it helped again. I was just wondering if you might know why this may be? maybe I'm way off and it's just a coincidence but it seems like 600 mg of ibuprofen seems to help me with my situation.
   We have not heard of the effect of ibuprofen on libido before, but unusual reactions can occur in some people.

 

I just wanted to comment on the page you made regarding ibuprofen. I take an anti-psychotic, Saphris( brand new drug and by far the best yet). It does a good job getting rid of my delusions. It also decreases my libido as all the anti-psychotics do for me. Now, I had some slight shoulder pain from working out yesterday. I took some ibuprofen (200mg tablets) and suddenly my libido increased. So I searched "ibuprofen sex drive" on google and clicked your ibuprofen article. I noticed a previous question stated that someone else had noticed an increase in their libido when they took it for their sore throat. I think there might be something to it given my recent experiences today. I just thought this incident was interesting enough to share it with you. You don't need to reply. I just thought I'd let you know that he isn't the only one and that there may be something to this.
 

What do you think of Ibuprofen, and what would be the purest form of this (not a bunch of other additives)? Or do you have an alternative recommendation.
    The use of this medication, the dosage used and the frequency, along with alternatives depends on the condition being treated.