I'm a Doctor and Warn You Know This Before Taking Ibuprofen
Although Ibuprofen is a common over-the-counter painkiller that effectively helps manage pain, doctors caution there's many risks to consider. Ibuprofen can have serious and damaging side effects and Eat This, Not That! Health spoke with experts who explain what to know before taking it. Read on—and to ensure your health and the health of others, don't miss these Sure Signs You've Already Had COVID.
What is Ibuprofen Taken For?
Dr. Ali Jamehdor, DO Medical Director, Emergency Department at Dignity Health St. Mary's Medical Center says, "Ibuprofen is taken to help reduce pain associated with such things as headache, muscle ache and sore throat. Ibuprofen is also taken to reduce fever. People commonly take it for dental pain as well."
Dr. Michael Hirt, a Board Certified Nutrition from Harvard University and Board Certified in Internal Medicine and is with The Center for Integrative Medicine in Tarzana California adds, "Ibuprofen is a prescription NonSteroidal AntiInflammatory (NSAID) that is available Over-The-Counter in reduced strength dosages to treat pain, fever, and reduce inflammation."
How Does Ibuprofen Work?
Dr. Jamehdor explains, "Ibuprofen is a Non-Steroidal Anti-inflammatory Drug (NSAID). It works by blocking the enzymes that produce the inflammatory hormones in your body. So if you block the enzyme that is needed to convert certain acids into inflammatory hormones…you reduce the inflammation in your body."
Dr. Hirt shares, "Ibuprofen partially blocks the body's ability to make prostaglandins, an important local signaling molecule involved in the sensation of pain, the ability to mount a fever, and promotion of inflammation. When the body cannot make as many prostaglandin molecules, then the body will experience less pain, lower body temperatures, and reduced inflammation."
What are the Benefits of Ibuprofen?
According to Dr. Jamehdor, "It has been used for a very long time and physicians feel very comfortable with this medicine. It is non-addictive, non-habit forming and can be taken safely in many circumstances. Dosing is easy, it is widely available and it works by actually decreasing the very thing that is causing the pain in most cases…INFLAMMATION.. It is safe in children and has been used in patients as young as 3 months old.Ibuprofen also works fairly quickly with an onset of action as rapid as 30-60 minutes.Other upsides are that they come in many forms including capsules, pills, liquid and chewable tablets."
Dr. Hirt explains, "The positive effects of ibuprofen typically last 4-6 hours and include a reduction in the sensation of minor to moderate pain, fever and the redness and swelling of inflammation. The net effect of ibuprofen's benefits is to make us temporarily more comfortable when we are fighting an infection, recovering from a surgery or injury, breaking a bad headache, or relieving menstrual cramps."
What's the Downside to Taking Ibuprofen?
Dr. Jamehdor reveals, "Ibuprofen can be upsetting to the stomach and the duration of action is a….bit short, requiring it to be taken every 4-6 hours. Long term use has been associated with developing ulcers. FDA has warnings about potential side effects of heart disease and strongly recommends against taking it before or after any heart procedure. Ibuprofen is removed from your body by your kidneys, so patients with kidney disease are encouraged to avoid this medicine."
Dr. Hirt shares, "Unfortunately, the upsides of taking ibuprofen come with some significant downside risks. While prostaglandins are involved in our experience of pain, fever and inflammation, this important signaling molecule is also important for the health of our intestinal lining. With each dose of ibuprofen you take, the lining of your intestinal tract is compromised, and over time (sometimes days, sometimes months), this can lead to intestinal irritation and bleeding. In 80 percent of patients who have intestinal complications of ibuprofen usage, there were no clinical warning signs that bad things were happening inside their intestines, like ulcers and inflammation. Ibuprofen can also thin your blood, much like aspirin, complicating GI bleeding and any other cut or bruise. Conservatively, well over 100,000 people each year are admitted to hospitals with complications of ibuprofen usage, including serious intestinal bleeding, heart attacks, strokes and kidney damage. In the US, more than 16,000 yearly deaths are linked to ibuprofen use, more deaths than those caused by HIV."
