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Ibuprofen & NSAIDS

ibuprofen-and-nsaids

Ibuprofen & NSAIDS

What are NSAIDs?

NSAIDs (non-steroidal anti-inflammatory drugs) help to manage pain and inflammation associated with arthritis and musculoskeletal problems. NSAIDs can help relieve pain associated with conditions such as migraines, back and muscle pain, dental pain and even period pain. They can also help with the reduction of fevers. 2 NSAIDs are one of the most commonly prescribed drugs worldwide.3

Common NSAIDs that can be found over-the-counter (OTC) at pharmacies include:4

  • Aspirin (e.g. Disprin)
  • Ibuprofen (e.g. Advil)
  • Naproxen (e.g. Naprogesic)
  • Diclofenac (e.g. Voltaren)

What is ibuprofen?

Ibuprofen is the active ingredient in a range of over-the-counter (OTC) medicines in Australia.5 Ibuprofen is classed as non-steroidal anti-inflammatory drug (NSAID). NSAIDs like ibuprofen are commonly used to manage mild to moderate pain, inflammation and fever in both adults and children.6

How do NSAIDs work, and how does ibuprofen work?

Pain is frequently experienced by both children and adults.7,8 , Everyday pain is often clinically uncomplicated, and it can be diagnostically insignificant (e.g. headache, menstrual pain), related to minor trauma (e.g. bruises) or it can be temporary.9 NSAIDs can help manage everyday pain and provide pain relief.

Ibuprofen, like most NSAIDs, assists with blocking a specific enzyme called cyclooxygenase (or COX) which is used in the production of prostaglandins.10 Prostaglandins are chemicals generated by the body that cause inflammation, pain and fever by increasing the temperature and dilating the blood vessels at

the location they are released from.11 By blocking the production of prostaglandins, NSAIDs and ibuprofen can help provide pain relief, and reduce inflammation and fever.12

What are the uses for ibuprofen?

Ibuprofen can help provide pain relief for the following:13

Ibuprofen can also help reduce fever.

For paediatric formulations, in addition to any of the indications above that are appropriate to the age group, ibuprofen can help with the relief of pain associated with teething, earache and/or immunisation.14

What is the difference between ibuprofen & other pain-relief medications?

Two of the most commonly used over-the-counter medicines to treat pain and fever are ibuprofen and paracetamol. Both pain-relief medications share the same properties of pain management but differ in the way that they work, how fast they work, how long they are in the body for and the side effects that may occur.15 However, ibuprofen has the extra benefit of being able to help reduce inflammation.16

What is the appropriate ibuprofen dose?

Over-the-counter ibuprofen is available in different forms, the most common available are tablets and liquid. The appropriate ibuprofen dose can vary between people, symptoms and type of ibuprofen being administered. Below are some tips on ibuprofen dosage for adults:17

  • Use ibuprofen as directed on the label, or as prescribed by the doctor
  • Try using the lowest dosage of ibuprofen that is effective in treating your condition
  • Do not take more than the recommended dose

The appropriate ibuprofen dose for children varies. Below are some tips on how to administer ibuprofen to children:18

  • Reading the instructions and dosage on the label is vital as the dosage is based on body weight
  • In the case of children, do not use ibuprofen for more than a few days
  • For infants younger than 6 months of age – use and dose must be determined by a doctor

Below is a table showing the appropriate ibuprofen dose for those aged twelve years and older.19

Dosage form & strength Age Single dose Dose interval Maximum daily dose
200 mg tablet Adults and children 12 years and over 1 - 2 tablets Every 4-6 hours when necessary 6 tablets in 24 hours

Below is a table highlighting the appropriate ibuprofen dose for those who are taking the oral ibuprofen liquid suspension (3 months – 12 years).20

Age Average body weight (kg) Dose (mg) Dose (mL) from 20 mg/mL suspension Dose (mL) from 40 mg/mL suspension
3-6 months 6-8 kg 40-60 mg 2-3 mL 1-1.5 mL
Age Average body weight (kg) Dose (mg) Dose (mL) from 20 mg/mL suspension Dose (mL) from 40 mg/mL suspension
6-12 months 8-10 kg 60-80 mg 3-4 mL 1.5-2 mL
1-2 years 10-12 kg 80-100 mg 4-5 mL 2-2.5 mL
2-3 years 12-14 kg 100-120 mg 5-6 mL 2.5-3 mL
3-4 years 14-16 kg 120-140 mg 6-7 mL 3-3.5 mL
4-5 years 16-18 kg 140 mg 7 mL 3.5 mL
5-6 years 18-20 kg 140-160 mg 7-8 mL 3.5-4 mL
6-7 years 20-22 kg 160-180 mg 8-9 mL 4-4.5 mL
7-8 years 22-25 kg 180-200 mg 9-10 mL 4.5-5 mL
8-9 years 25-28 kg 200-220 mg 10-11 mL 5-5.5 mL
9-10 years 28-32 kg 220-240 mg 11-12 mL 5.5-6 mL
10-11 years 32-36 kg 240-280 mg 12-14 mL 6-7 mL
11-12 years 36-41 kg 280-300 mg 14-15 mL 7-7.5 mL

How do I take ibuprofen?

