Does Ibuprofen Cause Liver Damage?

Ibuprofen rarely causes liver damage, heart attack, gastrointestinal bleeding or stroke. Even so, you must use this widely taken painkiller as directed and recognize the signs of trouble that might arise from continual ibuprofen use. You must be particularly careful when giving children nonprescription cough and cold medications that include ibuprofen as an active ingredient.

Uses

As a high-dose prescription product, the nonsteroidal anti-inflammatory drug ibuprofen has U.S. Food and Drug Administration-approved clearance for relieving osteoarthritis, rheumatoid arthritis symptoms and for relieving mild to moderate pain from other sources. The American Cancer Society notes in an online fact sheet that ibuprofen "is especially helpful in relieving bone pain related to cancer."
As a nonprescription product, ibuprofen by itself or in combination products is used to treat headaches and muscle aches, relieve back and menstrual pains, and reduce fever.
Physicians can also prescribe or recommend ibuprofen for treating pain, inflammation and tenderness associated with arthritis of the spine (ankylosing spondylitis), gouty arthritis and psoriatic arthritis.

Dosing for Adults

People older than 12 years of age can take ibuprofen every four to six hours as needed to relieve symptoms, according to the U.S. government's online health encyclopedia Medline Plus. Taking more than four doses in a 24-hour period can increase your risk for side effects, however.
Taking ibuprofen with milk or food can help you avoid stomach discomfort. Contact your health care provider if your pain remains after 10 days of taking ibuprofen or if your fever remains after three days.

Dosing for Children Under 12 Years

Do not give ibuprofen to children younger than 4 years old. For older children, follow labeled directions or prescribing instructions exactly and do not give a child more than one product containing ibuprofen. Be sure to read the ingredients list of all over-the-counter medications.
If you give your child a liquid medication, shake the container well before measuring out a dose.
Contact your physician if your child does not start to feel better within 24 hours of first receiving ibuprofen or if her symptoms become worse after three days.

Side Effects

Common and less-serious side effects from ibuprofen use include heartburn, nausea, constipation, diarrhea, dizziness, gas or bloating, drowsiness and ringing in the ears.
Rarer side effects that require medical attention include abdominal pain, blisters, bloating or swelling of the legs and feet, confusion, difficult, discolored or painful urination, flu-like symptoms, itching, jaundice, loss of appetite, rapid heartbeat, rash, sores in the mouth and lips, unexpected weight gain and vision problems.
If you become dizzy, have rapid eye movements, lose color around your lips and nose, or start having trouble breathing, you might have overdosed on ibuprofen. Contact your Poison Control Center at 1-800-222-1222.

Liver Risks and Other Warnings

The ACS cautions ibuprofen users that fever, nausea, tenderness under the right ribcage and yellowing of the skin and eyes can indicate liver damage. Stop taking ibuprofen and contact your doctor if you notice any of these problems.
Taking ibuprofen may increase your risk for a heart attack, stroke or stomach and intestinal bleeding. Your risk for these problems might increase if you take other NSAIDs, have allergies, asthma, high blood pressure, heart disease or nasal polyps. Speak with your health care provider if you have kidney disease or are pregnant, planning to become pregnant or are breast-feeding.
Stop using ibuprofen and seek medical attention if you have heart attack or stroke symptoms such as chest pains, slurred speech, trouble breathing or weakness on one side of your body.
If you have bloody stools or vomit mixed with material that looks like coffee grounds, severe heartburn or stomach pain and you are taking ibuprofen, you might be experiencing gastrointestinal bleeding.
Stop using ibuprofen shortly before and immediately following a heart bypass.

Interactions

Ibuprofen can change how your body metabolizes a number of other medications. Tell your physician or pharmacist if you take any of the following:
• Anticoagulants such as clopidogrel (e.g., Plavix from sanofi aventis) or warfarin
• High blood pressure drugs, including angiotensin-converting enzyme inhibitors and diuretics
• Lithium
• Methotrexate
• NSAIDs
• Oral corticosteroids such as prednisone
• Probenecid

Brand Name Products

Single- and multi-ingredient brand name over-the-counter products that contain ibuprofen are sold under the names of Advil, Dristan, Midol and Motrin.
Brand-name prescription products containing ibuprofen include Combunox, which combines ibuprofen with oxycodone and Vicoprofen, which combines ibuprofen with hydrocodone.

Resources

• NSAID Medication Guide