What is considered long-term use of ibuprofen

These common side effects of ibuprofen taken by mouth happen in more than 1 in 100 people. There are things you can do to help cope with them:

Headaches

Make sure you rest and drink plenty of fluids. Try not to drink too much alcohol. It's important not to take any other medicines for pain to help with headaches. Talk to your doctor if the headaches last longer than a week or are severe.

Feeling dizzy

If ibuprofen makes you feel dizzy, stop what you're doing and sit or lie down until you feel better. Avoid coffee, cigarettes and alcohol. If the dizziness does not get better within a couple of days, speak to your pharmacist or doctor. Do not drive or ride a bike while you're feeling dizzy.

Feeling sick (nausea)

Stick to simple meals. Do not eat rich or spicy food. Always take ibuprofen tablets, capsules, granules or liquid with a meal or snack or with a drink of milk.

Being sick (vomiting)

Have small, frequent sips of water to avoid dehydration. Speak to a pharmacist if you have signs of dehydration, such as peeing less than usual or having dark, strong-smelling pee. Do not take any other medicines to treat vomiting without speaking to a pharmacist or doctor.

If you take contraceptive pills and you're being sick, your contraception may not protect you from pregnancy. Check the pill packet for advice.

Wind

Try not to eat foods that cause wind (like lentils, beans and onions). Eat smaller meals, eat and drink slowly, and exercise regularly. There are pharmacy medicines that can also help, such as charcoal tablets or simeticone.

Indigestion

If you get repeated indigestion stop taking ibuprofen and see your doctor as soon as possible. If you need something to ease the discomfort, try taking an antacid, but do not put off going to the doctor.

Speak to a doctor or pharmacist if the advice on how to cope does not help and a side effect is still bothering you or does not go away.

Common side effects of gel, mousse and spray

You're less likely to have side effects when you apply ibuprofen to your skin than with tablets, capsules, granules or liquid because less gets into your body. But you may still get the same side effects, especially if you use a lot on a large area of skin.

Applying ibuprofen to your skin can sometimes cause your skin to become more sensitive than normal to sunlight. Speak to your doctor if this is a problem.

Serious side effects

Call a doctor or contact 111 straight away and stop taking ibuprofen if you have:

  • black poo or blood in your vomit – these can be signs of bleeding in your stomach
  • swollen ankles, blood in your pee or not peeing at all – these can be signs of a kidney problem

Go to 111.nhs.uk or call 111.

Serious allergic reaction

In rare cases, it's possible to have a serious allergic reaction (anaphylaxis) to ibuprofen.

Long term side effects

Ibuprofen can cause ulcers in your stomach or gut, especially if you take it by mouth for a long time or in big doses. If you need to take it for a long time your doctor may also prescribe a medicine to help protect your stomach.

Other side effects

These are not all the side effects of ibuprofen tablets, capsules and syrup. For a full list see the leaflet inside your medicines packet.

You can report any suspected side effect using the Yellow Card safety scheme.

Visit Yellow Card for further information.

Page last reviewed: 18 November 2021
Next review due: 18 November 2024

Ibuprofen is one of a group of drugs called non-steroidal anti-inflammatory drugs (NSAIDs). It's widely used for its pain-relieving and anti-inflammatory effects.

It’s available over the counter as tablets or capsules in doses of 200–400 mg and can be taken up to three times a day after food. Some tablets are designed to release the drug slowly over a period of time, and some people find these helpful for night-time pain relief.

Higher doses of ibuprofen are available on prescription and can be used if you have rheumatoid arthritis or another type of inflammatory arthritis.

Ibuprofen is also available in lipid-based soft capsules. These can be bought from pharmacies and are as effective as prescribed ibuprofen in relieving flaring joint pain. 

If ibuprofen doesn't give enough relief from pain, or if you need pain relief over a long period of time, then you should speak to your doctor, who may be able to prescribe a stronger type of NSAID or a combination of drugs that will be more effective.

Ibuprofen can usually be used in combination with paracetamol or a compound analgesic.

Side-effects and risks

As with other NSAIDS, ibuprofen can cause stomach-related side-effects, so you should speak to your doctor if you tend to have problems such as heartburn or indigestion. Your doctor may suggest a different type of NSAID and/or prescribe a drug called a proton pump inhibitor (PPI) to help protect your stomach.

Long-term use of NSAIDs, including ibuprofen, can also increase the risk of problems with your heart or circulation – especially if you have other risk factors for these conditions. Therefore you shouldn't take ibuprofen for long-term pain relief without seeing your doctor first, and you shouldn't take ibuprofen if you're also being prescribed another type of NSAID tablet.

Find out more about other NSAIDs that are available.

