From the FDA Drug Label
DOSAGE AND ADMINISTRATION ... Do not exceed 3200 mg total daily dose. Mild to moderate pain: 400 mg every 4 to 6 hours as necessary for relief of pain.
The highest dosage of ibuprofen for mild to moderate pain is 400 mg every 4 to 6 hours, but the maximum daily dose should not exceed 3200 mg. However, the question asks for the highest dosage pain medication sold over the counter in Europe. Since the provided text does not specify that this is the highest dosage pain medication sold over the counter in Europe, no conclusion can be drawn. 1
From the Research
The highest dosage pain medication available over the counter in Europe is typically ibuprofen 400mg tablets. In many European countries, adults can purchase ibuprofen in 400mg strength without a prescription, with a maximum daily dose of 1200mg (three 400mg tablets per day) 2. Paracetamol (acetaminophen) is also widely available in 500mg tablets with a maximum daily dose of 4000mg (eight tablets per day). When using these medications, it's essential to follow the package instructions and not exceed the recommended daily dosage.
Key Considerations
- Ibuprofen reduces inflammation by inhibiting prostaglandin production and is effective for inflammatory pain, while paracetamol works centrally in the brain to reduce pain perception but has less anti-inflammatory effect 3.
- For safety, these medications should be taken with food to reduce stomach irritation, especially ibuprofen which can cause gastric issues 4.
- If pain persists beyond a few days or is severe, medical advice should be sought as higher doses require prescription.
Comparison of Ibuprofen and Paracetamol
- Studies have shown that ibuprofen is consistently superior to paracetamol at conventional doses in a range of painful conditions, including acute post-operative pain, dysmenorrhoea, and osteoarthritis 3, 5.
- A meta-analysis of randomized controlled trials found that ibuprofen was more efficacious than acetaminophen for the treatment of pain and fever in both pediatric and adult populations, and that these two drugs were equally safe 5.
Recent Studies
- A 2019 study compared the analgesic efficacy of oral ibuprofen at three different doses (400,600, and 800 mg) in adult patients with acute pain, and found that all three doses had similar analgesic efficacy for short-term pain relief 2.
- A 2020 study evaluated the efficacy and safety of a fixed-dose combination of ibuprofen and acetaminophen in the treatment of postsurgical dental pain, and found that the combination provided superior analgesic efficacy to individual monocomponents 6.