Ibuprofen is a nonsteroidal anti-inflammatory drug (NSAID), with antipyretic (fever reducing) properties. It may be taken by both adults and children to manage many commonplace conditions associated with pain and inflammation, such as toothache, headache, joint pain and menstrual cramps.
Ibuprofen is an everyday painkiller which is used to:
- Relieve mild to moderate pain
- Reduce fever
- Reduce swelling
What is ibuprofen used for?
Ibuprofen functions by inhibiting the synthesis, i.e. blocking the production, of prostaglandins, hormones that cause pain within the body. Prostaglandins also cause fever, swelling and inflammation. Ibuprofen is a popular and effective way to lessen these types of discomfort, which are associated with a wide variety of conditions.
Ibuprofen can be used to treat:
- Mild to moderate localized pain, as is typical of conditions like menstrual cramps, toothache and headache
- Fevers, when the body’s temperature rises beyond its normal rating of around 37 degrees Celcius to 38 or more degrees Celsius
- Pain and swelling from injuries such as sprains and strains
- Redness and inflammation stemming from ongoing conditions such as osteoarthritis, a condition characterized by pain and stiffening in the joints
Ibuprofen is not recommended for regular or long-term use without the supervision of a doctor, as it has been linked to gastric discomfort such as stomach ulcers and heart problems.
Anybody who is often or constantly taking ibuprofen should seek a medical opinion, as they may be suffering from an undiagnosed condition and/or may be prescribed alternative medications that are more suitable for long-term pain management.
Types of ibuprofen
Ibuprofen can be purchased from most pharmacies and supermarkets as a prescription free over-the-counter (OTC) medication. However, some types and strengths of ibuprofen are only available on prescription. These are usually prescribed for treating specific conditions, such as rheumatoid arthritis.
Ibuprofen is available in various different forms, including:
- Oral medication, tablets, liquids and capsules
- Topical medication for application on the skin, such as creams, gels and sprays
- In products where it is combined with other ingredients, including other pain medications,for example, paracetamol, in form of granules that can be dissolved in a hot drink
Topical forms of ibuprofen tend to have fewer side-effects than oral ones. Therefore, in cases where ibuprofen is being used to treat an ongoing condition, e.g. pain related to a sporting injury, a topical form of ibuprofen ‒ such as a gel ‒ may be recommended.
Who can take ibuprofen?
Ibuprofen is suitable for most adults, and children who are at least six months old. There are formulations and dosages available for babies older than 3 months and weighing more than 5 kgs, too, but they should not be given without consulting a doctor.
A doctor or pharmacist will be able to recommend the correct strength and formulation of ibuprofen for an individual’s needs, and the instructions on the packet will specify the correct dose.
The appropriate dose will depend on factors like:
- The person’s age
- The extent and type of pain they are experiencing
- The recovery timeline of the condition that the ibuprofen is being used to treat
- The strength and formulation of the product
Ibuprofen is not suitable for certain people
In rare cases, ibuprofen can cause heart attacks and strokes, particularly if it is used long-term or if a person takes high doses. There are certain conditions and lifestyles which make this more likely, and which increase the risk of side-effects such as gastrointestinal damage.
It is not advisable for pregnant women to take ibuprofen, as it can affect the unborn child. In particular, it can compromise the development of the foetus and increases the risk that the newborn will develop asthma later on.
Factors which increase the risk of complications arising from the use of ibuprofen include:
- -Heart disease
- -High cholesterol
- -High blood pressure
- -A history of stomach ulcers
- Certain arthritis and musculoskeletal diseases such as Sjorgen’s syndrome
- -Liver disease
- -Kidney disease
It is advisable to discuss one’s medical history with a doctor or pharmacist and establish whether it is safe to take ibuprofen.
Children affected by certain conditions should not be given ibuprofen, unless specified by a doctor. These include:
- Chicken pox (ibuprofen can cause a severe allergic skin reaction)
- Inflammatory bowel disease, such as Crohn’s disease or ulcerative colitis
- Any conditions related to an increased risk of bleeding, such as haemophilia
- Liver problems
- Kidney problems
Ibuprofen may react with other medications in a way which impedes their function and/or causes an adverse reaction within the body, and it is advisable to investigate this before using ibuprofen if one is currently or regularly taking any other medications.
A person’s doctor will always be able to recommend a painkilling, and/or anti-inflammatory, alternative to ibuprofen, that is safe to use with other medications. It is never necessary, or advisable, to stop or miss a dose of one’s prescription medication in order to use ibuprofen.
