Ibuprofen Risks, Warnings, and Complications

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.