Ibuprofen and NSAIDs should not be taken on a regular basis. They should be taken at the lowest dose possible in order to reduce the chances of serious side effects.21

Advil is an ibuprofen based pain reliever. Consult your doctor before taking any analgesic if you have a sensitive stomach or a history of stomach problems such as heartburn, upset stomach or stomach pain.

Are there any ibuprofen side effects?

There are a few potential ibuprofen side effects. Some of the side effects one might experience when taking ibuprofen include: 22 23

  • Upset stomach (nausea, diarrhea or indigestion)
  • Abdominal pain
  • Headache
  • Dizziness
  • Fluid retention
  • Weight gain
  • Pale skin
  • Itching skin
  • Unusual bleeding or bruising
  • Unusual tiredness or weakness
  • Decrease in urine output

If you experience any of the below ibuprofen side effects, you should see a doctor immediately:24

  • Breathing difficulties
  • Swollen ankles
  • Dark coffee- coloured vomit
  • Black stools

Taking ibuprofen for long periods of time is not recommended as it can cause damage to the stomach and kidney.25 Despite some of the serious (but rare) side effects that can be experienced with taking ibuprofen and NSAIDs, if prescribed and used correctly, ibuprofen is an effective way to manage pain, inflammation and fevers.26

What is the history of ibuprofen?

Boots Laboratories, a British drug manufacturer and retailer, developed ibuprofen in the early 1960s and ibuprofen was launched in the UK as a prescription product in 1964.27 The development was a result of the increased need to find a drug more powerful and better tolerated than aspirin. In 1974, the distribution of ibuprofen began to appear in American pharmacies and it was one of the first new over-the-counter pain medications to enter the marketplace in a generation.28 Ibuprofen became available over the counter in the UK in 1983 and the USA in 1984.

References:

