NSAIDs can also increase the risk of serious gastrointestinal side effects, especially in older adults (aged 65 and older), such as bleeding, ulceration, and perforation of the stomaches or intestines.
Ibuprofen should not be used to treat pain around the time of coronary artery bypass graft (CABG) surgery.
It is available over the counter (OTC) as a tablet, capsule, chewable tablet, and liquid suspension. Some types of ibuprofen are available only by prescription.
What Is Advil Used For?
The Food and Drug Administration (FDA) has approved ibuprofen for:
Brand Name(s): Advil, Addaparin, Motrin, A-G Profen, Bufen, Genpril, Haltran, Ibu, Obuprohm, Ibu-Tab, I-Prin, Midol, Motrin, Nuprin, Proprinal, Q-Profen
Drug Availability: Over the counter, prescription
Therapeutic Classification: Analgesic
Available Generically: Yes
Controlled Substance: N/A
Administration Route: Oral
Active Ingredient: Ibuprofen
Dosage Form(s): Tablet, capsule, suspension
Fever reduction Headache and mild to moderate migraine pain Relief of minor aches and pains in muscles, bones, and joints, body pain, backache, and muscle sprains and strains Pain from inflammation associated with conditions, including rheumatoid arthritis and osteoarthritis Primary dysmenorrhea (painful menstrual periods) Aches and pains due to the common cold and flu Toothache
How to Take Advil
Follow the directions for taking ibuprofen on the product label. Generally, you will take it three to four times per day, as needed. Your dosage may depend on your individual needs, so it might be best to consult a healthcare provider if you are unsure. To prevent side effects, take the smallest effective dose necessary for relief.
You can take ibuprofen with food or milk to decrease the chance of stomach upset.
Storage
Store ibuprofen tablets, capsules, and oral suspension (liquid) at room temperature (between 68 F and 77 F), and keep tablets in a dry place.
Off-Label Uses
Ibuprofen can be used off-label for certain medical conditions not specifically named by the FDA.
Off-label uses include:
Gout flares Pericarditis (inflammation of the protective elastic sac that encloses the heart) Closure of patent ductus arteriosus, a congenital heart defect, in preterm infants
What Are the Side Effects of Advil?
This is not a complete list of side effects, and others may occur. A medical professional can advise you on side effects. If you experience other effects, contact your pharmacist or a healthcare provider. You may report side effects to the FDA at www.fda.gov/medwatch or 1-800-FDA-1088.
Ibuprofen can cause side effects, most of which are mild. However, some of ibuprofen’s side effects can be serious and require medical intervention. Be sure to mention any side effects you experience to your healthcare provider.
Common Side Effects
Common side effects of ibuprofen can include:
Gastrointestinal (GI) upset, including diarrhea, indigestion, nausea, vomiting, abdominal pain, constipationDizzinessSkin rash
Severe Side Effects
Contact your healthcare provider immediately if you have serious side effects. Call 911 if your symptoms feel life-threatening or you think you’re having a medical emergency.
Serious side effects and their symptoms can include:
GI bleeding, ulcer, or perforation, which may cause stomach pain and tenderness Cardiovascular complications, such as heart attack or stroke Body fluid retention and edema (swelling) Allergic skin reactions, which can result in a rash, itching, hives, swelling, or anaphylaxis
Ibuprofen’s prescribing information contains a black box warning (the FDA’s most stringent warning for drugs on the market) for both the serious cardiovascular events and gastrointestinal events described above.
Long-Term Side Effects
Prolonged use of NSAIDs, including ibuprofen, may cause elevated blood pressure (hypertension). This may reduce the effectiveness of some medications used to treat high blood pressure.
NSAIDs also may increase the risk of serious heart-related complications, such as cardiovascular thrombotic (clotting) events, heart attacks, and strokes. The risk is greater with prolonged use and for those with existing heart disease.
Long-term use of ibuprofen and other NSAIDs has resulted in renal (kidney) injury. People with impaired kidney function, those taking diuretics or angiotensin-converting enzyme (ACE) inhibitors, and older adults are at the highest risk.
Dosage: How Much Ibuprofen Should I Take?
Modifications
Pregnant people should avoid taking ibuprofen at 30 weeks and beyond because of its known effects on the fetal cardiovascular system. NSAIDs can cause premature closure of the ductus arteriosus (a normal fetal artery that closes shortly after birth) in the fetus.
