Ibuprofen – pros and cons

Dear Dr. Mo: Why is Ibuprofen so ‘good’ and always prescribed as a medication in flu conditions? Are there any known side effects for using it?

Dear reader: Ibuprofen belongs to a class of medications called NSAIDs – non-steroidal anti-inflammatory drugs. It works by discontinuing the body’s production of chemical messengers that cause pain, fever, and inflammation. These substances are called ‘prostaglandins’. But prostaglandins also help protect the lining of your stomach and other tissues, so blocking their production can cause side effects such as ulcers and gastrointestinal bleeding, which is the most common concern when NSAIDs are being used.

Use pain relievers with caution

Ibuprofen is one of the drugs used to relieve pain, tenderness, swelling, and stiffness caused by osteoarthritis (arthritis caused by a breakdown of the lining of the joints) and rheumatoid arthritis (arthritis caused by swelling of the lining of the joints).

Most people use ibuprofen to reduce fever and to relieve mild pain from headaches, muscle aches, arthritis, menstrual periods, the common cold, toothaches, and backaches. Ibuprofen also works well to alleviate hangover symptoms (mostly headache and chills).

All these effects are reasons why this drug is so often prescribed and used.

Now let’s turn to the other part of your question: the side effects.

I have already mentioned the most common concern and the most often side effect of ibuprofen (and other NSAIDs) – ulcers and gastrointestinal bleeding – especially if used in large doses and over longer periods of time. Note that the main reason for this is its indirect biochemical action and not a direct damage to the stomach; taking suppositories to avoid direct contact with the stomach will not remove the risk from this side effect.

But that’s not all there is.

Side effects of all NSAIDs including ibuprofen may also include stomach pain, weight loss, nausea, vomiting, drowsiness, dizziness, fluid retention, heartburn, diarrhea, constipation, blurred vision.
High doses can cause ringing in your ears.

Never take more than a minimum effective dose and try not to do so without consulting your doctor first.
People who are allergic to aspirin or who take blood thinners should not take NSAIDs.

High doses taken for longer time may damage your liver or kidneys in addition to gastric bleeding (bleeding from your stomach).
Aggravation of immune system disorders like asthma, psoriasis and colitis is also a possibility when you take NSAIDs for a long time.

The latest information published in a new study in Circulation, a journal of the American Heart Association warns that people who have survived a heart attack or live with a heart disease have a higher risk of a heart attack or death if they take NSAIDs (other than aspirin) for even short periods of time and at low doses. These data indicate that for patients with heart troubles and prior heart attacks, there are no safe therapeutic windows for NSAIDs (excluding aspirin). This likely happens because NSAIDs can cause the blood to clot more easily, which can lead to blockages of arteries. If these arteries feed the heart or the brain, this could trigger a heart attack or a stroke. Options for these patients, when they need some pain relief include acetaminophen (paracetamol).

Having said this, ibuprofen may cause life-threatening heart or circulation problems such as heart attack or stroke for people with heart disease, especially if you use it long term.
Do not use ibuprofen just before or after heart bypass surgery (coronary artery bypass graft, or CABG).

Get emergency medical help if you have chest pain, weakness, shortness of breath, slurred speech, or problems with vision or balance.

So as you see, I have gone into some detail on side effects to point out that ibuprofen, like any other drug has its benefits and risks and that both sides of that coin should be considered carefully before using it.

My recommendation would be to always consult your doctor before starting any therapy to determine which drug is the best option for your particular case and what would be the safest dose as well as the length of time to take the medication. Ibuprofen is an over the counter (OTC) drug and you can get it without your doctor’s prescription and consultation, but I urge you not to.

Yours in health,

Dr. Mo