About this medication
- Advil (ibuprofen) relieves minor aches and pains, such as headache, backache, muscle aches, joint pain, and toothache.
- It relieves menstrual cramps.
- It reduces fever and eases aches and pains from colds and the flu.
- It helps with pain and swelling caused by inflammation, such as from arthritis or minor injuries like sprains and strains.
- Ibuprofen relieves minor aches and pains in the muscles, bones, and joints, including body pain, backache, and muscle sprains or strains.
- Ibuprofen relieves pain from inflammation, including arthritis and physical or athletic overexertion such as sprains and strains.
- Ibuprofen relieves headache pain, including tension headache and mild to moderate migraine pain.
- Ibuprofen relieves menstrual pain (dysmenorrhea).
- Ibuprofen relieves toothache and dental pain.
- Ibuprofen relieves aches and pains associated with the common cold and flu.
- Ibuprofen reduces fever.
- Ibuprofen should not be used for fever lasting more than 3 days or pain lasting more than 5 days without medical advice.
How to use it
How to take or use it
- Take this medicine exactly as directed on the label, or as your healthcare professional tells you.
- Swallow regular tablets or caplets whole with a glass of water. If you use the 12-hour long-acting tablet, swallow it whole without crushing, chewing, or splitting it, since this changes how the medicine works in your body.
- You can take this medicine with or without food. If it upsets your stomach, take it with food, milk, or a snack.
- Do not use this medicine for fever for more than 3 days, or for pain for more than 5 days, unless your doctor tells you to, and never take more than the amount shown on the label in one day.
If you miss a dose
- This medicine is usually taken as needed for symptoms, not on a fixed schedule.
- If you are taking it regularly and miss a dose, take it as soon as you remember.
- If it is almost time for your next dose, skip the missed dose. Do not take two doses at the same time to make up for a missed one.
- For regular-strength ibuprofen tablets or caplets, adults and children over 12 may take 1 tablet every 4 hours or 2 tablets every 6 to 8 hours, to a maximum of 6 tablets in 24 hours unless directed otherwise by a physician.
- For extra-strength ibuprofen caplets, adults and children over 12 may take 1 caplet every 6 to 8 hours, to a maximum of 3 caplets in 24 hours unless directed otherwise by a physician.
- For the 12-hour extended-release tablet, adults 18 years and older may take 1 tablet every 12 hours, to a maximum of 2 tablets in 24 hours; the extended-release tablet should not be split, chewed, or crushed, and no more than 1 tablet should be taken at a time.
- Ibuprofen should not be used for fever beyond 3 days or pain beyond 5 days without consulting a physician.
- A lower starting dose should be used in elderly or frail patients.
Pregnancy
- Do not use this medicine during the last part of pregnancy.
- Talk to your doctor or healthcare professional before using this medicine earlier in pregnancy or if you are trying to become pregnant.
- Small amounts of this medicine pass into breast milk. Ask your healthcare professional before using it regularly while breastfeeding.
- Ibuprofen is contraindicated during the third trimester of pregnancy because of the risk of premature closure of the fetal ductus arteriosus and prolonged labour.
- Using ibuprofen from around 20 weeks of pregnancy onward may reduce the baby's amniotic fluid (oligohydramnios) and cause fetal or newborn kidney problems.
- Ibuprofen should be used with caution during the first and second trimesters and only on the advice of a doctor or healthcare professional, since prostaglandin-inhibiting drugs have been linked to a higher risk of miscarriage and heart-related birth defects when used early in pregnancy.
- Women who are trying to conceive should discuss ibuprofen use with a healthcare professional.
Breastfeeding
- Only very small amounts of ibuprofen pass into breast milk and it is generally considered compatible with breastfeeding at recommended doses, but a healthcare professional or doctor should be consulted before regular or prolonged use while nursing.
Older adults
- Older adults, especially those who are frail, are more likely to experience serious NSAID-related side effects such as stomach bleeding and kidney problems, and the risk increases with dose and length of use.
- A lower starting dose should be considered for older or frail patients, with close supervision.
- Older adults taking ibuprofen regularly should have their kidney function and blood pressure monitored periodically.
Children and adolescents
- Ibuprofen tablets, caplets, and extra-strength products are not recommended for children under 12 years of age; age-appropriate ibuprofen formulations should be used instead.
- The extended-release 12-hour ibuprofen tablet is not recommended for anyone under 18 years of age.
- Children with kidney disease or significant fluid loss from vomiting, diarrhea, or reduced fluid intake should not be given ibuprofen.
Before you use it
Before you take or use it
- Tell your healthcare professional if you have ever had a stomach ulcer, stomach bleeding, or a bad reaction to aspirin or another anti-inflammatory medicine.
