How Much Ibuprofen Can I Take?

orange ibuprofen pills

The Bottom Line

Ibuprofen is a pain medication available both over-the-counter and by prescription. It works by blocking substances produced by the body that stimulate pain and inflammation. While generally considered safe with routine use, ibuprofen increases the risk of stomach ulcers, bleeding, and kidney problems.

blue reflective advil pills

What are Advil and Motrin? What are they used for?

Advil and Motrin are common brand names for ibuprofen. Ibuprofen is a non-steroidal anti-inflammatory drug (NSAID) that reduces pain, inflammation, and fever by blocking the production of prostaglandins. Ibuprofen can be used to treat a variety of conditions, including headache, arthritis, body aches, toothache, menstrual cramps, and fever. It can also be used to treat sprains, strains, fractures, and post-operative pain. It can be used alone or in combination with other pain medication. 

How much ibuprofen can I take? How often can I take it?

In adults, the prescription dose of ibuprofen is 400 mg every 4 to 6 hours or 600 to 800 mg every 6 to 8 hours as needed, with a maximum dose of 3200 mg per day. The over-the-counter ibuprofen dose is 400 mg every 4 to 6 hours, with a maximum of 1200 mg per day. Dosing for children is based on weight. Refer to the product label or the doctor’s instructions for dosing in children. Ibuprofen should not be taken for longer than 10 days unless directed by a physician. 

What are the side effects of ibuprofen?

Ibuprofen can cause stomach ulcers and intestinal bleeding. Talk to your doctor if you have a history of stomach ulcers or bleeding problems or are on other blood thinners. Ibuprofen can also cause kidney problems, particularly in combination with other medicines that affect the kidney, such as diuretics (i.e., water pills) and blood pressure pills. Other milder side effects include drowsiness, abdominal discomfort, and constipation. Ibuprofen can cause allergic reactions, such as rash, wheezing, and—rarely—anaphylaxis. While allergies to ibuprofen are more common in people who have an aspirin allergy, many people who are allergic to aspirin can take ibuprofen without a problem.

Acetaminophen vs. ibuprofen vs. naproxen: What are the differences? 

Naproxen and ibuprofen are both NSAIDs, but naproxen lasts longer than ibuprofen. Ibuprofen’s effects last around 4 to 6 hours compared to 8 to 12 hours for naproxen. Acetaminophen also works in the body to decrease the formation of prostaglandins to relieve pain and fever like NSAIDs, but acetaminophen does not work as well for inflammation. Acetaminophen is less likely to cause problems with bleeding, stomach ulcers, and kidneys than NSAIDs.

Can you take Tylenol (i.e., acetaminophen) and ibuprofen together?

Acetaminophen and ibuprofen can be used together for the treatment of pain. The combined use of acetaminophen and ibuprofen—or alternating these two drugs for treating fever in children—may be required for fever control, but must be done carefully to avoid medication errors. Most pediatricians suggest not treating a fever unless the temperature is higher than 101o  F. Start with 1 medication and only add the second if the child is very uncomfortable or fever control is not achieved with 1. If 2 drugs are required, acetaminophen and ibuprofen can be alternated every 3 to 4 hours.

Ibuprofen contraindications: Can you take ibuprofen with blood pressure medications?

Ibuprofen causes small increases in blood pressure in people with hypertension, even if they are being treated with blood pressure medication. It is generally safe to take low doses of ibuprofen for a few days if hypertensive or being treated for high blood pressure. Consult your physician if higher doses are needed over long periods. NSAIDs like ibuprofen can cause problems in people with high blood pressure and congestive heart failure because they can cause the kidneys to retain salt and water. Ibuprofen can also interact with aspirin and platelet medications given to people following a heart attack. There is also an increased risk of bleeding in these cases.

Can you take ibuprofen while pregnant?

While there is no definitive evidence that ibuprofen given early in pregnancy causes fetal harm, other medications, such as acetaminophen, are considered safer in pregnancy. Ibuprofen should be avoided later in pregnancy because it can cause problems with the baby’s heart and lungs as they adapt to breathing outside of the womb.  

I took naproxen and ibuprofen together: What should I do?

It is not advised to take ibuprofen and naproxen together because they are both NSAIDs, which increases the risk of side effects. Seek medical attention if you experience any unusual bleeding or bruising, or experience other signs or symptoms such as dizziness; red or black tarry stools; or coughing or vomiting fresh or dried blood. Dried blood might look like coffee grounds. 

If you take too much ibuprofen or experience adverse or unexpected symptoms, get guidance from Poison Control immediately. Help from Poison Control is available online from the webPOISONCONTROL online tool  or by phone at 1-800-222-1222. Both options are free, confidential, and available 24 hours a day.
 
Stephanie Igharoro
PharmD Candidate 2023

Maryann Amirshahi, PharmD, MD, MPH, PhD
Medical Toxicologist

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Poisoned?

