ibuprofen

You may take ibuprofen to treat everything from menstrual cramps to headaches or even arthritis. Ibuprofen is an NSAID (nonsteroidal anti-inflammatory drug), and can be purchased without a prescription. The most familiar brand names of the drug are Advil, Midol, and Motrin.

"This drug works by inhibiting an enzyme that helps produce compounds called prostaglandins," explained Healthline. "Prostaglandins are associated with pain and inflammation in the body." It can take about a half-hour for ibuprofen to kick in, with levels at their maximum after one to two hours, according to Healthline. The timeframe does depend on several factors, like the dosage, weight, and age.

The typical ibuprofen dosage is 200 milligrams. Healthline cautioned against taking more than 1,200 milligrams in a day. Harvard Health Blog cited estimates which suggest that 15 percent of the U.S. population take NSAIDs regularly. This kind of medication is popular because it’s effective, relatively inexpensive, available over the counter, and is generally considered safe, according to the site. But like any medication, there are still some risks. They really come into play when ibuprofen is taken daily. Read on to learn why you should be careful.

If you take ibuprofen daily, your stomach might hurt

woman holding her stomach

According to Healthline, a common side effect of ibuprofen is an upset stomach. This is why it’s recommended to take it with food or milk. Along with abdominal pain and indigestion, common side effects include nausea, vomiting, and diarrhea. And if you notice black stool, that’s one sign that you’ve taken too much.

Ibuprofen also isn’t safe for everyone. Pregnant women are instructed to avoid it. People with elevated liver enzymes are told not to take it. If you’ve had an allergic reaction to an NSAID in the past, have a peptic ulcer or had one in the past, or if you’re about to have or recently had a surgical procedure, don’t take ibuprofen (via Healthline).

It can also interact with other medications. Because of this, talk to your doctor before using if you are 60 or older, frequently experience symptoms like stomach pain or upset or heartburn, or if you have a bleeding disorder or are taking blood-thinners. You should also consider speaking with your doctor if you have a history of conditions like high blood pressure, heart disease, liver disease, kidney disease, or asthma (via Healthline).

If you take ibuprofen daily, you might be at an increased risk for stroke

Back in 2015, the U.S. Food and Drug Administration (FDA) changed the warning on NSAIDs and made the language stronger. The old warning notified users that non-aspirin NSAIDs increase the chance of a heart attack or stroke. After reviewing safety information and various studies, the warning was updated to reflect the latest findings.

According to the FDA website, the current information now includes: The risk of heart attack or stroke can occur in the first weeks of using an NSAID and may increase with extended use. The risk can be greater at higher doses. Whether or not you already have a risk factor is irrelevant as everyone is at increased risk, even people who don’t have cardiovascular disease.

"If you’re taking an NSAID and you notice any signs or symptoms of a heart attack or stroke — such as chest pain, shortness of breath, weakness in one part of the body or side of the body, or sudden slurred speech — get medical attention right away," the Mayo Clinic advised.

It can be dangerous to take ibuprofen daily after having a heart attack

Heart attacks and strokes have many of the same risk factors. But when it comes to taking ibuprofen, the heart attack risk may be greater. According to the FDA, "patients treated with NSAIDs following a first heart attack were more likely to die in the first year after the heart attack compared to patients who were not treated with NSAIDs after their first heart attack."

Additionally, there’s an increased risk of heart failure with NSAID use, the FDA said. Ibuprofen bottles include the updated warning from the FDA, which reads: "Heart attack and stroke warning: NSAIDs, except aspirin, increase the risk of heart attack, heart failure, and stroke. These can be fatal. The risk is higher if you use more than directed or for longer than directed."

Indeed, a 2017 study published in the British Medical Journal found that taking any amount of NSAIDs for either a week, month, or multiple months was associated with an increased risk of heart attack.

Taking ibuprofen every day could lead to kidney injury or kidney disease

According to the National Kidney Foundation, heavy or long-term use of ibuprofen can lead to "chronic kidney disease known as chronic interstitial nephritis." And if you already have decreased kidney function, you shouldn’t be taking ibuprofen at all.

In a July 2017 study published in Emergency Medicine Journal, researchers tested the ibuprofen versus placebo effect on acute kidney injury in athletes. As they wrote in the abstract, "Despite concerns that non-steroidal anti-inflammatory drugs contribute to acute kidney injury (AKI), up to 75 percent of ultramarathon runners ingest these during competition." They found that there were increased rates of acute kidney injury in participants who took ibuprofen. The severity of kidney injury was also greater in the ibuprofen group.