If you experience a serious side effect, you or your healthcare provider may send a report to the FDA’s MedWatch Adverse Event Reporting Program or by phone (1-800-332-1088).
The amount of medicine that you take depends on the strength of the medicine. Also, the number of doses you take each day, the time allowed between doses, and the length of time you take the medicine depend on the medical problem for which you are using the medicine.
For oral dosage form (tablets and suspension): For fever: Children over 2 years of age—Use and dose must be determined by your doctor. Children 6 months of age up to 2 years—Dose is based on body weight and body temperature, and must be determined by your doctor. For fever lower than 102. 5 °F (39. 2 °C), the dose usually is 5 milligrams (mg) per kilogram (kg) (about 2. 2 mg per pound) of body weight. For higher fever, the dose usually is 10 mg per kg (about 4. 5 mg per pound) of body weight. The medicine may be given every six to eight hours, as needed, up to 40 mg per kg per day. Infants younger than 6 months of age—Use and dose must be determined by your doctor . For menstrual cramps: Adults—400 milligrams (mg) every four hours, as needed. Children—Use and dose must be determined by your doctor . For mild to moderate pain: Adults and teenagers—400 milligrams (mg) every four to six hours, as needed. Children over 6 months of age—Dose is based on body weight and must be determined by your doctor. The dose usually is 10 milligrams (mg) per kilogram (kg) of body weight every six to eight hours, as needed, up to 40 mg per kg per day. Infants younger than 6 months of age—Use and dose must be determined by your doctor . For osteoarthritis and rheumatoid arthritis: Adults and teenagers—1200 milligrams (mg) up to 3200 mg per day divided into three or four equal doses. Children—Dose is based on body weight and must be determined by your doctor. The dose usually is 30 milligrams (mg) to 40 mg per kilogram (kg) of body weight per day, divided into three or four doses. Infants younger than 6 months of age—Use and dose must be determined by your doctor .
Ibuprofen is considered safe to use while breastfeeding. It is excreted into human breast milk at extremely low levels. Ibuprofen is safely used in infants at doses much higher than those present in the breast milk of a breastfeeding person taking ibuprofen.
Missed Dose
If you miss a dose of ibuprofen, take it as soon as you remember. If it is almost time for the next dose, skip the missed dose and take the next dose at the regularly scheduled time. Do not take an extra dose to make up for the missed dose.
Overdose: What Happens If I Take Too Much Advil?
Do not take more than 3200 milligrams per day of ibuprofen.
Severe toxicity and death after an overdose of ibuprofen and other NSAIDs are rare. An NSAID overdose can cause:
Mild GI upset (e. g. , nausea, vomiting, abdominal pain)DrowsinessLethargyHeadaches
However, some people may have no symptoms at all.
Large overdoses can be treated with activated charcoal at the hospital.
Precautions
What Are Reasons I Shouldn’t Take Advil?
People who have experienced asthma, urticaria (hives), or allergic-type reactions after taking aspirin or other NSAIDs should not take ibuprofen.
If someone collapses or isn’t breathing after taking ibuprofen, call 911.
This medicine may raise your risk of having a heart attack or stroke. This is more likely in people who already have heart disease. People who use this medicine for a long time might also have a higher risk .
This medicine may cause bleeding in your stomach or intestines. These problems can happen without warning signs. This is more likely if you have had a stomach ulcer in the past, if you smoke or drink alcohol regularly, if you are over 60 years old, if you are in poor health, or if you are using certain other medicines (a steroid or a blood thinner) .
Serious skin reactions can occur during treatment with this medicine. Check with your doctor right away if you have any of the following symptoms while taking this medicine: blistering, peeling, loosening of skin, chills, cough, diarrhea, fever, itching, joint or muscle pain, red skin lesions, sore throat, sores, ulcers, white spots in mouth or on lips, or unusual tiredness or weakness .
Possible warning signs of some serious side effects that can occur during treatment with this medicine may include swelling of the face, fingers, feet, and/or lower legs; severe stomach pain, black, tarry stools, and/or vomiting of blood or material that looks like coffee grounds; unusual weight gain; yellow skin or eyes; decreased urination; bleeding or bruising; and/or skin rash. Also, signs of serious heart problems could occur such as chest pain, tightness in chest, fast or irregular heartbeat, unusual flushing or warmth of skin, weakness, or slurring of speech. Stop taking this medicine and check with your doctor immediately if you notice any of these warning signs .
