Effective and freely available — and the medicine most often taken casually by people who should not take it at all.
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Ibuprofen is a non-steroidal anti-inflammatory drug — an NSAID. It reduces pain, inflammation and fever by blocking cyclo-oxygenase enzymes, which produce the prostaglandins that drive inflammation.
Those same prostaglandins also protect the stomach lining and maintain blood flow through the kidneys. That is not an unfortunate side effect of the drug — it is the same mechanism doing its job in the wrong place, and it explains essentially every risk on this page.
Topical ibuprofen gel gives useful relief for localised joint and muscle pain with a fraction of the systemic exposure, and is consistently underused for knee and hand osteoarthritis.
Adults: 200 to 400mg up to three times a day over the counter. Prescription doses go up to 400mg four times daily, and rarely higher.
During vomiting, diarrhoea, fever or heat illness, stop ibuprofen. Dehydration plus an NSAID is a recognised cause of acute kidney injury, and this is the single most useful piece of practical advice about it.
Children are dosed by weight and age.
In these situations paracetamol is the safer choice, and a topical NSAID gel is often a reasonable middle ground.
The "triple whammy" — an NSAID plus an ACE inhibitor or sartan plus a diuretic — is a well-recognised cause of acute kidney injury, especially during any illness causing dehydration.
If you take ramipril, losartan or a water tablet, ibuprofen is not a casual purchase.
Regular use warrants periodic kidney function checks and blood pressure monitoring. A proton pump inhibitor is co-prescribed where risk is higher.
Ibuprofen is available over the counter, so a prescription is rarely the point. What is worth paying for is the question of whether you should be taking it at all.
A large number of people take ibuprofen regularly who should not — because of kidney function, blood pressure medication, heart failure, a previous ulcer, or a combination of medicines that together cause kidney injury.
We will check that, check kidney function where it matters, and say plainly if a different painkiller is safer for you.
Ibuprofen is inexpensive, and supermarket own-brand tablets are identical to branded ones. Branded products marketed for specific complaints — migraine, period pain, back pain — usually contain exactly the same drug at the same dose.
Topical gels cost more than tablets but carry far less systemic risk, which frequently makes them better value.
The 400mg prescription-strength tablet and two 200mg tablets are the same thing.
Ibuprofen can be stopped at any time. There is no withdrawal.
Naproxen is taken twice daily and is generally preferred where an NSAID is needed regularly, with a slightly more favourable cardiovascular profile. Topical NSAIDs suit localised joint pain. Paracetamol is the safer systemic option where NSAIDs are contraindicated.
Regular painkiller use for headache can cause daily headache in its own right — worth considering before increasing the dose.
Yes, where ibuprofen is safe for you. Different mechanisms, so the combination beats a higher dose of either.
Because it reduces the prostaglandins that protect the stomach lining. Taking it with food helps but does not remove the risk, and ulcers can develop with no warning pain at all.
Avoid from 20 weeks and do not take from 30 weeks. Paracetamol is the recommended alternative. Before 20 weeks, take advice rather than assuming.
Take advice first. Ibuprofen raises blood pressure and reduces the effect of most blood pressure medicines, and the combination with an ACE inhibitor and a diuretic can injure the kidneys.
Yes, dosed by weight and age, with food. Not in chickenpox, where NSAIDs are associated with skin complications — use paracetamol instead. Stop it if a child is vomiting or not drinking.
Clinically reviewed by Dr Mohammad Zubair Khan, GMC 7563469
Last reviewed
August 30, 2026
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Yes. Care is led personally by Dr Mohammad Khan, so you are not passed between clinicians. Continuity is the point of a small practice: someone who knows your history and is listening attentively rather than working through a checklist.
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It means the diagnosis can usually be made from your history and photographs, and that treatment can be arranged safely without examining you. Where a condition is not marked treatable online, it is because examination is the diagnosis — listening to a chest, feeling an abdomen, examining an ear or a joint — or because a procedure or device is needed.
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If your problem turns out to be genuinely outside what we can do remotely, the doctor will tell you straight away, point you to the right service, and refund your fee in full. We would rather do that than fill twenty minutes to justify the charge.
Call 999 or go to A&E — do not book an online appointment and do not wait for a reply to an email. For urgent problems that are not emergencies, NHS 111 is available 24 hours a day, online or by phone, and can direct you to the right service.
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