Ibuprofen Side Effects: What You Need to Know
Ibuprofen is one of the most commonly used over-the-counter pain relievers in the world. Sold under brand names like Advil and Motrin, it's a nonsteroidal anti-inflammatory drug (NSAID) used for headaches, muscle pain, arthritis, menstrual cramps, and fever. While generally safe when used as directed, ibuprofen does carry real risks — especially with long-term or high-dose use.
Common Side Effects
These side effects affect roughly 1-10% of users and usually resolve on their own:
- Upset stomach and nausea — the most common complaint
- Heartburn — ibuprofen can irritate the stomach lining
- Dizziness or headache — usually mild
- Bloating and gas
- Mild skin rash
Serious Side Effects
These are less common but require immediate medical attention:
- Signs of stomach bleeding: black/tarry stools, vomiting blood, stomach pain that doesn't go away
- Signs of heart attack or stroke: chest pain, sudden weakness, slurred speech, shortness of breath
- Severe allergic reaction: hives, facial swelling, difficulty breathing
- Signs of kidney problems: little or no urination, swelling in feet/ankles, unusual fatigue
- Signs of liver problems: dark urine, yellowing of skin/eyes, persistent nausea
Cardiovascular Risk
All NSAIDs, including ibuprofen, carry an FDA boxed warning about increased risk of heart attack and stroke. This risk increases with higher doses and longer duration of use. People with existing heart disease are at greatest risk, but it can occur even in people without prior cardiovascular problems.
Who Should Avoid Ibuprofen?
- People with a history of stomach ulcers or GI bleeding
- Anyone taking blood thinners like warfarin or Eliquis
- People with severe kidney or liver disease
- Anyone who has had an allergic reaction to aspirin or other NSAIDs
- Pregnant women, especially in the third trimester
- People about to undergo heart surgery (CABG)
Safer Alternatives
If ibuprofen isn't right for you, consider discussing these options with your doctor:
- Acetaminophen (Tylenol) — effective for pain and fever without the GI and cardiovascular risks of NSAIDs. Easier on the stomach but be careful not to exceed 3,000-4,000mg per day.
- Naproxen (Aleve) — another NSAID but with potentially lower cardiovascular risk than ibuprofen. Lasts longer (12 hours vs 4-6 hours).
- Topical NSAIDs — diclofenac gel applied directly to the skin reduces systemic side effects while providing local pain relief.
Safe Use Guidelines
- Use the lowest effective dose for the shortest time needed
- Don't exceed 1,200mg per day (OTC) or 3,200mg (prescription)
- Take with food or milk
- Don't combine with other NSAIDs (including aspirin for pain relief)
- Avoid alcohol while taking ibuprofen (increases bleeding risk)
- Stay hydrated — NSAIDs can affect kidney function