To find out if NSAIDs have affected your kidneys, ask your doctor about getting a blood test called a serum creatinine level. "This test measures the amount of a waste product in your blood that is normally removed by your kidneys," the National Kidney Foundation explained. "If your kidneys are not working as well as they should, the creatinine level will be increased in your blood." This result is then used to estimate how much kidney function you have.

You could develop internal bleeding by taking ibuprofen daily

As tempting as it might be to take ibuprofen to treat everyday aches and pains, it can have serious side effects. One of them is significant gastrointestinal bleeding. High doses can cause this. In fact, people who take high doses on a regular basis are not one, not two, but three times more likely to experience this symptom, a 2005 analysis published in Clinical Gastroenterology and Hepatology reported. It doesn’t even take much time to accrue this kind of damage, as it can be seen just three days after starting ibuprofen. Even more alarming: This happens to otherwise healthy people.

Research published in Arthritis and Rheumatism explained that stomach bleeding is a risk associated with all NSAIDs (via Reuters). A "traditional" NSAID like ibuprofen more than doubles the risk of complications for people taking up to 1,200 milligrams daily. At higher doses of 1,200–2,400 milligrams daily, there’s a fivefold increased risk of gastrointestinal bleeding.

Taking ibuprofen daily could result in an ulcer

Although you may think of stomach bleeding and an ulcer as one and the same, "ulcers are sores that are slow to heal or keep returning. They can take many forms and can appear both on the inside and the outside of your body," as defined by WebMD. When someone takes a NSAID like ibuprofen, there’s a risk of peptic ulcer — or an ulcer in the lining of your stomach or upper intestine. The open sores develop when the stomach acid damages the digestive tract. Doesn’t sound like fun, does it? "You may have no symptoms, or you may feel discomfort or burning pain," WebMD explained. This kind of ulcer can also lead to internal bleeding, so there is some overlap after all. In fact, if someone already has an ulcer, the risk of serious bleeding is greater.

Everyday Health reported that about 15 percent of chronic NSAID users will develop an ulcer, which may not cause symptoms until it’s seriously progressed. InformedHealth.org shared in an article that people can take medication to protect their stomach from NSAID risks, but it depends on individual risk. For example, if you’re over 65, have had a peptic ulcer in the past, or take steroids, you’re more likely to develop a peptic ulcer.

Your potassium levels may skyrocket if you take ibuprofen on the regular

What even is potassium? It’s "a mineral that your body needs to work properly," according to MedlinePlus, and is "a type of electrolyte" that helps your nerves function, muscles contract, and heartbeat stay regular. Thus, it follows that too much or too little potassium can be harmful. Ibuprofen, in particular, can raise potassium levels as it causes kidneys to retain potassium, revealed GoodRx.

Too much potassium, aka hyperkalemia, is defined at a level over 5.5, and it can cause "life-threatening cardiac arrest with no specific warning signs," the website explained. If your potassium is too high, you may notice symptoms like confusion and weakness.

NSAIDs like ibuprofen can also lead to renal tubular acidosis, a disease that occurs when the kidneys fail to excrete acids into the urine, according to the National Institute of Diabetes and Digestive and Kidney Diseases. Although this condition is rare, a 2019 article published in Cureus highlighted the "importance of inquiring about OTC [over the counter] medication history and considering ibuprofen as one of the differentials in patients with a combination of refractory [or resistant] hypokalemia and renal tubular acidosis." The studies cited by the publication also proved "the need to further educate patients regarding the multiple … effects of excessive NSAID use."

Taking ibuprofen every day may harm your liver

Medical News Today described the liver as the body’s key filter, "processing elements of everything we ingest, including drugs." Because of this, medication can have adverse effects.

A 2020 study in Scientific Reports looked closely at how ibuprofen affects the liver. In the study, mice were given a dose ibuprofen, similar to what a human would take, for one week. "More than 300 proteins were significantly altered between the control and ibuprofen-treated groups," the study read. Several major pathways were altered in the livers, and there were even gender-related differences. This could affect how men and women are given ibuprofen in the future, once more information is gleaned.

One of the researchers told Science News,"No drug is perfect, as all drugs have side effects. However, many commonly used drugs, such as ibuprofen, are being overused and should not be used for certain conditions, such as mild pain."

If you take ibuprofen daily, your ears might start to ring

If your ears are ringing and there’s no bells around, the ibuprofen you’ve been taking every day could be the culprit. You’d be one of 25 million Americans with tinnitus, a figure cited by the American Tinnitus Association (ATA). This condition is most commonly referred to as a ringing in the ears, but by no means is it limited to that particular sound. Clicking, roaring, whooshing, or buzzing are among the sounds listed by the ATA. It isn’t even limited to your ears; it can be heard in one or both of your ears as well as in or outside of your head. Whatever the sound, pitch, or volume, the consensus is that it could be a sign of damage to the ear.

