Which medical conditions and medications are contraindicated for ibuprofen?

What is ibuprofen?

In its oral form for adults (mainly tablets or capsules), ibuprofen is a drug used to treat mild to moderate pain and fevers, similar to that of acetaminophen. However, unlike acetaminophen, ibuprofen also can be used to treat inflammation since it is an anti-inflammatory.

When and how to take ibuprofen?

The following recommendations apply to an adult, 15 years and older.

• 200 to 400 milligrams per dose
• Each dose should be at least 6 hours apart.
• The maximum daily dose should not exceed 1,200 milligrams, i.e. 6 tablets of 200 mg or 3 tablets of 400 mg.
• It is advisable to take ibuprofen in the middle of meals to limit any stomach discomfort or heartburn it may cause.

When taking ibuprofen daily, if a fever persists for more than 3 days or if pain persists for more than 5 days, it is advisable to consult with your doctor to re-evaluate the treatment.

What medications contain ibuprofen?

There are several medications that contain ibuprofen that are available without a prescription. Among them, the most common are:

• Advil 

• Motrin

• Children's Motrin

• Nuprin

With which medical conditions is ibuprofen contraindicated ?

Medical conditions

Ibuprofen can damage the kidneys by reducing blood flow to them and it can aggravate infections. Ibuprofen also prevents production of the enzyme that protects the stomach lining, making individuals more prone to suffer heartburn after ingestion of the medication. Additionally, ibuprofen inhibits the enzyme responsible for platelet aggregation, which as a result decreases the body’s ability to form blood clots, making it harder for the body to stop (clot) bleeding.

These reasons explain, among others, why ibuprofen should not be taken if:

• You have or are prone to bleeding disorders

• You have or are prone to stomach ulcers or have a history of gastrointestinal bleeding

• You have chickenpox

• You are diagnosed with asthma or a history of asthma

• You are diagnosed with systemic lupus erythematosus

• You are diagnosed with acute kidney failure

• You are diagnosed with severe liver failure

• You are diagnosed with severe heart failure

Pregnancy

If you are pregnant, you should stop taking ibuprofen by the fifth month of pregnancy as continued consumption may lead to complications or death of the fetus in-utero. If you are breast-feeding, taking ibuprofen is not recommended as the medication could be passed to the baby via breast milk.

Infections

In case of a fever and/or pain related to an infection (angina, rhinopharyngitis, otitis, cough, lung infection, skin lesion or chickenpox) consult with your doctor and use acetaminophen instead. Ibuprofen can mask signs of infection, which can lead to complications if not treated early.

This article is not a substitute for a medical consultation. If in doubt or if you have any questions or concerns, consult with your doctor or pharmacist.

With which medications is ibuprofen be contraindicated?

Anticoagulants  / Antiplatelet medications

Ibuprofen is not recommended if you are being treated with anticoagulants, such as warfarin (Coumadin, Jantoven), heparin, rivaroxaban (Xarelto), edoxaban (Savayasa), dabigatran (Pradaxa), and apixaban (Eliquis). Ibuprofen is also not recommended if you are being treated with antiplatelet medications, such as clopidogrel (Plavix), dipyridamole, dipyridamole/aspirin (Aggrenox), prasugrel (Effient), andticagrelor (Brilinta).

Taking these medications with ibuprofen can increase the risk of bleeding.

Other nonsteroidal anti-inflammatory drugs (NSAIDs)

Never take several medications containing ibuprofen; the effectiveness of the ibuprofen will not increase, and you will be at an increased risk to overdose.

Do not combine ibuprofen with aspirin or other nonsteroidal anti-inflammatory drugs, such as naproxen (Aleve) and ketoprofen. Combining ibuprofen with other NSAIDS or several medications of ibuprofen can increase the risk of serious side effects, such as GI bleeding, decreased ability to form blood clots (stop bleeding), and cardiovascular problems.

What are the other uses of ibuprofen?

In addition to the oral form of ibuprofen for adults (above-mentioned), ibuprofen can be found in a large number of medications, alone or in combination, and may be used for different indications.

• Oral use as a (flavoured) oral liquid for children

• Topical creams, gels, and rubs for osteoarthritis, sprains, pain, bruises, superficial tendinitis

• In combination with codeine (ibuprofen-codeine) to control moderate to severe pain

• In combination with pseudoephedrine tablets (such as Advil Cold and Sinus) to treat stuffy nose, sinus congestion, cough, and pain, and fever.

• In combination with levomenthol or menthol in gel/lotion form to treat pain in post-traumatic injuries, sprains, and bruises or edemas of traumatic origin

For each of the above-mentioned medications, be sure to read the instructions for use carefully. Instructions for use, dose, and contraindications for the above-mentioned medications are not necessarily the same as those for the oral form of exclusively ibuprofen for adults, such as Advil and Motrin.

If you take ibuprofen regularly without a prescription to treat pain, consider discussing this with your doctor other more effective treatments to relieve your pain.

Do you use ibuprofen regularly? What do you use it to treat? Were you already aware of the contraindications with ibuprofen?

Share your experience and opinion in the comments below.