Ibuprofen

About Ibuprofen

Ibuprofen blocks the COX enzymes that make prostaglandins, which drive pain, swelling and fever. Prescription strengths are labeled for rheumatoid arthritis and osteoarthritis, up to 3,200 mg a day, and for mild to moderate pain and period pain; over-the-counter products are for minor aches and fever.

Like every prescription NSAID, it carries boxed warnings for two risks. It raises the risk of heart attack and stroke, which can start early in treatment and grows with longer use, and it must not be used around heart bypass surgery. It can cause bleeding, ulcers and perforation in the stomach or intestines, more often in older adults and people with past ulcers. Both can be fatal. It can also raise blood pressure, worsen heart failure and harm the kidneys. Anyone who has had asthma or hives after aspirin or another NSAID must not take it, and it is avoided from about 20 weeks of pregnancy.

Prescription tablets are generic, as Motrin’s prescription tablets are discontinued, and a prescription suspension is also made. Over the counter there are 200 mg tablets and capsules, children’s suspension and infant drops; the Drug Facts limit adults to six tablets in 24 hours unless a doctor directs, and say to ask a doctor if pain lasts beyond 10 days or fever beyond 3. Caldolor, given into a vein, treats pain and fever from 3 months of age. A generic ibuprofen and famotidine tablet is also sold, though its Duexis brand is discontinued.

Taking Ibuprofen

How to take it

Usually three or four times a day for arthritis, or every 4 to 6 hours as needed for pain, with food or milk if it upsets your stomach. Shake liquids well and measure with the device supplied. Use the lowest dose that works for the shortest time.

If you miss a dose

If you take it regularly, take a missed dose when you remember, unless the next one is nearly due; then skip it. Do not take a double dose.

Storage

At room temperature, tightly closed, away from excess heat and moisture (not in the bathroom), out of reach of children.

Interactions to know about

Aspirin, other NSAIDs, blood thinners, steroids and SSRI or SNRI antidepressants raise bleeding risk, and it can blunt the heart protection of low-dose aspirin. It can weaken blood pressure medicines and water pills and strain the kidneys with them, and raises lithium and methotrexate levels. Three or more alcoholic drinks a day add to stomach bleeding risk.

This summarizes the official prescribing information. Your prescriber’s and pharmacist’s instructions, and the leaflet that comes with your medicine, take priority.

Why the cash price for Ibuprofen differs from pharmacy to pharmacy

Prescription tablets have many makers, so a quote is mostly the dispensing fee and pricing method; a flat-price list, a per-tablet price or a minimum charge can quote the same bottle very differently.

Over-the-counter tablets carry no dispensing fee, and the famotidine combination has fewer makers and is quoted on its own terms.

Ways to pay less for Ibuprofen without insurance

• Ask whether ibuprofen is on the pharmacy’s flat-price generic list.
• Ask the prescriber whether over-the-counter 200 mg tablets would do, since going beyond the package directions needs their instruction.
• If prescribed the ibuprofen and famotidine tablet, ask for quotes on the two generics separately too.
• For a child, ask whether over-the-counter suspension or drops would do.
• Upload the prescription to Script Unlock so licensed pharmacies can quote their cash price. You pay the pharmacy directly.

Questions to ask your pharmacist about Ibuprofen

1. 1.Is it safe with my blood pressure, heart or kidney conditions?
2. 2.Can I take it with low-dose aspirin, and how should I time them?
3. 3.Does it interact with my blood thinner, antidepressant or lithium?
4. 4.What stomach symptoms mean I should stop?
5. 5.Is the over-the-counter strength enough for me?

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