Some of the principal medications which are not recommended for use with ibuprofen without prior approval by your GP or healthcare provider include:
- Other non-steroidal anti-inflammatory drugs (NSAIDs) such as naproxen or high-dose aspirin
- Selective serotonin reuptake inhibitors (SSRIs), a type of antidepressant medication
- Medications used to prevent blood clots, such as warfarin or heparin
- Diuretics - medicines used to treat high blood pressure - and other heart medications like certain beta-blockers or digoxin
- Lithium, a medicine used to treat a range of mental health conditions including bipolar depression or major depression and
- Cyclosporin, a medicine sometimes used to treat autoimmune conditions such as ulcerative colitis
- Methotrexate, a medicine used to treat rheumatoid arthritis
- Phenytoin, an anti-epileptic medication
- Oral corticosteroids, a strong anti-inflammatory medication
Always consult a doctor before taking ibuprofen, if taking any prescription medication in order to avoid possible cross-reactivity.
Food and drink with ibuprofen
It is not necessary to avoid any particular foods or food groups whilst taking ibuprofen.
However, drinking alcohol excessively is not recommended, as it may cause irritation to the stomach and over time increases the chances of stomach side effects, like ulcers.
How to take ibuprofen
Ibuprofen comes in many different oral and topical (to be applied on the skin) forms, so it is important to read the instructions that accompany the medication. The appropriate dose depends on the strength and type of the ibuprofen and the age of the individual. The instructions will also explain how to store the ibuprofen. A cool, dry area is usually recommended, but certain products may need to be refrigerated.
Ibuprofen should always be taken with or after food to avoid digestive discomfort.
It is important to ensure that there are appropriate intervals between doses. The amount of time that must pass before it is safe to redose with ibuprofen depends on the strength of the product. For example, an adult may take one or two 200mg tablets every four to six hours, but should not take more than 1,200mg (six 200mg) tablets over a 24-hour period, if self-medicating. 
If prescribed and recommended by a doctor, adults can take up to a maximum of 2400 mg to 3200 mg within a 24 hour period. Different maximal doses are recommended in different countries. Children will usually need to take a lower, age-dependent dose.
Ibuprofen dose recommendations for children
Different types of ibuprofen are recommended for children of different ages:
- Three months: Ibuprofen should only be given to infants of three months and older in syrup form and if approved by a doctor.
- Six months and older: Ibuprofen in syrup form is most appropriate for children of six months and older. Until age six, children should not be given other forms of ibuprofen.
- Six years and older: From the age of six, children can take ibuprofen in tablet or capsule form.
- Seven years and older: From the age of seven, ibuprofen can be taken in form of chewable tablets.
- Twelve years and older: Granules containing ibuprofen are suitable for children of age twelve and older.
The dosage instructions for ibuprofen depend on a child’s age and the strength of the syrup or tablets used.
For ibuprofen syrup containing 100mg per 5ml, the following dosages are appropriate for children:
- 3-5 months old: 2.5ml, 3 times in 24 hours
- 6-11 months old: 2.5ml, 3-4 times in 24 hours
- 1-3 years old: 5ml, 3 times in 24 hours
- 4-6 years old: 7.5ml, 3 times in 24 hours
- 7-9 years old: 10ml, 3 times in 24 hours
- 10-11 years old: 15ml, 3 times in 24 hours
- 12-17 years old: 15-20 ml, 3-4 times in 24 hours
For ibuprofen tablets, the following dosages are appropriate:
- 7-9 years old: 200mg, 3 times in 24 hours
- 10-11 years old: 300mg, 3 times in 24 hours
- 12-17 years old: 300-400 mg, 3-4 times in 24 hours, up to a maximum of 600 mg, 4 times in 24 hours. If treating a child oneself, administer no more than 1200 mg of ibuprofen in 24 hours. If higher dosages are needed to relieve symptoms, please consult a doctor.
NSAIDs like ibuprofen can increase the likelihood of internal bleeding and can irritate the stomach and the gut. This is because the prostaglandins play several key roles within the body. In addition to the negative properties that the NSAIDs inhibit, i.e. causing pain and inflammation, prostaglandins perform positive functions such as protecting the lining of the gut and helping facilitate coagulation (clotting of the blood).
Common side-effects of ibuprofen include:
- Nausea and/or vomiting
- Abdominal pain
Ibuprofen is also associated with some more serious, but less common, side-effects.
