Ibuprofen

Medically Reviewed by Dr. Harshi Dhingra, M.D.

Last Reviewed: Aug 08, 2022

Warnings

Ibuprofen Risks, Warnings, and Complications

Ibuprofen can cause serious side effects in certain people. Talk to your doctor or pharmacist about other treatment options if you are at high risk of complications from ibuprofen use. Some of the risks of ibuprofen use include:

HEART ATTACK AND STROKE: Taking ibuprofen can lead to an increased risk of blood clots, heart attacks, and strokes. The risk is greater in people with pre-existing heart problems and those taking high doses of ibuprofen or taking this medicine for a long time. You should take the lowest possible dose of ibuprofen for the shortest possible time to treat your pain. If you have a history of heart problems, talk to your doctor before starting ibuprofen. Do not take ibuprofen if you have had or are scheduled to have coronary artery bypass graft (heart bypass surgery). Call 911 or seek immediate medical attention if you experience shortness of breath, chest pain, weakness on one side of your body, or problems with walking or talking.
STOMACH BLEEDING: Ibuprofen is a nonsteroidal anti-inflammatory drug (NSAID), and it can cause potentially dangerous stomach bleeding. Risk factors for stomach bleeding on ibuprofen include taking the medicine for a long time, a prior history of stomach bleeding, older age, and taking other medicines like other oral NSAIDs including low dose aspirin, blood thinners, oral corticosteroids. Drinking alcohol and smoking are also risk factors. Stop taking ibuprofen and contact your doctor immediately or seek emergency medical care if you notice vomit that looks like coffee grounds, bright red blood in your stool, tarry stools, or persistent stomach pain.
SEVERE ALLERGIC REACTIONS: In a small number of people, taking ibuprofen can lead to a severe allergic reaction, including a potentially life-threatening reaction like anaphylaxis (throat closing) or Stevens-Johnson syndrome (skin reaction). Call 911 if you develop signs and symptoms such as skin rash and blisters all over the body, swelling of the lips or tongue, or difficulty breathing. Tell your healthcare provider if you have an allergy to aspirin or other nonsteroidal anti-inflammatory drugs (NSAIDs) or a history of asthma with nasal polyps, because this can put you at increased risk of allergic reactions to ibuprofen.
KIDNEY DAMAGE: Ibuprofen can damage the kidneys. There is an increased risk of this happening in people with pre-existing kidney problems, liver disease, and heart failure. Risk factors for kidney damage also include taking ibuprofen for a long time. Older adults and people taking certain medications for high blood pressure are also at increased risk. Talk to your doctor if kidney damage is a concern for you. Contact your doctor immediately if you notice any changes in urination while taking ibuprofen.
HARM TO UNBORN BABIES: Pregnant women should not take ibuprofen in the last 3 months of pregnancy because this medicine can lead to a higher risk of heart problems in an unborn baby. If you are currently pregnant, talk to your healthcare provider or pharmacist about what medications are safe to take.

Precautions Before Starting Ibuprofen

Tell your doctor if you have had an allergic reaction to ibuprofen, any of the active or inactive ingredients in ibuprofen tablets, chewable tablets, or oral suspension, any other nonsteroidal anti-inflammatory drugs (NSAIDs) such as aspirin or naproxen (Naprosyn, Aleve), or any other medications. Your pharmacy can give you a list of ingredients.

Give your doctor a complete medical history. Ibuprofen may not be right for people with certain medical conditions such as asthma, nasal polyps, frequent stuffy or runny nose, heart failure, swelling of the legs or feet, lupus, liver disease, or kidney disease.

Give your doctor and pharmacist a complete list of your medications, including prescription drugs, over-the-counter medicines, vitamins, supplements, and herbal products. This can help avoid possible drug interactions.

Tell your doctor if you are pregnant, could be pregnant, are planning a pregnancy, or are breastfeeding. Ibuprofen can be harmful to the unborn baby if it is taken by a pregnant woman in the third trimester (after around 20 weeks of pregnancy).

