Ibuprofen Dosing for Pain Relief
For pain relief in adults, ibuprofen should be dosed at 400-800 mg every 6 hours as needed, with a maximum daily dose of 2400 mg, using the lowest effective dose for the shortest duration possible. 1, 2
Standard Dosing Recommendations
Initial Dosing
- Start with 400-800 mg for acute pain relief 2, 1
- For mild to moderate pain: 400 mg every 4-6 hours as needed 1
- For moderate to severe pain: 400-800 mg every 6 hours 2, 1
Maximum Dosing
- Maximum single dose: 800 mg 2, 1
- Maximum daily dose: 2400 mg 2, 1
- Duration: Use for shortest time consistent with treatment goals 1
Specific Pain Conditions
Musculoskeletal Pain
- Acetaminophen and NSAIDs (including ibuprofen) are recommended as first-line agents for musculoskeletal pain 3
- For acute musculoskeletal pain: 400-800 mg every 6 hours 2
Dysmenorrhea
- Begin with earliest onset of pain: 400 mg every 4 hours as needed 1
Dental Pain
- Ibuprofen 400 mg has been shown to be superior to paracetamol 1000 mg for dental pain relief 4
- Duration of action for ibuprofen 400 mg is at least 6 hours compared to 4-6 hours for ibuprofen 200 mg 5
Special Considerations
Elderly Patients
- In older persons, start with lower doses due to increased risk of adverse effects 3
- Particular caution must be exercised when considering NSAID therapy for individuals with low creatinine clearance, gastropathy, cardiovascular disease, or heart failure 3
Administration Tips
- Take with food or milk if gastrointestinal complaints occur 1
- The smallest effective dose should be used to minimize adverse effects 1
Safety Considerations
Adverse Effects
- NSAID-associated adverse events include significant gastrointestinal toxicity, which increases in frequency and severity with age 3
- Gastrointestinal toxicity may be dose-related and time-dependent 3
- At OTC doses (≤1200 mg/day), ibuprofen has a good safety profile comparable to paracetamol 6
Contraindications
- Avoid in patients with aspirin/NSAID-induced asthma, history of GI bleeding or ulceration, severe heart failure, or third trimester pregnancy 2
- Use with caution in patients with renal impairment, cardiovascular disease, or liver disease 3, 2
Comparative Efficacy
- Ibuprofen 400 mg is more effective than paracetamol for pain relief, particularly in dental pain models 5, 4
- The smallest clinically useful dose of ibuprofen is 200 mg 5
- For chronic inflammatory pain (such as rheumatoid arthritis), NSAIDs are more effective than acetaminophen 3
Formulation Considerations
- Absorption of ibuprofen is influenced by formulation 5
- Certain salts of ibuprofen (lysine, arginine, potassium) and solubilized formulations have an enhanced onset of activity 5
Ibuprofen remains one of the most widely used and effective analgesics for acute pain management when used at appropriate doses. The balance of efficacy and safety makes it a valuable option for pain relief when used according to recommended guidelines.