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Ibuprofen, a common nonsteroidal anti-inflammatory drug (NSAID), has associated safety considerations that are essential for all users to understand. Below, we provide a detailed overview of potential risks, precautions, and actions to take in case of emergencies.

• Heart Attack and Stroke Risk: Ibuprofen may increase the risk of heart attack or stroke, particularly if used long-term or in higher doses. Those with pre-existing heart conditions or risk factors (e.g., smoking, diabetes, high blood pressure) should exercise caution. Avoid using ibuprofen before or after heart surgeries, such as coronary artery bypass grafting (CABG). Seek immediate medical attention if you experience chest pain, difficulty breathing, or sudden speech or vision changes.

• Stomach and Intestinal Bleeding: This medication can sometimes lead to serious stomach or intestinal bleeding, possibly without warning. The risk is higher for older adults, those with a history of ulcers or bleeding, and those using other medications that increase bleeding risk. If you experience persistent stomach pain, black/tarry stools, or vomit resembling coffee grounds, discontinue use and consult a healthcare provider immediately.

• High Blood Pressure and Heart Failure: Ibuprofen can cause fluid retention, contributing to elevated blood pressure or heart failure, particularly in individuals with existing heart issues. Those on blood pressure medications should discuss ibuprofen use with their healthcare provider. Contact your provider if you experience fainting, chest pain during activity, or irregular heartbeats.

• Kidney Damage: Prolonged use of ibuprofen can impair kidney function, especially in older adults or those with diabetes or pre-existing kidney issues. Regular kidney function tests might be necessary during extended treatment. Notify your healthcare provider if you notice changes in urination, fatigue, or muscle cramps.

• Liver Issues: Though rare, ibuprofen can cause severe liver problems. Seek immediate medical help if you observe symptoms such as abdominal swelling, yellowing of the skin or eyes, or dark urine.

• Severe Allergic Reactions: Allergic reactions to ibuprofen can occur, particularly in those with aspirin or NSAID allergies. If you experience hives, facial swelling, or difficulty breathing, discontinue use and seek urgent medical care.

• Pregnancy Risks: Ibuprofen may harm an unborn baby, especially if taken after the 20th week of pregnancy. Pregnant individuals should consult their healthcare provider for alternative pain management options.

• Phenylketonuria (PKU) Caution: The chewable form of ibuprofen contains phenylalanine. Individuals with PKU should avoid this formulation and seek alternatives from their healthcare provider.

• Contraindications: Avoid ibuprofen if you've had asthma, hives, or other allergic reactions after taking aspirin or another NSAID, or if you are undergoing or have recently undergone CABG surgery.

Always discuss with your healthcare provider before starting ibuprofen, especially if you have any pre-existing conditions or are taking other medications. In case of an overdose, seek emergency medical attention immediately.

Common side effects:

• upset stomach
• nausea
• headache
• dizziness
• drowsiness
• stomach pain
• heartburn
• diarrhea
• constipation
• mild rash

Less common but important to monitor:

• low appetite
• ringing in the ears
• blurry vision

Serious side effects:

• vomiting blood
• bloody stools
• chest pain
• slurred speech
• weakness in one side of the body
• unusual tiredness
• swelling ankles and feet
• changes in urination
• muscle cramps
• yellowing of the skin or eyes
• dark urine
• severe abdominal pain
• severe dizziness
• trouble breathing
• swelling of the face, tongue, or throat

Interactions with high risk of serious adverse effects and should be avoided:

• Ketorolac

Interactions with moderate risk that may require dose adjustment, closer monitoring, or timing changes:

• Abciximab
• Clopidogrel
• Warfarin
• ACE inhibitors (e.g., lisinopril)
• Angiotensin II receptor blockers (e.g., losartan)
• Diuretics (e.g., furosemide)
• Lithium
• Aspirin