The short answer
Ibuprofen is used in the long term to treat rheumatic pain and severe musculoskeletal pain. Studies considered the use of ibuprofen for more than 180 days as a long-term use while the short-term use is less than 180 days.
- Several studies considered the use of ibuprofen for more than 180 days as a long-term use while the short-term use is less than 180 days.
- Ibuprofen is used in the long term for the treatment of rheumatic pain and severe musculoskeletal pain.
- You shouldn’t exceed the maximum daily dose of ibuprofen which is reported as 1200 mg per day (over-the-counter uses) and 3200 mg per day for the prescribed dose
- The main side effects of long-term use of ibuprofen are attributed to the inhibition of cyclooxygenase enzymes that are responsible for the production of prostaglandins and thromboxane.
- The side effects of long-term use of ibuprofen are gastrointestinal bleeding, ulcers, perforations, renal impairments, increased risk of stroke, and heart attacks.
- Ibuprofen is contraindicated for patients with hypersensitivity against ibuprofen, aspirin, and other NSAIDs, pregnancy (3rd trimester), patients with renal or hepatic impairments, and patients with cardiovascular disease.
What are the Indications of ibuprofen?
Ibuprofen was first discovered in 1961 by Dr. Adams and John Nicholson. Nowadays, ibuprofen has become one of the most widely used NSAIDs worldwide (Ref).
It is a nonsteroidal anti-inflammatory agent that is commonly used over-the-counter (OTC) or prescribed to relieve pain and inflammation.
The typical dosage formulations of ibuprofen include oral capsule, oral suspension, oral tablet, chewable tablet, intravenous solution, topical gel, and combination kit.
For oral administration, it is usually recommended to consume the ibuprofen with food or milk in both adults and children.
It is used in high doses (2400 mg per day) for the treatment of rheumatic pain.
The lower dose of ibuprofen (less than 1200 mg per day for less than 2 weeks) is used for the treatment of mild to moderate acute pain such as the following conditions:
- Dental pain
- Acute injury
- Muscle sprains or strains
- Joint aches
- Pain from migraine
- Sore throat
- Pain from cold or cases of flu.
Ibuprofen offers a favorable safety profile compared with other NSAID agents. The most commonly reported side effects include gastrointestinal and cardiovascular which are relatively rare to occur (Ref).
Ibuprofen with its short circulation half-life (1.8–2.0 h) and its lack of a pathologic metabolite, showed a low reported rate of liver toxicity compared with other NSAIDs (Ref).
At low doses (800–1,200 mg per day), which in many countries are approved for non-prescription (OTC) sale, ibuprofen has a good safety profile comparable with paracetamol (Ref).
What is considered long-term use of ibuprofen?
Ibuprofen is used over-the-counter or prescribed to relieve pain and to reduce inflammation. However, its uses are associated with numerous side effects especially when used in high doses and/or long-term uses.
Studies considered that the long-term use of ibuprofen means taking ibuprofen for more than 180 days While when it is used for less than 180 days it is considered short-term use ( Ref-1, Ref-2, Ref-3). Other studies considered the long-term uses of ibuprofen when it is used for more than 90 days (Ref-4).
For daily use of ibuprofen, It is recommended not to take it more than 1 month. The daily dose ranges from 400 mg to 800 mg (the highest allowed daily dose to be taken at once) while the maximum daily dose is 3200 mg (Ref).
At OTC doses (1,200 mg/day) ibuprofen has a comparable safety profile with that of paracetamol (Ref).
When you use ibuprofen at a dose higher than the maximum daily dose, the side effects can outweigh the desired benefits of ibuprofen as a painkiller.
You shouldn’t exceed the maximum daily dose of ibuprofen, a study published in 2018 showed that about 15% of adult ibuprofen users in the US exceed the maximum recommended daily dose of 1 or more over-the-counter or prescription NSAIDs during a week
What are the Long-term uses of ibuprofen?
The long-term uses of ibuprofen in high doses (1800 to 2300 mg per day) is employed in the treatments of the following
Severe musculoskeletal conditions
How much ibuprofen can you take safely long term?
for adults, the recommended daily dose of ibuprofen ranges from 400 to 800 mg every 4-6 hours.
You should exceed the maximum daily dose of ibuprofen which is reported as 1200 mg per day (over-the-counter uses) and 3200 mg per day for the prescribed dose.
The long-term uses of ibuprofen are commonly associated with many side effects including gastrointestinal, cardiovascular, renal, and hepatic side effects.
You should consult your doctor if you need to use ibuprofen for the long term. In this case, the risk benefits should be considered.
It is advised not to use ibuprofen for the long term without consulting your doctor.
What are the adverse effects of long-term use of ibuprofen?
The main causes of adverse effects of ibuprofen administration are derived from the various cellular processes throughout multiple organ systems which are affected by the inhibition of the cyclooxygenase pathway by ibuprofen.
Cyclooxygenase enzymes are essential for the production of prostaglandins and thromboxane which are important for maintaining the gastric mucosal layer and renal blood flow and are employed in several body functions.
Now the question is, what happens if you take ibuprofen for a long time?
The long-term uses of ibuprofen, especially high doses of ibuprofen, can lead to the following:
- Gastrointestinal side effects: The inhibition of COX-1 and COX-2 by ibuprofen is associated with higher stomach acid production, reduced mucus, and depletion of the mucosal tissue of the cryoprotective prostaglandins, inhibition of repair and make the mucus membranes more vulnerable to damage (Ref).
- Gastrointestinal bleeding is a well-known adverse effect of ibuprofen usage that can lead to gastritis, ulceration, hemorrhage, or/and perforation.
- Anemia can results from bleeding induced by ibuprofen
- Increase your risk of having a stroke which means disturbed blood supply to your brain
- Higher risk of heart attack which results from reduced blood supply to your heart
- For women, long-term uses of ibuprofen can reduce fertility. However, this effect is reversible after stopping ibuprofen administration.
- Reduced renal function is also a concern with long-term uses of ibuprofen
What are the contraindications of ibuprofen?
Ibuprofen is contraindicated in the following conditions:
- Patients with a known history of hypersensitivity or allergic reactions to ibuprofen, other NSAIDs, or aspirin.
- Pregnancy (3rd trimester)
- Patients with congenital heart diseases
- Active bleeding
- Coagulation defects
- Gastrointestinal or cerebrovascular bleeding
- Uncontrolled heart failure
- Renal impairment
- Hepatic impairment or hepatic disease.