Judi asked
I had a tooth extracted on Monday and have been taking OTC ibuprofren (200 mg) every 4 hrs. This seems to help greatly with the pain. Can I take this much for a few days until the healing gets better?
At a glance
- Long-term use of ibuprofen is associated with several adverse effects, including gastrointestinal bleeding and cardiac events.
- Over-the-counter ibuprofen is recommended to be used for no more than 10 days unless otherwise directed by your doctor.
Answer
As a general rule of thumb, over the counter ibuprofen should be used at the lowest effective dose for the shortest possible duration to reduce the risk of adverse effects.
Labeling for over the counter ibuprofen products recommend:
- A maximum dose of 1,200 mg per day (six 200 mg tablets).
- A maximum of 10 days of therapy, unless directed by a clinician.
Taking ibuprofen for long periods of time increases the risk of several gastrointestinal related disorders, including ulcers and bleeds. Additionally, studies show it can increase the risk of cardiovascular events, such as stroke and heart attack.
About Ibuprofen
Ibuprofen is a nonsteroidal anti-inflammatory drug (NSAID). It belongs to the propionic acid chemical class of NSAIDs. It is available generically and in several brand name products (e.g. Advil, Motrin).
Ibuprofen is utilized for many purposes, including for:
- Dental pain
- Fever
- Headaches or migraines
- Osteoarthritis (OA)
- Rheumatoid arthritis (RA)
- Menstrual pains
- Minor aches and pains
While effective, extended or chronic use of ibuprofen can result in a variety of side effects, including:
- Gastritis
- Ulceration
- GI bleeding
In fact, all NSAIDs carry an increased risk of serious gastrointestinal adverse effects including:
- Bleeding
- Ulceration
- Perforation of the stomach or intestines
- Increased risk of serious cardiovascular (CV) events (e.g. heart attack and stroke)
Prolonged use of ibuprofen can increase the risk of these adverse effects.
Due to the risks of ibuprofen use, it is important to use cautiously if you:
- Have a history of or active GI disease (e.g. peptic ulcer disease or GI bleeding).
- Are on concomitant oral corticosteroid therapy.
- Are on concomitant anticoagulant, anti-platelet or anti-hypertensive therapy (including low-dose aspirin).
- Are on chemotherapy.
- Are a tobacco user or are an alcoholic.
- Have a history of ulcerative colitis, or Crohn's disease.
- Have been diagnosed with renal failure.
- Have been diagnosed with heart disease.
Ibuprofen, while available over the counter as 200 mg tablets, is also available in higher, prescription-only strengths:
- 400 mg
- 600 mg
- 800 mg
Ibuprofen Limits
If you are prescribed ibuprofen, it may be for longer than 10 days. However, 10 days of continuous use is the limit for over the counter use. A longer duration of therapy should only be at the direction of your doctor.
Additionally, the maximum daily dose for over the counter ibuprofen use is 1,200 mg. For prescription use, the maximum daily dose is 3,200 mg per day.
References
- ClinicalKey: Ibuprofen Monograph. ClinicalKey (Subscription Required)
- A Comprehensive Review of Non-Steroidal Anti-Inflammatory Drug Use in The Elderly. PubMed
