Ibuprofen

Ibuprofen is an anti-inflammatory, which is what separates it from paracetamol. That makes it better for anything swollen or inflamed — and it is also why it suits fewer people, because the same mechanism that reduces inflammation can irritate the stomach and affect the kidneys.

What it is used for

Ibuprofen treats pain with an inflammatory component particularly well: sprains and strains, back pain, arthritis, period pain, dental pain and sore throats. It also reduces fever.

The gel and spray forms are rubbed into a painful joint or muscle. Because far less is absorbed into the bloodstream, they carry much lower risk than tablets and are often a better choice for a localised problem such as a knee or shoulder.

How to take it

The usual over-the-counter adult dose is 200–400mg up to three times a day, with a maximum of 1,200mg in 24 hours. Prescribed doses can be higher and should be followed exactly.

Take tablets with or just after food, or with a glass of milk. Use the lowest dose that works, for the shortest time — this is not a medicine to take routinely for months without review.

For children, use an age-appropriate ibuprofen liquid and follow the bottle. It should not be given to babies under three months or under 5kg.

Who should not take it

Do not take ibuprofen without checking with us or your GP if you:

• Have or have had a stomach ulcer, or bleeding in the stomach
• Have asthma that is made worse by aspirin or anti-inflammatories
• Have kidney or liver problems, or heart failure
• Have had a heart attack or stroke, or have high blood pressure that is not well controlled
• Are taking warfarin, apixaban or another anticoagulant
• Are taking steroids, an SSRI antidepressant, or a diuretic and an ACE inhibitor together
• Are over 65, when the stomach risks are higher
• Are dehydrated, or unwell with vomiting or diarrhoea — ibuprofen and dehydration together are hard on the kidneys

Ibuprofen should be avoided from 20 weeks of pregnancy onwards and is not usually recommended earlier either — paracetamol is the alternative. It can be used while breastfeeding.

Side effects

The most common are indigestion, heartburn, nausea and stomach ache. Taking it with food helps. If you need it regularly and it upsets your stomach, a stomach-protecting medicine may be appropriate — come and ask.

Stop and get medical help if you notice:

• Vomiting blood, or vomit that looks like coffee grounds
• Black or tarry stools
• Severe stomach pain
• Swelling of the face, lips or throat, wheezing, or a widespread rash
• Passing much less urine than usual, or swollen ankles

Chickenpox and infections

Avoid ibuprofen in chickenpox. There is an association with more serious skin infections, so paracetamol is the recommended choice for fever and discomfort while a child has chickenpox.

Frequently asked questions