Ibuprofen for adults

Sounds like 'eye -bew-pro-fen'

Easy-to-read medicine information about ibuprofen – what it is, how to take it safely and possible side effects.

Note: the information on this page is about ibuprofen for adults. For information about use for children, see ibuprofen for children.

Type of medicine	Also called
Analgesics (pain killer) Antipyretic (to control fever) Anti-inflammatory (reduces pain and swelling) Non-steroidal anti-inflammatory drug (NSAID)	Brufen® Ibugesic® I-Profen® Nurofen® Advil® Medix®

Ibuprofen is also contained in some other combination medications such as:

Nurofen Plus®
Maxigesic®
Nuromol®
Brufen extra®
Nurofen Cold and Flu®

What is ibuprofen?

Ibuprofen is in a group of medicines known as non-steroidal anti-inflammatory drugs (NSAIDs).

It is used to treat different types of pain such as headache, migraine, dental pain, back pain or muscle pain, and pain from injury – read more about pain.

It also helps to ease redness and swelling, and to treat fever.

Different brands and strengths

Ibuprofen is available in different brands and strengths. The lower strength (200 mg) tablets can be bought from a supermarket or over-the-counter from a pharmacy. The higher strength tablets (400 mg, 600 mg, 800 mg) tablets are only available on prescription from your doctor.

Dose

The dose of ibuprofen will be different for different people depending on your condition.
Usually, you may need to take ibuprofen for a short time only, while you have pain or swelling.
The usual dose for adults is 200 mg to 400 mg 3 or 4 times daily if needed.
Do not take more than 1200 mg per day without checking with your doctor.
Use the lowest dose that works for you and stop as soon as you can.
The dose will be different to this if you have been prescribed a tablet which releases ibuprofen slowly; this is called a modified-released tablet.
Always follow the directions on the package or pharmacy label. If you are unsure about how much to take, check with your pharmacist.

How to take ibuprofen

Take ibuprofen with food or immediately after food, to prevent stomach upset.
Take ibuprofen with a full glass of water.
Swallow the tablets whole. Do not crush or chew them.
Limit or avoid alcohol while you are taking ibuprofen. Alcohol can increase the risk of side effects like stomach upset.
If you forget to take a dose, take it when you next need pain relief and then continue as before. Do not take two doses together to make up for a forgotten dose.

Take care with ibuprofen

For most people taking ibuprofen is safe. However, extra care is needed if you have high blood pressure, high cholesterol, diabetes, stomach ulcers or kidney problems or if you smoke. It can also be harmful if you take it when you are dehydrated or have been sick with nausea or vomiting. Discuss with your doctor whether taking ibuprofen is suitable for you.

NSAIDs (except low-dose aspirin) increase the chance of a heart attack or stroke, which can lead to death. These serious side effects can occur even in the first weeks of using an NSAID and the risk may increase the longer you are taking them. The risk appears greater at higher doses (such as ibuprofen 2400 mg per day) so use the lowest effective amount for the shortest possible time. Some other medicines contain NSAIDs, including those used for colds, flu, so always read the labels and avoid taking multiple medicines that contain NSAIDs. Also see Ibuprofen patient information guide SafeRx, Waitematā DHB, 2013.

Precautions – before taking ibuprofen

Do you have high blood pressure or problems with your heart?
Do you have any problems with the way your kidneys or liver works?
Have you had stomach ulcers?
Are you pregnant, planning a pregnancy or breast-feeding?
Do you have any breathing problems?

If so, it’s important that you tell your doctor before you start taking ibuprofen. Sometimes a medicine isn’t suitable for a person with certain conditions or taking other medicines, or it can only be used with extra care.

Possible side effects

Side effects	What should I do?
Heartburn Indigestion Stomach discomfort	Take ibuprofen with food Talk to your doctor if it is painful.
Serious stomach problems such as really bad stomach pain, blood in the stool, black or dark colour in your stool, cough or vomit up blood, or dark coloured vomit	Tell your doctor immediately or ring HealthLine on 0800 611 116
Signs of allergic reaction such as skin rashes, itching, swelling of the face, lips, mouth or have problems breathing, like a tight chest or shortness of breath	Tell your doctor immediately or ring HealthLine on 0800 611 116
Chest pain Shortness of breath or trouble breathing Weakness in one part or side of the body Slurred speech	Tell your doctor immediately or ring HealthLine on 0800 611 116

Interactions

Ibuprofen interacts with some medicines, especially those used for high blood pressure, so check with your doctor or pharmacist before you start taking it.

Do not take other NSAIDs such as diclofenac or naproxen or COX-2s such as celecoxib while taking ibuprofen. This can increase your risk of side effects.

Taking NSAIDs together with medicines called ACE inhibitors or ARBs and diuretics (water pills) can be harmful to your kidneys. This is called the ‘triple whammy’. If you are taking ACE inhibitors or ARBs and diuretics, tell your doctor or pharmacist before starting ibuprofen.

Examples of ACE inhibitors are captopril, cilazapril, enalapril, lisinopril, perindopril and quinapril.
Examples of ARBs are valsartan, candesartan and losartan.
Examples of diuretics are furosemide, bumetanide, bendroflumethiazide, chlortalidone, indapamide and metolazone.

Learn more

The following links provide further information about ibuprofen. Be aware that websites from other countries may have information that differs from New Zealand recommendations.