- Tell your healthcare professional if you have heart disease, high blood pressure, kidney disease, liver disease, asthma, or nasal polyps.
- Tell your healthcare professional if you are pregnant, trying to become pregnant, or breastfeeding.
- Tell your healthcare professional about all other medicines you take, especially blood thinners, other pain relievers, water pills, or medicines for blood pressure, heart failure, or diabetes.
Important warnings
- This medicine can cause stomach or intestinal bleeding, sometimes without any warning signs. Stop taking it and get medical help if you notice black or bloody stools, or if you vomit blood or material that looks like coffee grounds.
- Do not use this medicine during the last part of pregnancy, as it can harm the baby's heart and kidneys. Talk to your doctor or healthcare professional before using it at any stage of pregnancy.
- Taking this medicine long-term, especially at higher amounts, may slightly raise the risk of heart attack or stroke. Use the smallest amount that controls your symptoms, for the shortest time needed.
- This medicine can affect your kidneys, especially if you are older, dehydrated, or already have kidney problems.
- Do not use this medicine if you have ever had an allergic reaction, wheezing, or a severe skin reaction to aspirin or another anti-inflammatory medicine.
- Use with caution in patients with a history of stomach ulcers or gastrointestinal bleeding.
- Use with caution in patients with heart failure, high blood pressure, or other conditions causing fluid retention.
- Use with caution in patients with reduced kidney function, since NSAIDs can further impair kidney function.
- Use with caution in patients with liver impairment.
- Use with caution in older adults, who are at higher risk of gastrointestinal and kidney complications.
- Use with caution in patients taking blood thinners, corticosteroids, or other NSAIDs, including aspirin, due to increased bleeding risk.
- Use with caution in patients who drink 3 or more alcoholic beverages daily, which further increases the risk of stomach bleeding.
- Use with caution in patients scheduled for surgery, as NSAIDs are usually stopped beforehand to reduce bleeding risk.
- Use with caution in patients with asthma or nasal polyps, who are at higher risk of allergic-type reactions to NSAIDs.
Who should not use it
- Contraindicated in patients with an active peptic ulcer or a history of recurrent gastrointestinal ulceration or bleeding.
- Contraindicated in patients with known hypersensitivity to ibuprofen or other NSAIDs, or in whom asthma, nasal polyps, urticaria, or other allergic reactions are triggered by aspirin or other NSAIDs.
- Contraindicated in patients with significant liver impairment or active liver disease.
- Contraindicated in patients with severe or worsening kidney impairment.
- Contraindicated in patients with systemic lupus erythematosus.
- Contraindicated in patients with known hyperkalemia.
- Contraindicated immediately before or after heart surgery.
- Contraindicated during the third trimester of pregnancy.
- Contraindicated in children under the minimum age specified for the particular ibuprofen product.
Possible side effects
- Upset stomach, heartburn, or indigestion.
- Nausea.
- Diarrhea, gas, or stomach cramps.
- Headache or dizziness.
- Mild skin rash.
- Ringing in the ears.
- Nausea may occur.
- Heartburn or epigastric pain may occur.
- Indigestion (dyspepsia) may occur.
- Diarrhea or abdominal cramping may occur.
- Constipation or bloating may occur.
- Dizziness may occur.
- Headache or nervousness may occur.
- Skin rash may occur.
- Ringing in the ears (tinnitus) may occur.
- Fluid retention or swelling may occur.
- Decreased appetite may occur.
When to get help
Get emergency help now
- Signs of stomach bleeding: black or tarry stools, vomiting blood, or vomit that looks like coffee grounds.
- Chest pain, sudden weakness or numbness, slurred speech, or shortness of breath. These can be signs of a heart attack or stroke.
- Signs of a severe allergic reaction: swelling of the face, lips, tongue, or throat, hives, trouble breathing, or wheezing.
- A severe skin reaction with blistering, peeling skin, or a widespread rash, especially with fever.
Contact your healthcare professional
- If you notice yellowing of the skin or eyes, dark urine, or unusual tiredness, which could be signs of a liver problem.
- If you have swelling in your legs or feet, sudden weight gain, or shortness of breath, which could be signs of fluid retention or a heart problem.
- If your pain or fever does not improve, or gets worse, after a few days.
- If you notice unusual bruising or bleeding.
- Ibuprofen can cause stomach or intestinal ulcers, bleeding, or perforation, which can occur without warning symptoms at any time during use.
- Ibuprofen may worsen or precipitate congestive heart failure, particularly in patients with underlying heart problems.
- Long-term use, especially at higher doses, may slightly increase the risk of heart attack or stroke.
- Severe allergic reactions, including anaphylaxis, can occur, especially in people with asthma, nasal polyps, or previous reactions to aspirin or other NSAIDs.