  1. 1Encyclopedia, Ibuprofen, [Accessed 12 January 2017]
    http://www.encyclopedia.com/medicine/drugs/pharmacology/ibuprofen
  2. 2Encyclopedia, Ibuprofen, [Accessed 12 January 2017]
    http://www.encyclopedia.com/medicine/drugs/pharmacology/ibuprofen
  3. 3Better Health Channel, Medications – non-steroidal anti-inflammatory drugs, [Accessed 11 January 2017]
    https://www.betterhealth.vic.gov.au/health/conditionsandtreatments/medications-non-steroidal-anti-inflammatory-drugs
  4. 4 Better Health Channel, Medications – non-steroidal anti-inflammatory drugs, [Accessed 11 January 2017]
    https://www.betterhealth.vic.gov.au/health/conditionsandtreatments/medications-non-steroidal-anti-inflammatory-drugs
  5. 5 Bjarnason I, 2013, ‘Gastrointestinal Safety of NSAIDs and Over-the-counter Analgesics, The International Journal of Clinical Practice, vol.67, no.178, p.37
  6. 6Better Health Channel, Medications – non-steroidal anti-inflammatory drugs, [Accessed 11 January 2017]
    https://www.betterhealth.vic.gov.au/health/conditionsandtreatments/medications-non-steroidal-anti-inflammatory-drugs
  7. 7NPS Australia, Ibuprofen for pain and fever, [Accessed 11 January 2017]
    http://www.nps.org.au/medicines/muscles-bones-and-joints/anti-inflammatory-medicines-nsaids/ibuprofen
  8. 8Better Health Channel, Medications – non-steroidal anti-inflammatory drugs, [Accessed 11 January 2017]
    https://www.betterhealth.vic.gov.au/health/conditionsandtreatments/medications-non-steroidal-anti-inflammatory-drugs
  9. 9Fearon I, McGrath PJ, Achat H, 1996, ‘Booboos’: The Study of everyday pain among young children, Pain, vol.68, pp. 55-62
  10. 10Breivik H, Collett B, Ventafridda V, Cohen R, Gallacher D, 2006 ‘Survey of Chronic Pain in Europe: Prevalence, impact on daily life and treatment, Eur J Pain, vol.10, pp. 287-333
  11. 11Eccleston C, 2013, ‘A normal psychology of everyday pain’, The International Journal of Clinical Practice, vol.67, no.178, p.47
  12. 12Better Health Channel, Medications – non-steroidal anti-inflammatory drugs, [Accessed 11 January 2017]
    https://www.betterhealth.vic.gov.au/health/conditionsandtreatments/medications-non-steroidal-anti-inflammatory-drugs
  13. 13Better Health Channel, Medications – non-steroidal anti-inflammatory drugs, [Accessed 11 January 2017]
    https://www.betterhealth.vic.gov.au/health/conditionsandtreatments/medications-non-steroidal-anti-inflammatory-drugs
  14. 14 Better Health Channel, Medications – non-steroidal anti-inflammatory drugs, [Accessed 11 January 2017]
    https://www.betterhealth.vic.gov.au/health/conditionsandtreatments/medications-non-steroidal-anti-inflammatory-drugs
  15. 15 TGA, OTC Medicine Monograph: Ibuprofen in oral use, [Accessed 16 January 2017]
    https://www.tga.gov.au/otc-medicine-monograph-ibuprofen-oral-use
  16. 16TGA, OTC Medicine Monograph: Ibuprofen in oral use, [Accessed 16 January 2017]
    https://www.tga.gov.au/otc-medicine-monograph-ibuprofen-oral-use
  17. 17NPS Australia, What is the difference between paracetamol and ibuprofen? [Accessed 12 January 2017]
    http://www.nps.org.au/topics/how-to-be-medicinewise/Medicinewise-questions/medicinewise-questions/treating-pain-and-fever-in-children
  18. 18NPS Australia, What is the difference between paracetamol and ibuprofen? [Accessed 112 January 2017]
    http://www.nps.org.au/topics/how-to-be-medicinewise/Medicinewise-questions/medicinewise-questions/treating-pain-and-fever-in-children
  19. 19 Mayo Clinic, Ibuprofen (Oral Route), [Accessed 12 January 2017]
    http://www.mayoclinic.org/drugs-supplements/ibuprofen-oral-route/proper-use/drg-20070602
  20. 20 May Clinic, Ibuprofen (Oral Route), [Accessed 12 January 2017]
    http://www.mayoclinic.org/drugs-supplements/ibuprofen-oral-route/proper-use/drg-20070602
  21. 21TGA, OTC Medicine Monograph: Ibuprofen in oral use, [Accessed 16 January 2017]
    https://www.tga.gov.au/otc-medicine-monograph-ibuprofen-oral-use
  22. 22TGA, OTC Medicine Monograph: Ibuprofen in oral use, [Accessed 16 January 2017]
    https://www.tga.gov.au/otc-medicine-monograph-ibuprofen-oral-use
  23. 23Better Health Channel, Medications – non-steroidal anti-inflammatory drugs, [Accessed 31 January 2017]
    https://www.betterhealth.vic.gov.au/health/conditionsandtreatments/medications-non-steroidal-anti-inflammatory-drugs
  24. 24NPS Australia, Side effects of Ibuprofen, [Accessed 11 January 2017]
    http://www.nps.org.au/medicines/muscles-bones-and-joints/anti-inflammatory-medicines-nsaids/ibuprofen/for-individuals/what-are-the-side-effects-of-ibuprofen
  25. 25 Mayo Clinic, Ibuprofen (Oral Route), [Accessed 12 January 2012]
    http://www.mayoclinic.org/drugs-supplements/ibuprofen-oral-route/side-effects/drg-20070602
  26. 26NPS Australia, Side effects of Ibuprofen, [Accessed 11 January 2017]
    http://www.nps.org.au/medicines/muscles-bones-and-joints/anti-inflammatory-medicines-nsaids/ibuprofen/for-individuals/what-are-the-side-effects-of-ibuprofen
  27. 27NPS Australia, Side effects of Ibuprofen, [Accessed 11 January 2017]
    http://www.nps.org.au/medicines/muscles-bones-and-joints/anti-inflammatory-medicines-nsaids/ibuprofen/for-individuals/what-are-the-side-effects-of-ibuprofen
  28. 28Better Health Channel, Medications – non-steroidal anti-inflammatory drugs, [Accessed 13 January 2017]
    https://www.betterhealth.vic.gov.au/health/conditionsandtreatments/medications-non-steroidal-anti-inflammatory-drugs