Ibuprofen (Māori) New Zealand Formulary Patient Information
Ibuprofen for pain and inflammation Patient info, UK

References

Ibuprofen and cardiovascular safety Medsafe Safety Information, 17 June 2015
Ibuprofen New Zealand Formulary

Resources

Brochures

Ibuprofen

Saferx patient guide, Waitematā District Health Board, 2013

5 questions to ask about your medications

Health Quality and Safety Commission NZ, 2019

Information for clinicians

This section will be of most interest to clinicians (eg, nurses, doctors, pharmacists and specialists).

Ibuprofen paediatric dose calculator

Other resources

Medsafe prescriber updates

NSAIDs and risk of cardiovascular events (September 2013)
Key messages All non-steroidal anti-inflammatory drugs (NSAIDs) are associated with a small increased risk of serious cardiovascular adverse events. The risk is increased with high doses, increasing duration of use and in patients with other cardiovascular risk factors. The lowest effective NSAID dose should be used for the shortest possible duration. The overall benefit to risk of harm balance of NSAIDs remains positive. Patients requiring long-term NSAID therapy should be regularly reviewed for efficacy, adverse effects and the development of cardiovascular risk factors. Effectiveness of different NSAIDs may vary between individual patients. Read more: NSAIDs and Risk of Cardiovascular Events

NSAIDs and risk of cardiovascular events (September 2013)

Key messages

All non-steroidal anti-inflammatory drugs (NSAIDs) are associated with a small increased risk of serious cardiovascular adverse events.
The risk is increased with high doses, increasing duration of use and in patients with other cardiovascular risk factors.
The lowest effective NSAID dose should be used for the shortest possible duration.
The overall benefit to risk of harm balance of NSAIDs remains positive.
Patients requiring long-term NSAID therapy should be regularly reviewed for efficacy, adverse effects and the development of cardiovascular risk factors.
Effectiveness of different NSAIDs may vary between individual patients.
Read more: NSAIDs and Risk of Cardiovascular Events

NSAIDs and acute kidney injury (June 2013)
Key messages All NSAIDs (including COX-2 inhibitors) have been associated with the development of acute kidney injury. Acute kidney injury is more likely to occur in patients with other risk factors — particularly hypovolaemic states. Other risk factors include: Increasing age (>65 years), chronic hypertension and atherosclerosis. Pre-exisiting renal or glomerular disease. Use of angiotensin-converting enzyme (ACE) inhibitors or angiotensin-II receptor antagonists. Use of the 'triple whammy' (concurrent use of ACE inhibitor or angiotensin-II receptor antagonist plus diuretic plus NSAID). Renal function should be monitored in at risk patients. If acute kidney injury occurs, the NSAID should be stopped. NSAIDs should be avoided in patients who develop or have a history of interstitial nephritis. Read more: NSAIDs and Acute Kidney Injury

NSAIDs and acute kidney injury (June 2013)

Key messages

All NSAIDs (including COX-2 inhibitors) have been associated with the development of acute kidney injury.
Acute kidney injury is more likely to occur in patients with other risk factors — particularly hypovolaemic states. Other risk factors include:

Increasing age (>65 years), chronic hypertension and atherosclerosis.
Pre-exisiting renal or glomerular disease.
Use of angiotensin-converting enzyme (ACE) inhibitors or angiotensin-II receptor antagonists.
Use of the 'triple whammy' (concurrent use of ACE inhibitor or angiotensin-II receptor antagonist plus diuretic plus NSAID).

Renal function should be monitored in at risk patients.
If acute kidney injury occurs, the NSAID should be stopped.
NSAIDs should be avoided in patients who develop or have a history of interstitial nephritis.
Read more: NSAIDs and Acute Kidney Injury

Reducing the risk of GI reactions with NSAIDs and/or COX-2 inhibitors (December 2010)
For all patients requiring treatment with either a non-selective NSAID or COX-2 inhibitor, the extent and severity of gastrointestinal events can be reduced by: Using the lowest effective dose for the shortest duration possible. Avoiding the concomitant use of more than one NSAID, or a NSAID with a COX-2 inhibitor. Avoiding the concomitant use of aspirin and/ or an anticoagulant where possible. If such a combination is necessary, a gastro-protective agent such as a proton pump inhibitor should be considered. Informing patients of, and monitoring for, signs and symptoms of gastrointestinal adverse events. Identifying patients with risk factors for serious GI adverse events and considering the use of a gastro-protective agent such as a proton pump inhibitor. Read more: Reducing the risk of GI reactions with NSAIDs and/or COX-2 inhibitors

Reducing the risk of GI reactions with NSAIDs and/or COX-2 inhibitors (December 2010)

For all patients requiring treatment with either a non-selective NSAID or COX-2 inhibitor, the extent and severity of gastrointestinal events can be reduced by:

Using the lowest effective dose for the shortest duration possible.
Avoiding the concomitant use of more than one NSAID, or a NSAID with a COX-2 inhibitor.
Avoiding the concomitant use of aspirin and/ or an anticoagulant where possible. If such a combination is necessary, a gastro-protective agent such as a proton pump inhibitor should be considered.
Informing patients of, and monitoring for, signs and symptoms of gastrointestinal adverse events.
Identifying patients with risk factors for serious GI adverse events and considering the use of a gastro-protective agent such as a proton pump inhibitor.
Read more: Reducing the risk of GI reactions with NSAIDs and/or COX-2 inhibitors

Resources	Links
New Zealand Formulary	ibuprofen
Medsafe datasheet	Ibugesic® Ibuprofen Relieve®