I take Advil pretty regularly for pain, but how can I tell if I'm taking more than is safe?
Headaches. Fevers. Period cramps. Back pain. These are all symptoms that all can be treated with ibuprofen, better known by one of its brand names, Advil.
Given the drug's broad pain-reducing effects, excellent safety profile and availability over the counter, it's no surprise that some people pop the little brownish-red tablets whenever they feel the slightest twinge of discomfort.
"It's my go-to when I have pain," said Candy Isouromes. a professor of clinical pharmacy at the University of California San Francisco.
Still, ibuprofen - also sold under brand names like Motrin and Nuprin - can pose certain health risks. especially for those with kidney or stomach issues.
Scan the label of over-the-counter ibuprofen and you'll see that adults and children 12 years and older are advised to take one (or two, if needed) 200-milligram tablets, caplets or gel caplets every four to six hours while symptoms persist. And those taking the drug should not exceed 1,200 milligrams (or six pills) in 24 hours.
But because doctors sometimes prescribe ibuprofen in much higher dosages, up to 3,200 milligrams a day, it can be hard to say how much is too much.
This discrepancy is rooted in safety concerns. The Food and Drug Administration sets strict dosage limits for over-the-counter drugs because they may be taken by people with various risk factors, Dr. Tsourounis said. If you're unlikely to have an adverse reaction, your doctor may prescribe a higher dose.
If you haven't consulted a doctor about how much is safe, or if you aren't certain about your risk factors, it's best not to exceed the recommended limit of 1,200 milligrams a day, Dr. Tsourounis said.
And be careful that you don't accidentally take more than intended: Ibuprofen is sometimes added to certain cold medications, like Sudafed PE Head Congestion and Pain Relief, so always read the ingredient list on medications before using them.
Ibuprofen belongs to a class of drugs known as nonsteroidal anti-inflammatory drugs, or NSAIDs, which reduce pain and inflammation by blocking the activity of certain enzymes, Dr Tsourounis said. This is why tamping them down often makes you feel better.
But these enzymes also help maintain kidney and liver function and regulate the balance of fluids and electrolytes in your body, she added. So taking ibuprofen can be dangerous for patients with kidney disease or failure; those with liver damage or cirrhosis; and people with conditions that put strain on their kidneys, like high blood pressure or heart failure
Those at high risk for these conditions - as well as for stomach ulcers, heart attacks, strokes or bleeding problems - should talk with their doctors before taking ibuprofen. The same goes if you're pregnant; ibuprofen is not recommended at or after 20 seeks. according to the F.D.A., since it may in rare cases harm the fetus's kidneys
People who take medicatoins such as diuretics anticoagulants, ACE inhibitors or ARBs (anglotensin receptor blockers) to manage cardiovascular issues should also be careful, Dr Tsourounis said, because ibuprofen streses, the kidneys and the heart.
And ironically, regular ibuprofen use among people with headache disorders (such as migraines) can cause rebound headaches, for reasons doctors don't completely understand.
Melinda Wenner Moyer