If you are an older adult (age 75 years and above), talk to your healthcare provider about the safety of taking ibuprofen. Do not take ibuprofen at a higher dose or for longer than recommended by your doctor or the package label.

People with a condition called phenylketonuria should talk to their doctor about which ibuprofen products are safe for them to use. In this condition, high serum levels of a substance called phenylalanine can cause serious problems. Some brands of nonprescription (OTC) ibuprofen products like chewable tablets may contain phenylalanine. The regular ibuprofen tablets and liquid medicine don't contain phenylalanine, however. If you have phenylketonuria, talk to your healthcare provider about what ibuprofen products are safe for you.

Precautions During Use of Ibuprofen

Keep all your doctor’s appointments and lab appointments while taking ibuprofen.

Call your doctor if you become pregnant while taking ibuprofen.

Ibuprofen is present with other medications in many combination products, some of which are available by prescription and some without a prescription. If your doctor has prescribed ibuprofen, do not take other nonprescription pain medications that also contain ibuprofen. Check the label of all over-the-counter medicines, especially those used to treat cough or cold symptoms, as they may contain ibuprofen. Avoid using two or more products at the same time because they may contain the same active ingredient and could lead to an overdose. This is especially true for children younger than 6 years of age. When giving nonprescription ibuprofen products to children, follow the package directions carefully. Also, read the package label to ensure you are using an ibuprofen product that is suitable for children.

Tell all your doctors you are on ibuprofen before any surgery, including dental procedures.

Ibuprofen Drug Interactions

Certain other drugs can affect how ibuprofen works. Possible interactions between ibuprofen and other medicines can increase the risk of severe adverse effects. The following medications can have possible interactions with ibuprofen:

Medications used to treat high blood pressure such as angiotensin-converting enzyme (ACE) inhibitors, for example, captopril, lisinopril (in Zestoretic), benazepril (Lotensin, in Lotrel), enalapril (Vasotec, in Vaseretic), moexipril (Univasc), fosinopril, perindopril (Aceon, in Prestalia), ramipril (Altace), quinapril (Accupril, in Quinaretic), and trandolapril (Mavik, in Tarka); angiotensin receptor blockers (ARBs) like eprosartan (Teveten), candesartan (Atacand, in Atacand HCT), irbesartan (Avapro, in Avalide), olmesartan (Benicar, in Benicar HCT, in Azor, in Tribenzor), losartan (Cozaar, in Hyzaar), valsartan (in Exforge HCT), and telmisartan (Micardis, in Micardis HCT, in Twynsta); and beta blockers like atenolol (Tenormin, in Tenoretic), metoprolol (Lopressor, Toprol XL, in Dutoprol), labetalol (Trandate), propranolol (Hemangeol, Inderal, Innopran), and nadolol (Corgard, in Corzide)
Anticoagulants (blood thinners) such as warfarin (Coumadin, Jantoven); aspirin; other NSAIDs such as ketoprofen and naproxen (Aleve, Naprosyn); oral steroids such as dexamethasone, methylprednisolone (Medrol), and prednisone (Rayos); selective serotonin reuptake inhibitors (SSRIs) such as citalopram (Celexa), fluoxetine (Prozac, Sarafem, Selfemra, in Symbyax), fluvoxamine (Luvox), paroxetine (Brisdelle, Paxil, Pexeva), and sertraline (Zoloft); or serotonin norepinephrine reuptake inhibitors (SNRIs) such as desvenlafaxine (Khedezla, Pristiq), duloxetine (Cymbalta), and venlafaxine (Effexor XR).
Water pills (diuretics)
Psychiatric medications like lithium (Lithobid)
Cancer drugs like methotrexate (Rasuvo, Trexall, Otrexup)

The above list may not include all possible interactions of ibuprofen. Give your doctor or pharmacist a complete list of your medications, including prescription drugs, over-the-counter medicines, dietary supplements, and herbal remedies. Also, tell your healthcare professional if you smoke, drink alcohol, or use recreational drugs because some of these substances can cause serious health complications when used with prescription and over-the-counter medicines.

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