What is the recommended dosing schedule and maximum daily amount of over‑the‑counter ibuprofen for a typical healthy adult without contraindications?

Over-the-Counter Ibuprofen Dosing for Healthy Adults

For a typical healthy adult without contraindications, the recommended dose of over-the-counter ibuprofen is 200–400 mg every 4–6 hours as needed, with a maximum daily dose of 1200 mg (not exceeding 10 days of continuous use). 1

Standard OTC Dosing Schedule

• Single dose: 200 mg is the smallest clinically useful dose, though 400 mg provides superior and longer-lasting analgesia 2
• Frequency: Every 4–6 hours as needed for pain relief 1
• Maximum daily dose: 1200 mg per day for OTC (non-prescription) use 3
• Duration limit: Up to 10 days for self-treatment of acute pain without medical supervision 3

Dose-Response Relationship

• 200 mg dose: Provides 4–6 hours of pain relief and is broadly comparable to naproxen 220 mg 2
• 400 mg dose: Delivers at least 6 hours of analgesia—superior to aspirin 600–900 mg and paracetamol in dental pain models—and is comparable to ketoprofen 25 mg 2
• Doses above 400 mg: In controlled analgesic trials, single doses greater than 400 mg were no more effective than 400 mg for acute pain 1

Timing and Administration

• Take with food, meals, or milk if gastrointestinal discomfort occurs 1
• The 400 mg dose offers a longer duration of action (≥6 hours) compared with 200 mg (4–6 hours), allowing less frequent dosing 2
• Absorption is rapid and complete when given orally, with peak analgesic effect occurring within 1–2 hours 4

Safety Profile at OTC Doses

• Gastrointestinal risk: At OTC doses (≤1200 mg/day), ibuprofen has a safety profile comparable to paracetamol and lower GI toxicity than aspirin 3, 5
• Cardiovascular and renal risk: Low possibilities of serious renal or cardiovascular events at OTC doses, particularly with short-term use 3
• Hepatotoxicity: Ibuprofen does not carry the risk of irreversible liver damage seen with paracetamol overdose 3
• Overdose tolerance: Ibuprofen is considered relatively benign in overdose compared with other analgesics 6

Common Pitfalls to Avoid

• Do not exceed 1200 mg/day for self-directed OTC use; higher doses (1800–3200 mg/day) require physician supervision and are associated with dose-dependent adverse reactions 1, 6
• Do not use continuously for more than 10 days without medical evaluation, as adverse reactions appear to be duration-dependent 6, 3
• Avoid combining with aspirin in patients taking low-dose aspirin for cardiovascular protection, as ibuprofen may interfere with aspirin's antiplatelet effects 3
• Do not assume higher doses are more effective for acute pain; controlled trials show 400 mg is the optimal single dose for analgesia 1, 2

Prescription vs. OTC Distinction

• OTC range: 200–400 mg per dose, maximum 1200 mg/day, short-term use (≤10 days) 1, 3
• Prescription range: 1200–3200 mg/day in divided doses (tid or qid) for chronic inflammatory conditions like rheumatoid arthritis, requiring ongoing medical supervision 1
• The key differentiator is that adverse reactions are dose- and duration-dependent, which explains the favorable tolerability of OTC ibuprofen 6