Ibuprofen (Advil, Motrin, Nurofen)
Ibuprofen is one of the most widely used over-the-counter pain relievers. It works well for headaches, muscle pain, menstrual cramps, and inflammation — but it interacts with many prescription medications.
What it's used for
Short-term relief of mild-to-moderate pain, fever reduction, and inflammation (arthritis, sprains, menstrual cramps). Available OTC in 200mg tablets and by prescription up to 800mg.
How it works
Ibuprofen inhibits COX-1 and COX-2 enzymes, reducing the production of prostaglandins — chemicals that cause pain, fever, and inflammation.
Typical dosing (adults)
- OTC: 200-400mg every 4-6 hours as needed, max 1200mg/day without medical supervision.
- Prescription: up to 800mg every 6-8 hours, max 3200mg/day.
- Take with food to reduce stomach upset.
Key interactions
- Warfarin: major — significantly increased bleeding risk.
- Aspirin (daily low-dose for heart): moderate — may blunt the cardioprotective effect and increase GI bleeding.
- SSRIs (sertraline, fluoxetine): moderate — increased GI bleeding risk.
- ACE inhibitors (lisinopril), ARBs, diuretics: moderate — reduced blood pressure control, possible kidney injury.
- Methotrexate: moderate-major — raised methotrexate levels.
- Lithium: moderate — raised lithium levels.
Common side effects
Stomach upset, heartburn, nausea. Long-term or high-dose use increases the risk of GI bleeding, ulcers, kidney issues, and cardiovascular events.
Who should be cautious
- People with stomach ulcers, kidney disease, heart failure, or uncontrolled high blood pressure.
- Last trimester of pregnancy (avoid).
- People over 65 — consider acetaminophen as a first-line alternative when appropriate.
What to ask your pharmacist
- Is ibuprofen safe with my other medications?
- Should I take it with food?
- How long is it safe to take daily?
- Is acetaminophen a better choice for my situation?