Section 02 · Monograph
Ibuprofen
Reviewed Nov 2026FDA label
Motrin / AdvilNSAID
- Forms
- Tab: 200, 400, 600, 800mg | Susp: 100mg/5mL
- Dose
- 400-800mg PRN (max 3200mg/day Rx; 1200mg/day OTC)
- MOA
- COX inhibition
Black Box Warning
- Prescription NSAIDs: risk of serious cardiovascular thrombotic events; contraindicated in CABG surgery
- Risk of serious GI bleeding, ulceration and perforation, which can be fatal
Indications
- Mild to moderate pain, fever, dysmenorrhea, osteoarthritis and rheumatoid arthritisFDA-labeled
Off-Label Uses
- Acute migraine (first-line simple analgesic per guidelines)Off-label
- Tension-type headacheOff-label
Mechanism of Action
- Non-selective COX inhibitor reducing prostaglandin-mediated inflammation, pain and fever
Full Dosing
Adult / usual
- Migraine and pain: 400-800mg PRN; maximum 3200mg/day (prescription) or 1200mg/day (OTC)
- Give early in the attack with food; limit simple analgesic use to fewer than 15 days per month to avoid medication overuse headache
Contraindications
- Asthma, urticaria or allergic reaction to aspirin or NSAIDs
- Perioperative CABG pain
- Active GI bleeding
Drug Interactions
- Anticoagulants and aspirin: bleeding risk (ibuprofen may blunt aspirin's antiplatelet effect)
- ACE inhibitors, ARBs and diuretics: reduced effect and renal risk
- Raises lithium and methotrexate levels
Adverse Effects
- GI upset, ulcer and bleeding
- Renal impairment and fluid retention
- Hypertension
- Cardiovascular thrombotic events
- Medication overuse headache
Monitoring Parameters
- Renal function and blood pressure with chronic use
- GI symptoms
- Headache frequency
Pregnancy & Lactation
- Avoid at 20 weeks gestation and later; avoid in the third trimester
- Compatible with breastfeeding