September 22, 2018
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Don't Go Overboard With Ibuprofen

by Wellness Letter  

Many people who regularly take the pain reliever ibuprofen unknow­ingly exceed the daily dosing limits, according to a 2018 study in Pharmaco­epidemiology & Drug Safety.

Ibuprofen is a nonsteroidal anti-inflammatory drug (NSAID), along with aspirin, naproxen, and others. Over-the-counter (OTC) ibu­profen is sold as a generic and under brand names such as Advil and Motrin; it is also available by prescription at higher doses. The recommended daily OTC maximum, set by the FDA and stated on ibuprofen labels, is 1,200 milligrams, or six regular-strength tablets (the maximum is higher for prescription ibuprofen).

In the study, 1,326 ibuprofen users com­pleted a one-week diary about their intake of NSAIDs; 87 percent took OTC ibuprofen, the rest prescription ibuprofen. More than one-third of these ibuprofen users also took another NSAID, usually naproxen, though most of them didn’t know that these are related drugs. Low-dose aspirin, taken for heart health, was not included in the tallies.

The diaries showed that 12 percent of OTC ibuprofen users exceeded the daily maximum at least one day that week; 4 per­cent exceeded the maximum for naproxen (660 milligrams); another 4 percent exceeded the maximum for a combination of NSAIDs. Ibuprofen users who also took naproxen were even more likely to exceed the maximum for that drug than for ibuprofen.

Men were more likely to exceed dosing recommendations, as were people who reported ongoing pain or poor physical function and those who expressed an “okay to choose my own dose” attitude.

NSAIDs, especially when taken long term or overused, have a range of potential adverse effects, including gastrointestinal bleeding, increased risk of heart attacks and strokes, and kidney damage. For healthy people who take ibuprofen and other OTC pain relievers as directed, the risks are small. However, because these drugs are so popular, thousands of Americans may be adversely affected.

Don’t let these concerns prevent you from taking the drugs if you need them, but do follow label instructions and consult your health care provider if you are taking the drugs often.

This article first appeared in the UC Berkeley Wellness Letter.