NSAIDs, like ibuprofen, are considered as one of the causes of tinnitus. However, when tinnitus is a side effect of a medication, it usually goes away when the medication is stopped.

Taking ibuprofen regularly can result in a muscle injury or joint deterioration

Would you pop ibuprofen regularly if you knew it could "trigger a spiral of inflammation that results in autoimmune disease," as mentioned by Experience Life? The website adds that "some people who take NSAIDs over a long period of time may actually worsen the underlying condition that causes their pain and inflammation." Arthritis is an example.

"People are taking this for their joints, but it’s not helping their joint health," physician Sunil Pai told the site. He shared that his patients will tell him they started off by taking one NSAID a day at the onset of arthritis, and then 20 years later they’re up to three or four a day. "They need more because they’ve built up a tolerance and because they have more joint deterioration," Dr. Pai said. He pointed toward a study in the Journal of Rheumatology that confirmed the link between NSAIDs and joint deterioration.

Taking ibuprofen every day could result in high blood pressure

While ibuprofen can increase blood pressure, the amount varies, MedicineNet reported. If you’re taking a medication for elevated blood pressure, ibuprofen may make it less effective. High blood pressure is concerning because it can lead to health problems if it goes untreated — health problems that are serious, like a heart attack or stroke.

In people with osteoarthritis or rheumatoid arthritis, ibuprofen has been found to increase blood pressure and hypertension, a 2017 study in the European Heart Journal found. The study compared the use of ibuprofen and another NSAID, celecoxib, for these conditions, and discovered that ibuprofen increases the risk of cardiovascular disease.

As ScienceDaily noted, "19% of the US population use at least one NSAID on a regular basis, including 30 million Americans with osteoarthritis, of whom more than 40% also have hypertension." As such, "NSAIDs, particularly ibuprofen, may be not as safe as previously thought,"Frank Ruschitzka, professor of cardiology and co-head of the Department of Cardiology at the University Heart Centre in Switzerland, told the site.

Daily usage of ibuprofen can make you feel weak or tired

If you’re using resistance training to build up muscles or strength, avoid taking ibuprofen because it will counteract your efforts, according to an Acta Physiologica 2017 study. This was the case with young adults, so don’t go around thinking you’re exempt. Whether the ibuprofen is in high doses or taken too often, the result seems to be the same.

Additionally, weakness is a common side effect of ibuprofen, according to GoodRx. You should see how it affects you before doing anything that requires alertness. The last thing you want is to feel fatigued or dizzy — which is also listed as a common side effect — while driving. GoodRx specifically mentioned the potential of being drowsy or dizzy on ibuprofen. "Do not stand or sit up quickly, especially if you are an older patient," the site said. "This reduces the risk of dizzy or fainting spells."

Taking ibuprofen every day can cause headaches

Taking ibuprofen can cause headaches. How’s that for a contradiction? It may be tempting to continue taking ibuprofen whenever you have a headache, but it may make the issue worse. Have you heard of a rebound headache? It’s also called a medication overuse headache, and is caused "by the frequent or excessive use of pain-relieving drugs to treat headache attacks that are already in progress," Dr. Sait Ashina revealed in a 2019 article for Harvard Health Blog. He added that they can be disabling.

To be diagnosed with this, Dr. Ashina said a person must have headaches on more than 15 days a month for at least three months while taking a medication like ibuprofen. He listed other symptoms in addition to headache, which include nausea, vomiting, light or sound sensitivity, irritability, difficulty concentrating, insomnia, restlessness, and constipation.

Medication overuse headache is common; Dr. Ashina said about one to two people out of every 100 has experienced it in the past year, though it occurs more in women. The good news is this condition should stop when you stop taking ibuprofen. Dr. Ashina warned that it could get worse before it gets better. To make sure it doesn’t happen again, don’t use ibuprofen more than two or three days a week.

Daily ibuprofen can cause hearing loss

A 2017 study in the American Journal of Epidemiology found that longer durations of NSAID and acetaminophen use was associated with slightly greater risks of hearing loss. Younger women who used these medications at least two days had a higher risk of hearing loss, so researchers decided to see if this was also the case with older women. This study is referred to as the Nurses’ Health Study, when almost 56,000 women were questioned about their use of pain relievers over two decades.

The conclusion stated that "longer duration [more than two days per week] of regular …NSAID use and longer duration of regular acetaminophen use were associated with higher risks of hearing loss, but longer duration of aspirin use was not." The conclusion continued, "Considering the high prevalence of analgesic use and the high probability of frequent and/or prolonged exposure in women of more advanced age, our findings suggest that NSAID use and acetaminophen use may be modifiable risk factors for hearing loss."