- Serious skin reactions, including Stevens-Johnson syndrome, toxic epidermal necrolysis, and DRESS syndrome, have rarely been reported.
- Kidney problems, including reduced kidney function and, rarely, kidney failure, can occur, especially with long-term use or in people with existing kidney disease.
- Liver problems, including hepatitis and jaundice, have rarely been reported.
- Aseptic meningitis, with fever, stiff neck, severe headache, and nausea, has rarely been reported, particularly in people with autoimmune conditions such as lupus.
- Blood disorders, including low white blood cell or platelet counts and anemia, have rarely been reported.
- Vision changes, including blurred vision, have been reported; an eye examination should be arranged if this occurs.
- Seek urgent medical attention for signs of stomach bleeding such as black or bloody stools or vomiting blood, for chest pain, sudden weakness, or shortness of breath, or for a severe allergic reaction.
If too much is taken
- Ibuprofen overdose most commonly causes abdominal pain, nausea, vomiting, drowsiness, and lethargy.
- Higher overdoses can cause headache, ringing in the ears, and in more severe cases, seizures or slowed breathing.
- Severe overdose may lead to metabolic acidosis, low blood pressure, an irregular or slowed heartbeat, coma, and acute kidney failure.
- Treatment of overdose is mainly supportive, including gastric emptying or activated charcoal if given soon after ingestion, and management of blood pressure, acid-base balance, and any gastrointestinal bleeding.
- Very young children who ingest a large amount of ibuprofen are at particular risk and require prompt medical evaluation.
Other medicines and products
- You can take this medicine with or without food; taking it with food or milk can help prevent an upset stomach.
- Avoid drinking 3 or more alcoholic drinks a day while using this medicine, as this increases the risk of stomach bleeding.
- Do not take this medicine together with aspirin or other anti-inflammatory pain relievers unless your doctor tells you to. If you take a daily low-dose aspirin for your heart, ask your healthcare professional how to time your doses, since this medicine can interfere with how well aspirin protects your heart.
- Tell your healthcare professional if you take blood thinners, water pills, blood pressure medicine, lithium, methotrexate, or diabetes medicine, since this medicine can interact with them.
- Combining ibuprofen with aspirin or other NSAIDs is not recommended, as it increases the risk of side effects without added benefit.
- Regular ibuprofen use can interfere with the heart-protective, blood-thinning effect of low-dose aspirin; when both are needed, ibuprofen should generally be taken at least 1 hour after or several hours before the daily low-dose aspirin.
- Combining ibuprofen with blood thinners increases the risk of gastrointestinal bleeding.
- Ibuprofen can raise blood digoxin levels, increasing the risk of digoxin toxicity.
- Ibuprofen may reduce the effectiveness of diuretics and blood pressure medications, including ACE inhibitors and angiotensin receptor blockers, and combined use can increase the risk of kidney problems and high potassium levels.
- Ibuprofen may increase the blood-sugar-lowering effect of insulin and oral diabetes medications.
- Ibuprofen can raise lithium levels and increase the risk of lithium toxicity.
- Ibuprofen may increase the risk of methotrexate toxicity.
- Combining ibuprofen with SSRIs or corticosteroids increases the risk of gastrointestinal bleeding.
- Combining ibuprofen with acetaminophen on a regular basis is not advised, as it may increase the risk of kidney effects.
Food and drinks
- Ibuprofen can be taken with or without food; food slows down how quickly it is absorbed but does not reduce the total amount absorbed.
- Taking ibuprofen with food, milk, or an antacid can help reduce stomach upset if it occurs.
When to use it
- Ibuprofen can be taken at any time of day, with or without food, and does not need to be timed around meals.
- If stomach upset occurs, taking ibuprofen with food or milk can help.
How to store it
- Store at room temperature, away from heat and moisture, in a tightly closed container.
- Keep out of reach of children.
- Do not use this medicine after the expiry date on the package.
- Store ibuprofen tablets, caplets, and extended-release tablets in a tightly closed container at room temperature (15-30°C).
Key takeaways
- Use the smallest amount that controls your symptoms, for the shortest time needed.
- Do not use this medicine for longer than directed without talking to your doctor or healthcare professional.
- Keep track of all the pain relievers and cold or flu products you take, so you do not accidentally take too much ibuprofen at once.
- Ibuprofen is an effective NSAID for pain, fever, and inflammation, but should be used at the lowest effective dose for the shortest time needed.
- Ibuprofen should not be used in the third trimester of pregnancy and should be avoided or used cautiously earlier in pregnancy.
- Report any signs of stomach bleeding, unusual swelling, or allergic reaction to a healthcare professional right away.
These practical points are adapted from the Pharmasist patient handout and its linked product monograph.