From the Guidelines
The recommended dose of ibuprofen is 400 to 800 mg every six hours, with a maximal initial dose of 800 mg and a maximal daily dosage of 2.4 g. This dosage is based on the study published in the American Family Physician in 2002 1. The study provides a comprehensive overview of acute pain management in patients with migraine headaches and lists the dosage of ibuprofen as 400 to 800 mg every six hours.
Key Considerations
- The maximal initial dose of ibuprofen should not exceed 800 mg, and the maximal daily dosage should not exceed 2.4 g 1.
- Ibuprofen should be used with caution in patients with aspirin/NSAID-induced asthma 1.
- Common adverse reactions to ibuprofen include dizziness, rash, and GI upset 1.
Patient Guidance
- Patients should be advised to take ibuprofen with food or milk to reduce stomach irritation.
- Patients with certain conditions, such as kidney disease, heart disease, high blood pressure, or stomach ulcers, should consult a healthcare provider before using ibuprofen.
- Patients should be aware of the potential side effects of ibuprofen, including stomach upset, heartburn, and increased risk of cardiovascular events with prolonged use.
From the FDA Drug Label
DOSAGE AND ADMINISTRATION Carefully consider the potential benefits and risks of ibuprofen tablets and other treatment options before deciding to use ibuprofen tablets. Use the lowest effective dose for the shortest duration consistent with individual patient treatment goals [see WARNINGS] After observing the response to initial therapy with ibuprofen tablets, the dose and frequency should be adjusted to suit an individual patient's needs. Do not exceed 3200 mg total daily dose. Rheumatoid arthritis and osteoarthritis, including flare-ups of chronic disease: Suggested Dosage: 1200 mg to 3200 mg daily (400 mg, 600 mg or 800 mg tid or qid). Mild to moderate pain: 400 mg every 4 to 6 hours as necessary for relief of pain. Dysmenorrhea: For the treatment of dysmenorrhea, beginning with the earliest onset of such pain, ibuprofen tablets should be given in a dose of 400 mg every 4 hours as necessary for the relief of pain.
The recommended dose of ibuprofen is:
- For rheumatoid arthritis and osteoarthritis: 1200 mg to 3200 mg daily
- For mild to moderate pain: 400 mg every 4 to 6 hours as necessary
- For dysmenorrhea: 400 mg every 4 hours as necessary The maximum daily dose should not exceed 3200 mg 2.
From the Research
Ibuprofen Dose Information
- The provided study 3 does not specify the recommended dose of ibuprofen.
- However, it mentions that the study reviews the safety of non-aspirin over-the-counter (OTC) analgesics, including ibuprofen, at OTC doses.
- The study notes that the risk of serious gastrointestinal (GI) toxicity, including upper GI bleeding and peptic ulcers, was low at OTC doses of ibuprofen and other nonsteroidal anti-inflammatory drugs (NSAIDs).
- It also mentions that liver injury due to acetaminophen can occur at doses < 4000 mg, but does not provide specific dose information for ibuprofen.
Gastrointestinal Safety
- The study 3 reports that the gastrointestinal adverse event (AE) rate for ibuprofen at OTC doses was 7.2% in one study.
- GI effects accounted for 75% of total AEs in the study, indicating that gastrointestinal safety is an important consideration when taking ibuprofen.
- However, the study notes that the risk of serious GI toxicity was low at OTC doses of ibuprofen and other NSAIDs.
Hepatic Safety
- The study 3 mentions that both NSAIDs, including ibuprofen, and acetaminophen may be associated with hepatotoxicity and acute liver failure (ALF).
- However, the risks associated with acetaminophen are somewhat higher and better documented, and liver injury due to acetaminophen can occur at doses < 4000 mg.
- The study notes that reports of NSAID-associated hepatotoxicity rarely make distinctions by dose, making the risk at OTC doses difficult to assess.