This medicine may also cause a serious type of allergic reaction called anaphylaxis. Although this is rare, it may occur often in patients who are allergic to aspirin or other nonsteroidal anti-inflammatory drugs. Anaphylaxis requires immediate medical attention. The most serious signs of this reaction are very fast or irregular breathing, gasping for breath, wheezing, or fainting. Other signs may include changes in skin color of the face; very fast but irregular heartbeat or pulse; hive-like swellings on the skin; and puffiness or swelling of the eyelids or around the eyes. If these effects occur, get emergency help at once .
Some people who have used this medicine had symptoms of meningitis. If you have fever, headache, nausea, vomiting, and stiff neck or back while using this medicine, check with your doctor right away .
Using this medicine while you are pregnant can harm your unborn baby. If you think you have become pregnant while using this medicine, tell your doctor right away .
Check with your doctor immediately if blurred vision, difficulty in reading, or any other change in vision occurs during or after your treatment. Your doctor may want you to have your eyes checked by an ophthalmologist (eye doctor) .
Before having any kind of surgery or medical tests, tell your doctor that you are taking this medicine. It may be necessary for you to stop treatment for a while, or to change to a different nonsteroidal anti-inflammatory drug before your procedure .
People with heart disease or risk factors for heart disease are at increased risk of serious cardiovascular complications with this medication. They should weigh the risks versus benefits with their healthcare provider. Additionally, those with a history of GI bleeding or ulcer disease are at increased risk of serious GI complications with ibuprofen.
Do not use ibuprofen for pain control following coronary artery bypass graft (CABG) surgery, as it may increase heart attack and stroke risk.
What Other Medications Interact With Advil?
There are several drug interactions that can occur while taking ibuprofen. Be sure to discuss any medications you are taking with your healthcare provider.
The following medications can interact with ibuprofen:
ACE inhibitors, such as Zestril (lisinopril), Vasotec (enalapril), and Altace (ramipril) Diuretics, such as Microzide (hydrochlorothiazide), Lasix (furosemide), and torsemide Lithium Aspirin Methotrexate Cyclosporine Jantoven (warfarin)
ACE Inhibitors and Diuretics
Ibuprofen may reduce how well ACE inhibitors and diuretics work. This can result in increased blood pressure and/or fluid retention.
Lithium
Taking ibuprofen in combination with lithium increases blood levels of lithium. Lithium users should monitor for signs of toxicity when taking both medications.
Aspirin
Ibuprofen reduces the blood clotting effect of aspirin and, therefore, may increase the risk of cardiovascular events in people taking low-dose aspirin to prevent heart disease. The combination also increases the risk of GI ulcers.
Methotrexate
Ibuprofen may decrease the clearance of methotrexate from the body, causing increased toxicity. Closely monitor for signs of methotrexate toxicity when this combination is used.
Cyclosporine
Ibuprofen and other NSAIDs can increase the risk of kidney toxicity with this medication. Use caution if taking the two medications together.
Warfarin
In combination with ibuprofen, warfarin can increase the risk of serious GI bleeding. Use caution with this combination.
What Medications Are Similar?
Drugs that are similar to ibuprofen and also belong to the NSAID family include:
Aspirin Naprosyn (naproxen) Indomethacin Diclofenac Sulindac Celebrex (celecoxib)
These medications differ in the amount needed to take effect, how long they remain effective in the body, and the risks of GI toxicity.
In most cases, you should take only one NSAID at a time. Many people continue low-dose aspirin for heart disease prevention when taking another NSAID. However, this does increase the risk of GI side effects.
How Can I Stay Healthy While Taking Advil?
Be aware of when you are taking your ibuprofen if you are also taking low-dose aspirin for heart disease prevention. To minimize the interactions between these two, take immediate-release aspirin at least two hours before or eight hours after taking ibuprofen. For extended-release aspirin, take it two to four hours before or eight hours after taking ibuprofen.
Take the lowest effective dose for the shortest duration possible to decrease the risk of serious GI complications from ibuprofen and other NSAIDs. Be alert to symptoms that may indicate GI bleeding or ulcers, such as epigastric pain (pain in the upper part of the abdomen), and blood in vomit or stool.
Do not drink alcohol while taking ibuprofen to reduce the risk of GI bleeds.
People who need to take ibuprofen long-term should speak with their healthcare providers about adding a medication to prevent gastric ulcers.