Call 1-800-222-1222 or

HELP ME online

Prevention Tips

  • Always store medicines away from and out of sight of children.
  • Use measuring spoons or syringes to give ibuprofen liquid, as they are more accurate than household spoons.
  • Do not take more ibuprofen than recommended or combine ibuprofen with other NSAIDs, like naproxen. 
  • Ask your doctor or pharmacist if you can take ibuprofen safely with other medications you are on. 
  • People with kidney problems, poorly controlled blood pressure, heart failure, and those with a history of bleeding problems should talk to their physician before taking ibuprofen. 
  • Ibuprofen should not be taken in the later stages of pregnancy. 

This Really Happened

Case 1: A 2-year-old girl drank approximately 3 oz of over-the-counter ibuprofen suspension. Her mother called Poison Control and the Poison Specialist determined that based on the girl’s weight, it would be safe to observe her at home. The child only developed a stomachache, which lasted a few hours and got better after she was given something to eat. No serious symptoms occurred. 

Case 2:
A 68-year-old woman with high blood pressure fractured her ankle. She began taking over-the-counter ibuprofen but her ankle was hurting badly, so she took 2 to 3 times the recommended dose. She went to the emergency department because she had dark urine and was making less urine than usual. Her doctor found that her kidneys were not working well, likely because she had taken too much ibuprofen and because of an interaction with her blood pressure medication, lisinopril. Both medications were stopped, and her kidney function normalized after 1 week. 

Case 3: A 52-year-old man presented to the emergency department vomiting dark brown material that looked like coffee grounds. He had torn his rotator cuff 3 weeks prior and had been taking 2 times the prescribed dose of ibuprofen while awaiting surgery. In the emergency department, they found he had anemia and was bleeding from somewhere in his intestines. He was admitted to the hospital and given a blood transfusion and stomach ulcer medications, and an endoscopy was performed. The gastroenterologist found a bleeding ulcer in his stomach. They stopped the ibuprofen and continued medications to help manage his stomach acid and he made a full recovery. 

Case 4: A 19-year-old woman intentionally took at least half a bottle of ibuprofen that contained 500 tablets in a suicide attempt. Her family brought her to the emergency department when they found her. Initially, she had some abdominal pain and vomiting, and while she was in the emergency department she became so sleepy that she needed a breathing tube and a ventilator. She was in the intensive care unit for a couple of days and had an injury to her kidneys, but went on to recover fully after a week in the hospital.

References

Grosser T, Ricciotti E, FitzGerald GA. The Cardiovascular Pharmacology of Nonsteroidal Anti-Inflammatory Drugs. Trends Pharmacol Sci. 2017;38(8):733-748. doi:10.1016/j.tips.2017.05.008

Weibert RT, Townsend RJ, Kaiser DG, Naylor AJ. Lack of ibuprofen secretion into human milk. Clin Pharm. 1982;1(5):457-458.

Paul IM, Walson PD. Acetaminophen and ibuprofen in the treatment of pediatric fever: a narrative review. Curr Med Res Opin. 2021;37(8):1363-1375. doi:10.1080/03007995.2021.1928617

Tan E, Braithwaite I, McKinlay CJD, Dalziel SR. Comparison of Acetaminophen (Paracetamol) With Ibuprofen for Treatment of Fever or Pain in Children Younger Than 2 Years: A Systematic Review and Meta-analysis. JAMA Netw Open. 2020;3(10):e2022398. Published 2020 Oct 1. doi:10.1001/jamanetworkopen.2020.22398

Smith C, Goldman RD. Alternating acetaminophen and ibuprofen for pain in children. Can Fam Physician. 2012;58(6):645-647.

Ong CK, Seymour RA, Lirk P, Merry AF. Combining paracetamol (acetaminophen) with nonsteroidal antiinflammatory drugs: a qualitative systematic review of analgesic efficacy for acute postoperative pain. Anesth Analg. 2010;110(4):1170-1179. doi:10.1213/ANE.0b013e3181cf9281

Mother To Baby | Fact Sheets [Internet]. Brentwood (TN): Organization of Teratology Information Specialists (OTIS); 1994-. Ibuprofen. 2020 Nov 1. Available from: https://www.ncbi.nlm.nih.gov/books/NBK582759/

Lands LC & Stanojevic S: Oral non-steroidal anti-inflammatory drug therapy for lung disease in cystic fibrosis. Cochrane Database Syst Rev 2016; 2016(4):CD001505.

U.S. Preventive Services Task Force. Routine aspirin or nonsteroidal anti-inflammatory drugs for the primary prevention of colorectal cancer: U.S. Preventive Services Task Force recommendation statement. Ann Intern Med. 2007 Mar 6;146(5):361-4. 

Section on Clinical Pharmacology and Therapeutics; Committee on Drugs; Sullivan JE, Farrar HC. Fever and antipyretic use in children. Pediatrics. 2011 Mar;127(3):580-7.

