Recommended Ibuprofen Dosing
The recommended dose of ibuprofen is 400-800 mg every 6 hours, with a maximum daily dose of 3200 mg for adults. 1
Adult Dosing
General Pain Management
- For mild to moderate pain: 400 mg every 4-6 hours as needed 1
- Maximum single dose: 800 mg 1
- Daily maximum: 3200 mg (do not exceed this amount) 1
Specific Conditions
- Rheumatoid arthritis and osteoarthritis: 1200-3200 mg daily (divided as 400 mg, 600 mg, or 800 mg three or four times daily) 1
- Dysmenorrhea (menstrual pain): 400 mg every 4 hours as needed, starting at earliest onset of pain 1
- Acute migraine: 400-800 mg every six hours, avoiding more than 2.4 g per day 2
Administration Considerations
- Take with food or milk if gastrointestinal complaints occur 1
- Use the lowest effective dose for the shortest duration consistent with treatment goals 1
- For emergency department management of acute pain: 400-600 mg orally every 4-6 hours 2
Safety Precautions
Contraindications
- Aspirin/NSAID-induced asthma 2
- History of NSAID-associated upper GI tract bleeding 2
- Uncontrolled hypertension 2
- Advanced renal disease 2
Common Adverse Effects
- Dizziness, rash, GI upset 2
- Dyspepsia and GI discomfort occur in 10-20% of patients 2
- Risk of GI bleeding increases with age 2
Special Populations
Elderly
- Consider starting at the lower end of the dosing range 2
- Increased risk of adverse effects, particularly GI bleeding 2
- One-year risk of serious GI bleeding is approximately 1 in 110 in adults older than 75 years 2
Pregnancy
- Safe for short-term use (7-10 days) during first and second trimesters 2
- Should be discontinued after gestational week 28 (end of second trimester) 2
- May interfere with ovulation if used continuously during periovulatory period 2
Children
- Not covered in the provided evidence for this specific question
Risk Mitigation
- Consider combining with a proton pump inhibitor or histamine H2 blocker in patients at risk for GI complications 2
- Avoid use in patients with history of cardiovascular disease when possible 2
- Monitor for signs of GI bleeding, especially in elderly patients 2
- Avoid concomitant use with anticoagulants when possible, as this increases risk of GI bleeding 5-6 times 2
Clinical Pearls
- Linear blood level dose-response relationship exists with single doses up to 800 mg 1
- Therapeutic response in chronic conditions may take a few days to two weeks 1
- In acute pain management, doses greater than 400 mg were not shown to be more effective than the 400 mg dose in controlled analgesic trials 1
- Ibuprofen 400 mg has a duration of action of at least 6 hours compared with 4-6 hours for ibuprofen 200 mg 3