Ibuprofen

What it is

Ibuprofen is a non-steroidal anti-inflammatory drug. It blocks the cyclooxygenase enzymes and so reduces the production of prostaglandins, which brings down pain, fever and inflammation together. It is used for painful and inflammatory conditions and to lower fever.

A usual adult range, not a national label — the dose and the timing differ by country and by product.

Used for

• Pain
• Fever
• Inflammation

Approved uses differ by country — some of these may be off-label or unapproved where you live.

What to know while taking it

Those same prostaglandins protect the stomach lining and help the kidneys manage their own blood flow, which explains most of what follows: it is taken with food, stomach bleeding is its main risk, and existing kidney disease calls for caution. Creatinine, eGFR, hemoglobin and ALT are the values watched during longer use, and slow, unnoticed blood loss from the gut is what drains iron stores. Alcohol, prednisolone and acetylsalicylic acid all add to the bleeding risk, and it is not combined with anticoagulants such as warfarin or with a second anti-inflammatory such as diclofenac, naproxen or ketorolac. It also interferes with blood-pressure control, so lisinopril, enalapril, losartan and furosemide may not behave as usual alongside it.

When to see a doctor

Black or tarry stools, vomit that looks like coffee grounds, or stomach pain that keeps returning mean see a doctor rather than switching painkillers at home. Passing much less urine than usual, swelling of the ankles, or growing breathlessness and pallor are the other signs worth acting on.

Worth knowing

• Raises the risk of stomach bleeding
• Caution with kidney disease
• Do not combine with alcohol
• Can raise blood pressure

Markers to watch

• Creatinine
• eGFR
• Hemoglobin
• ALT

Nutrients affected

• iron — depleted by (Ferritin, Hematocrit, Hemoglobin)