Less common side-effects of ibuprofen include:
- Allergic reactions, such as skin itching or a rash, up to severe allergic reactions that are an emergency
- Stomach ulcers
- Worsening of asthma symptoms
- Kidney failure
- Problems with the liver
- Problems with the heart and circulation, for example, strokes and heart attacks
- Internal bleeding, indicated by black stools and the presence of blood in one’s vomit
The likelihood of experiencing side-effects from ibuprofen is increased by:
- Taking more than the recommended dose
- Taking ibuprofen at high doses for long periods of time
- Taking ibuprofen with some of the drugs mentioned above, like corticosteroids
- Being in poor general health
- Being elderly
- Having severe pre-existing kidney and/or liver diseases
Anyone who experiences side-effects as a result of taking ibuprofen should seek a medical opinion in a timely manner, as both internal bleeding and complications arising from stomach and/or gut irritation can become life-threatening if left unchecked/untreated.
Most people can take up to 800mg of ibuprofen four times in a 24-hour period without the risk of overdosing. However, overdoses of ibuprofen can be fatal, and symptoms of an overdose are not always seen immediately. For this reason, it is important and generally recommended to seek medical attention if a person has taken more than the maximum dose of ibuprofen recommended for their age and condition, especially when experiencing any of the symptoms below.
Symptoms of an overdose can include:
- Abdominal pain
- Breathing difficulties
- Reduced motor skills
- Tinnitus (ringing in the ears)
Q: Why is ibuprofen unsuitable for use in pregnancy and what medications can be used safely by pregnant people, instead of ibuprofen?
A: Ibuprofen is not suitable for use at any point during a pregnancy, but the risks posed to the developing fetus are different, depending on how many weeks pregnant a person is. Before week 30 of pregnancy, ibuprofen may increase the risk of miscarriage. After week 30 of pregnancy, ibuprofen may cause the baby to develop a heart problem and may reduce the amount of amniotic fluid in the womb.
Paracetamol is the most suitable medication for pregnant people to use instead of ibuprofen. There is no evidence that paracetamol poses risks to a developing baby, and this medication can provide pain relief and/or reduce the symptoms of a fever, similar to the effects of ibuprofen. Pregnant people are recommended to take the lowest possible dose of paracetamol, for the shortest possible time.
Good to know: Many OTC brands of paracetamol also contain caffeine. Excess caffeine intake should be avoided during pregnancy, so it is important to ensure that any paracetamol intended for use by a pregnant person is caffeine-free.
Q: Is ibuprofen suitable to use when breastfeeding?
A: In general, ibuprofen is safe to use when breastfeeding, unless a person has asthma or a stomach ulcer which gets worse when they take ibuprofen. Only small amounts of ibuprofen are usually present in breast milk and these are not believed to cause harm to the baby. However, if a baby has a low birth weight, was born prematurely or has a medical condition, it is advisable to consult a doctor before using ibuprofen, as the traces in breast milk may be harmful in these cases.
Q: Is it safe to drink alcohol at the same time as using ibuprofen?
A: Drinking alcohol excessively when taking any NSAID is likely to irritate the stomach. Drinking a moderate amount of alcohol is not thought to have an impact on the safety or effectiveness of taking ibuprofen, provided a person is over 21 years of age, is not pregnant and is not affected by any long-term health conditions. The Centres for Disease Control and Prevention (CDC) recommend that women drink no more than one drink per day and that men drink no more than two drinks per day.
Q: Is it safe to consume grapefruit-containing products at the same time as using ibuprofen?
A: Yes, it is safe to consume grapefruit when taking ibuprofen. However, it is always advisable to check whether any medication, including other pain-relief and anti-inflammatory medication, will perform differently in the body when grapefruit is consumed. Grapefruit, especially grapefruit juice, contains particular chemicals which can alter the way the body metabolizes (breaks down) some medications, resulting in more, or, in some cases, less, than the required quantity of a given drug entering a person’s bloodstream. All OTC medications come with a “Drug Facts” label which will mention whether there is any cross-reactivity with grapefruit.
“The effects of a prostaglandin synthetase inhibitor, ibuprofen, on the cardiopulmonary response to endotoxin in sheep.” Circulatory Shock. 1982. Accessed: 19 February 2018. ↩
“Effects of ibuprofen, diclofenac, naproxen, and piroxicam on the course of pregnancy and pregnancy outcome: a prospective cohort study.” BJOG: An International Journal of Obstetrics and Gynaecology. July, 2013. Accessed: 19 February 2018. ↩
“Non-steroidal anti-inflammatory drugs and gastrointestinal damage—problems and solutions.” British Medical Journal: Postgraduate Journal. 26 October 1999. Accessed: 19 February 2018. ↩