Q: I take a couple of over-the-counter ibuprofen tablets a least twice per day and often three times per day. How long can a person safely continue taking it?
A: Ibuprofen is one of the nonsteroidal anti-inflammatory drugs (NSAIDs). It's sold under brand names, such as Advil and Motrin. It's also widely available as less expensive generic versions. Other over-the-counter NSAIDs include aspirin and naproxen (Aleve, generic versions).
As with most medicine, the higher the dose of an NSAID, the more likely you'll have side effects. The typical over-the counter ibuprofen tablet contains 200 milligrams (mg) of active ingredient. So you're taking between 800 and 1,200 mg each day. I know that seems like a lot, but it's actually a fairly low dose. For some conditions, people may take as much as 3,200 mg daily.
The safest general advice for ibuprofen and other NSAIDs is the lowest effective dose for the shortest time. But for chronic conditions like arthritis, that usually won't work.
Ibuprofen and the other NSAIDs tend to irritate the stomach lining. So the most common side effect from the amount of ibuprofen you're taking is an upset stomach. You may experience a burning pain in the upper part of your abdomen, mild nausea or a loss of appetite. To prevent these problems, try taking NSAIDs at mealtimes or with an antacid.
NSAIDS can cause other side effects, but these are less common. For instance, NSAIDs may cause:
Another common painkiller, acetaminophen (Tylenol). It provides pain relief but does not reduce inflammation. It doesn't cause the bleeding problems and other side effects associated with NSAIDs. But too much acetaminophen can build up and cause liver damage.
A newer strategy for pain relief is to combine ibuprofen and acetaminophen. For example, you might try just 200 mg of ibuprofen and 325 mg of acetaminophen together. And you could safely double the ibuprofen dose with the same 325 mg of ibuprofen on occasion. If that still is not sufficient, it's time to talk with your doctor.
(Howard LeWine, M.D. is an internist at Brigham and Women's Hospital in Boston and assistant professor at Harvard Medical School. For additional consumer health information, please visit www.health.harvard.edu.)
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