From the Guidelines
Alternatives to ibuprofen include paracetamol, diclofenac, or naproxen, with paracetamol being the first line of treatment for pain relief, as recommended by the North of England Non-Steroidal Anti-Inflammatory Drug Guideline Development Group 1. When considering alternatives to ibuprofen, it's essential to weigh the benefits and risks of each option.
- Paracetamol is a suitable first-line treatment for pain relief, with a recommended dose of up to 4g daily 1.
- Diclofenac and naproxen are alternative NSAIDs that can be considered if paracetamol is ineffective, with diclofenac being a more potent anti-inflammatory agent 1.
- Naproxen provides longer-lasting relief and is preferred for chronic conditions such as rheumatoid arthritis 1.
- Aspirin is another alternative, but it carries bleeding risks and should be used with caution 1.
- Celecoxib, a prescription NSAID, causes less stomach irritation and can be considered for patients with increased gastrointestinal risk 1. Non-medication alternatives, such as topical treatments, heat/cold therapy, physical therapy, and gentle exercise, can also be effective in managing pain and improving quality of life 1. It's crucial to consult a healthcare provider before switching pain medications, especially for patients with chronic conditions or those taking other medications, to determine the best course of treatment and minimize potential risks 1.
From the FDA Drug Label
NSAID medicines are used to treat pain and redness, swelling, and heat (inflammation) from medical conditions such as: different types of arthritis menstrual cramps and other types of short-term pain NSAID medicines that need a prescription Generic Name Trade Name Celecoxib Celebrex® Diclofenac Cataflam®, Voltaren®, ArthrotecTM (combined with misoprostol) Diflunisal Dolobid® Etodolac Lodine®, Lodine® XL Fenoprofen Nalfon®, Nalfon® 200 Flurbiprofen Ansaid® Ibuprofen Motrin®, Tab-Profen®, Vicoprofen®* (combined with hydrocodone), CombunoxTM (combined with oxycodone) Indomethacin Indocin®, Indocin® SR, Indo-LemmonTM, IndomethaganTM Ketoprofen Oruvail® Ketorolac Toradol® Mefenamic Acid Ponstel® Meloxicam Mobic® Nabumetone Relafen® Naproxen Naprosyn®, Anaprox®, Anaprox® DS, EC-Naproxyn®, Naprelan®, Naprapac® (copackaged with lansoprazole) Oxaprozin Daypro® Piroxicam Feldene® Sulindac Clinoril® Tolmetin Tolectin®, Tolectin® DS, Tolectin® 600
Alternatives for ibuprofen include:
- Naproxen (Naprosyn®, Anaprox®, Anaprox® DS, EC-Naproxyn®, Naprelan®, Naprapac®)
- Celecoxib (Celebrex®)
- Diclofenac (Cataflam®, Voltaren®, ArthrotecTM)
- Etodolac (Lodine®, Lodine® XL)
- Ketoprofen (Oruvail®)
- Meloxicam (Mobic®)
- Indomethacin (Indocin®, Indocin® SR, Indo-LemmonTM, IndomethaganTM)
- Ketorolac (Toradol®)
- Mefenamic Acid (Ponstel®)
- Nabumetone (Relafen®)
- Oxaprozin (Daypro®)
- Piroxicam (Feldene®)
- Sulindac (Clinoril®)
- Tolmetin (Tolectin®, Tolectin® DS, Tolectin® 600) 2
From the Research
Alternatives to Ibuprofen
Alternatives to ibuprofen can be considered based on the type and severity of pain. Some options include:
- Paracetamol (acetaminophen) 3, 4, 5, 6, 7
- Other non-steroidal anti-inflammatory drugs (NSAIDs) such as aspirin, diclofenac, and naproxen 7
- Triptans, which are migraine-specific medications 7
- Combination analgesics, such as acetaminophen/aspirin/caffeine 7
- Ergotamine/caffeine compounds 7
Considerations for Choosing an Alternative
When choosing an alternative to ibuprofen, consider the following:
- The type and severity of pain 4, 7
- Underlying medical conditions, such as liver, kidney, or cardiovascular disease 3
- Age and individual tolerance to medications 3, 5
- Potential interactions with other medications 5
- The need for stratified care, where treatment is tailored to the severity of the pain 7
Efficacy of Paracetamol as an Alternative
Paracetamol has been shown to be effective for mild to moderate acute pain 3, 4, 5, but its efficacy for chronic pain is less clear 6. It is generally considered a safe alternative to ibuprofen, with a lower risk of gastrointestinal and cardiovascular side effects 3, 5. However, it is essential to follow the recommended dosage and consult with a physician if necessary 3, 5.