If you take more than the recommended dose, you could overdose. Call an ambulance straight away by dialling triple zero (000) if you or someone else has any of these symptoms (ambulance officers don’t need to involve the police):

  • confusion and disorientation
  • drowsiness
  • abdominal pain
  • blurred vision
  • tinnitus (ringing in the ears)
  • diarrhea
  • anxiety and paranoia
  • anaemia (low red blood cell count), nausea and vomiting
  • vomiting blood that may look like coffee grounds and bowel motions that look like black tar
  • severe allergic reaction, including swelling of the face
  • kidney and liver problems
  • seizures/convulsions
  • coma and death.1, 14, 5

Long-term effects

It’s best to discuss the side effects of long-term use with a medical practitioner. Regular use of ibuprofen may eventually cause:

  • anaemia due to bleeding in the stomach
  • impaired hearing
  • kidney and liver damage
  • bleeding in the stomach and bowels
  • increased risk of heart attack.1

Using ibuprofen with other drugs

The effects of taking ibuprofen with other drugs, including alcohol, prescription medications and other over-the-counter medicines, are often unpredictable.

Ibuprofen taken with alcohol can increase the risk of stomach irritation and discomfort.1

Ibuprofen can alter the effects of some blood pressure medicines and may increase the risk of bleeding if taken with medicines such as warfarin.1

Getting help

If your use of ibuprofen is affecting your health, family, relationships, work, school, financial or other life situations, you can find help and support.

Call 1300 85 85 84 to speak to a real person and get answers to your questions as well as advice on practical ‘next steps’.

If you pull a muscle while running, are experiencing menstrual cramps or have a killer headache, you’re likely to reach for an ibuprofen pill, such as Advil or Motrin, to reduce the inflammation and quash the pain. When taken correctly, ibuprofen is a safe and effective choice.

Available both over-the-counter and by prescription, ibuprofen is a nonsteroidal anti-inflammatory drug (NSAID) that inhibits cyclooxygenase enzymes to prevent or reduce pain and inflammation.

While ibuprofen works well when you take it as directed, taking more of the medicine or taking it too often is not helpful and can actually hurt you, says gastroenterologist Gerard Isenberg, MD.

“People who take it chronically are at risk of developing problems," he says. "A recent study showed that incorrect use of NSAIDs is estimated to account for 107,000 hospitalizations and 15,600 deaths annually in the United States.”

Risks of Incorrect Ibuprofen Use

Among the risks of chronic or incorrect ibuprofen use are:

  • Ulcers, with an annual incidence of 2 to 4 percent
  • Worsening kidney function
  • Cardiovascular issues, such as heart attack, heart failure, stroke and increased blood pressure
  • Gastrointestinal bleeding
  • Stomach upset and - rarely - a condition called microscopic colitis, which can cause diarrhea
  • Nausea
  • Complications with childbirth and in the newborn, when the mother takes ibuprofen during the third trimester (but ibuprofen use is fine when breastfeeding)

Ibuprofen is an appropriate option for most people, but Dr. Isenberg says it can cause these complications when:

  • Used by someone who has liver disease
  • Taken with another NSAID, such as aspirin
  • Taken with a blood thinner, such as Coumadin
  • Taken with other medications, such as clopidogrel, phenytoin or cyclosporine
  • Dosing instructions are ignored (i.e., taking too many at a time or taking subsequent doses too soon)
  • Used during the third trimester of pregnancy

If you choose to take ibuprofen to help you through an injury or other painful condition, Dr. Isenberg says you can mitigate your risk of developing side effects by following these five guidelines:

  1. Take the lowest dose that is effective for your symptoms.
  2. Consult your doctor before taking ibuprofen if you have a history of stomach, kidney or heart issues, or if you are pregnant.
  3. Ask your doctor about using a topical NSAID gel, such as Diclofenac, instead of oral ibuprofen for musculoskeletal pain. This gel, available in a patch, is a good choice for athletes.
  4. Consider taking something to reduce acid when taking ibuprofen. Check with your doctor and/or pharmacist to make sure you're not on other medications that can increase your chance for side effects.
  5. Ask your physician whether ibuprofen or another NSAID best treats your symptoms and has the fewest potential side effects.

“Ibuprofen is one of the most commonly used meds in the United States,” Dr. Isenberg says. “It has many therapeutic benefits and, despite some of the risks, a very strong safety profile. You just need to be cognizant of how much you use, for how long and whether you have any issues that could cause an increased risk of side effects.”

Gerard Isenberg, MD is a gastroenterologist and associate chief and director, Clinical Operations, Division of Gastroenterology and Liver Disease, and chief medical quality officer, University Hospitals Digestive Health Institute, at University Hospitals Cleveland Medical Center. You can request an appointment with Dr. Isenberg or any other medical provider online.

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