by Q: I take Advil fairly regularly for pain, but how do I know if I’m taking more than is safe?
Headaches. Fevers. Period pains. Back pain.
These are all symptoms that can be treated with ibuprofen, a medication best known by one of its brand names, Advil.
Given the drug’s broad analgesic effects, excellent safety profile, and over-the-counter availability, it’s no surprise that some people take the small, brownish-red tablets whenever they feel the slightest twinge of discomfort.
“It’s my go-to when I’m in pain,” said Candy Tsourounis, a professor of clinical pharmacy at the University of California, San Francisco.
Still, ibuprofen, which is also sold under brand names such as Motrin and Nuprin, may pose certain health risks, especially for those with kidney or stomach problems.
Here’s how to feel good and stay safe.
How to know if you are overdoing it
Scan the label on over-the-counter ibuprofen and you’ll see that adults and children ages 12 and older are recommended to take one (or two, if necessary) 200-milligram tablets, capsules, or gelcaps every four to six hours while the symptoms persist. And those taking the medication should not exceed 1,200 milligrams (or six pills) in 24 hours.
But since doctors sometimes prescribe ibuprofen in much higher dosesup to 3,200 milligrams per day, it can be difficult to say how much is too much.
This discrepancy is rooted in security concerns. The Food and Drug Administration sets strict dosage limits for over-the-counter medications because they can be taken by people with various risk factors, Dr. Tsourounis said. If you are unlikely to have an adverse reaction, your doctor may prescribe a higher dose.
Even with over-the-counter ibuprofen, doctors sometimes recommend patients take up to 3,200 milligrams per day for a short period (up to a week or two) because the anti-inflammatory effects are better at higher doses, Lauren Haggerty said. clinical pharmacist at Johns Hopkins Medicine. This could happen after an injury or surgery, she said.
If you haven’t consulted a doctor about how much is safe, or if you’re unsure of your risk factors, it’s best not to exceed the recommended limit of 1,200 milligrams per day, Dr. Tsourounis said.
Since ibuprofen can upset your stomach, consider taking it with at least a few bites of food; Dairy products or non-dairy alternatives are especially helpful, Dr. Tsourounis said.
Be careful not to accidentally take more than intended. “I have patients who don’t know that Advil and generic ibuprofen are the same, so they could take both,” said Dr. Sarah Ruff, a UNC Family Medicine physician in Durham, North Carolina.
Also note that ibuprofen is sometimes added to certain cold medications, such as Sudafed PE Head Congestion and Pain Relief, so always read the ingredients list on medications before using them.
When to be more cautious
Ibuprofen belongs to a class of medications known as nonsteroidal anti-inflammatory drugs or NSAIDs, which reduce pain and inflammation by blocking the activity of certain enzymes, Dr. Tsourounis said. That’s why tamping them often makes you feel better.
But these enzymes also help maintain kidney and liver function and regulate fluid and electrolyte balance in the body, Dr. Tsourounis said. Therefore, taking ibuprofen can be dangerous for patients with kidney disease or failure; those with liver damage or cirrhosis; and people with conditions that put pressure on their kidneys, such as high blood pressure or heart failure.
People at high risk for these conditions (as well as stomach ulcers, heart attacks, strokes or bleeding problems) should talk to their doctors before taking ibuprofen, Dr. Haggerty said. The same thing happens if you are pregnant; According to the FDA, ibuprofen is not recommended at 20 weeks or later because in rare cases it can damage the kidneys of the fetus.
People who take medications such as diuretics, blood thinners, ACE inhibitors, or ARBs (angiotensin receptor blockers) to manage cardiovascular problems should also be careful, Dr. Tsourounis said, because ibuprofen puts pressure on the kidneys and blood vessels. heart.
To reduce these health risks, don’t take the maximum recommended dose for more than one or two weeks at a time, Dr. Ruff cautioned. “If you need it for more than two weeks, that’s a good sign to see your doctor.”
When taken for long periods of time, ibuprofen can also increase the risk of stomach ulcers, Dr. Ruff said. The medication inhibits enzymes that, among other things, help in the production of mucus that Coats and protects the lining of the stomach. — So, without these enzymes, the stomach becomes vulnerable to irritation and damage.
And, ironically, regular use of ibuprofen among people with headache disorders (such as migraines) can cause rebound headachesfor reasons doctors don’t fully understand.
“It’s really frustrating for patients, because if they find themselves in that situation, the only way to make it go away is to stop taking all the pain medications,” Dr. Ruff said. “And that’s a painful process.”