Edwards JE, McQuay HJ, Moore RA, Collins SL. Reporting of adverse effects in clinical trials should be improved: lessons from acute postoperative pain. J Pain Symptom Manage. 1999 Dec;18(6):427-37.

Fosnes GS, Lydersen S, Farup PG. Constipation and diarrhoea - common adverse drug reactions? A cross sectional study in the general population. BMC Clin Pharmacol. 2011 Feb 18;11:2.

Ruschitzka F, Borer JS, Krum H, Flammer AJ, Yeomans ND, Libby P, Lüscher TF, Solomon DH, Husni ME, Graham DY, Davey DA, Wisniewski LM, Menon V, Fayyad R, Beckerman B, Iorga D, Lincoff AM, Nissen SE. Differential blood pressure effects of ibuprofen, naproxen, and celecoxib in patients with arthritis: the PRECISION-ABPM (Prospective Randomized Evaluation of Celecoxib Integrated Safety Versus Ibuprofen or Naproxen Ambulatory Blood Pressure Measurement) Trial. Eur Heart J. 2017 Nov 21;38(44):3282-3292.

Moore RA, Derry S, Wiffen PJ, Straube S, Aldington DJ. Overview review: Comparative efficacy of oral ibuprofen and paracetamol (acetaminophen) across acute and chronic pain conditions. Eur J Pain. 2015 Oct;19(9):1213-23.

Moore RA, Derry S, Wiffen PJ, Straube S. Effects of food on pharmacokinetics of immediate release oral formulations of aspirin, dipyrone, paracetamol and NSAIDs - a systematic review. Br J Clin Pharmacol. 2015 Sep;80(3):381-8.

Barron SE, Perry JR, Ferslew KE. The effect of ibuprofen on ethanol concentration and elimination rate. J Forensic Sci. 1992 Mar;37(2):432-5. 

Kaufman DW, Kelly JP, Wiholm BE, Laszlo A, Sheehan JE, Koff RS, Shapiro S. The risk of acute major upper gastrointestinal bleeding among users of aspirin and ibuprofen at various levels of alcohol consumption. Am J Gastroenterol. 1999 Nov;94(11):3189-96.

Salort-Llorca C, Mínguez-Serra MP, Silvestre-Donat FJ. Interactions between ibuprofen and antihypertensive drugs: incidence and clinical relevance in dental practice. Med Oral Patol Oral Cir Bucal. 2008 Nov 1;13(11):E717-21.

Poisoned?

Call 1-800-222-1222 or

HELP ME online

Prevention Tips

  • Always store medicines away from and out of sight of children.
  • Use measuring spoons or syringes to give ibuprofen liquid, as they are more accurate than household spoons.
  • Do not take more ibuprofen than recommended or combine ibuprofen with other NSAIDs, like naproxen. 
  • Ask your doctor or pharmacist if you can take ibuprofen safely with other medications you are on. 
  • People with kidney problems, poorly controlled blood pressure, heart failure, and those with a history of bleeding problems should talk to their physician before taking ibuprofen. 
  • Ibuprofen should not be taken in the later stages of pregnancy. 

This Really Happened

Case 1: A 2-year-old girl drank approximately 3 oz of over-the-counter ibuprofen suspension. Her mother called Poison Control and the Poison Specialist determined that based on the girl’s weight, it would be safe to observe her at home. The child only developed a stomachache, which lasted a few hours and got better after she was given something to eat. No serious symptoms occurred. 

Case 2:
A 68-year-old woman with high blood pressure fractured her ankle. She began taking over-the-counter ibuprofen but her ankle was hurting badly, so she took 2 to 3 times the recommended dose. She went to the emergency department because she had dark urine and was making less urine than usual. Her doctor found that her kidneys were not working well, likely because she had taken too much ibuprofen and because of an interaction with her blood pressure medication, lisinopril. Both medications were stopped, and her kidney function normalized after 1 week. 

Case 3: A 52-year-old man presented to the emergency department vomiting dark brown material that looked like coffee grounds. He had torn his rotator cuff 3 weeks prior and had been taking 2 times the prescribed dose of ibuprofen while awaiting surgery. In the emergency department, they found he had anemia and was bleeding from somewhere in his intestines. He was admitted to the hospital and given a blood transfusion and stomach ulcer medications, and an endoscopy was performed. The gastroenterologist found a bleeding ulcer in his stomach. They stopped the ibuprofen and continued medications to help manage his stomach acid and he made a full recovery. 

Case 4: A 19-year-old woman intentionally took at least half a bottle of ibuprofen that contained 500 tablets in a suicide attempt. Her family brought her to the emergency department when they found her. Initially, she had some abdominal pain and vomiting, and while she was in the emergency department she became so sleepy that she needed a breathing tube and a ventilator. She was in the intensive care unit for a couple of days and had an injury to her kidneys, but went on to recover fully after a week in the hospital.