Can Ibuprofen Interact With Other Medications?
Dr. Jamehdor says. "Ibuprofen comes in many forms and many names. You really need to make sure that you are not on an NSAID already before taking another similar pill….as this can have additive effects and lead to serious Gastrointestinal problems such as bleeding ulcers.NSAIDS such as ibuprofen should never be taken in combination with blood thinners such as Aspirin or coumadin, as this can increase risk of bleeding."
Dr. Hirt explains, "Ibuprofen can interact with many commonly prescribed medications including blood thinners, acid blocking pills, and blood pressure pills. Just because a medicine is sold Over-The-Counter like ibuprofen does not mean it is safe for you to take, especially if you are taking other prescription medications. It is always best practice to ask your healthcare partner whether ibuprofen is safe for you to take, the dose, and length of time you should take ibuprofen."
What Should People Know Before Taking
Dr. Jamehdor emphasizes, "Just because Ibuprofen is OTC…please…please, do not underestimate its potential side effects. If you take any other medicine or have any other health conditions talk to the pharmacist before purchasing ANY medicine…including ibuprofen. Renal injury, stomach ulcers and bleeding are real risk factors of this medicine."
Tips for Taking Ibuprofen People Should Know
Dr. Jamehdor states, "While this is a wonderful medicine that can usually be taken very safely over the counter…it is a very powerful medicine and should be treated with caution. Do not use for prolonged periods of time.If you take any other medicine, consult with your doctor or pharmacist before taking ibuprofen.Like most other medicine, the earlier on in the symptoms it is taken…the better and more effective it can be.Try not to take this medicine on an empty stomach…this can help prevent some of the most common side effects…such as upset stomach."
Dr. Hirt states, "MYTH #1: Taking ibuprofen with food neutralizes the risk of intestinal damage. Not true. Taking ibuprofen with food may reduce the chances of immediate stomach irritation, but the damage to the intestinal lining comes from reducing the tissue levels of intestinal prostaglandins, not just the direct hit of the ibuprofen tablet against the stomach lining.
MYTH #2: Taking ibuprofen with antacids or histamine-blocking acid reducers (like Pepcid) will prevent serious GI complications. Not true. Products like TUMS, Rolaids, Mylanta, or Pepcid will not stop ibuprofen from triggering serious intestinal complications. Stronger acid blockers like Prilosec OTC and Nexium OTC (taken at their prescription strength doses) can reduce the risk of intestinal damage, but still not eliminate the risk completely."
How Effective is Ibuprofen?
Dr. Jamehdor says, "Ibuprofen is an extremely effective medicine. Some people downplay its effects stating that it's just over the counter. This could not be further from the truth. Taken at the correct dosing and early at the onset of symptoms…it would be my first choice for pain control."
According to Dr. Hirt, "The planet will spend over $7 Billion on NSAIDs like ibuprofen, which is an incredible testament to their effectiveness at mitigating our collective headaches, menstrual cramps, sports injuries, body aches, arthritis, and fevers. While NSAIDs are pretty inexpensive as medicines go, the true cost may not just be what you pay at the pharmacy, but the dollars you pay to your local doctor or hospital to correct the medical complications when you inadvertently take too many NSAIDs for too long. Knowing when to stop is a conversation you'll want to have with your healthcare team well before the often silent risks outweigh the 4 hours of pain and fever reducing benefits."
Warning for Children Taking Ibuprofen
Dr. Jamehdor warns, "For pediatric patients, the weight of your child is very important. The dosing for kids is 10 mg/kg….so a child that weighs 20 kgs, would need 200 mg of ibuprofen. Under-dosing children really diminishes the effectiveness of the medicine, while still exposing them to potential side effects. We see children routinely in the ER, where the parents are very frustrated. They report giving 2-3 doses of ibuprofen every 6 hours without any effect. Most of the time they have underestimated the child's weight by 50 percent."
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