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Most people who buy Ibuprofen as an over-the-counter medication to relieve pain or muscle aches do not think that it can be dangerous or addictive. Yet, too much Ibuprofen can have damaging side effects and Ibuprofen dependency does exist as a health condition.
It is not just illegal or prescription drugs that can cause problems and regular Ibuprofen users should be aware of the pitfalls.
What is Ibuprofen?
Ibuprofen is a nonsteroidal anti-inflammatory drug (NSAID) first formulated in the 1960s and is now available as an over-the-counter (OTC) drug in tablet, capsule and liquid form. It is commonly used as a fast-acting painkiller for everyday events, such as toothache and chronic pain and also to treat inflammation, such as sprains and arthritis.
Are There Adverse Side Effects of Using Ibuprofen?
While occasional use of this drug within the recommended dose is generally thought safe, care and proper consultation should always take place before using any OTC drug for the first time.
There are a number of side effects that can arise (as with many prescription medications). These will vary per person because factors such as age, size, weight and general health play a part as well as the amounts taken and possible interaction with other drugs.
Special care should be taken in controlling even moderate pain for certain groups, such as pregnant women.
Common Side Effects
These are generally transient and non-life-threatening. They can be one or more of the following physical symptoms:
- Feeling dizzy
- Drowsiness, tiredness and sleep problems
- Thirst and sweats
- Tingling or numbness in hands and feet
- Ringing in the ears
- Blurred vision
- Fluid retention and swollen ankles
- Mild allergic reactions
- Stomach pain and diarrhoea
- Nausea and vomiting
- Bladder irritation.
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Serious Side Effects
There are a number of serious side effects that can occur when more medication than the maximum recommended daily dose is taken to relieve severe pain or when the drug is taken over a long period due to a person’s health conditions.
These side effects carry an increased risk of complications affecting a person’s life and requiring medical care. They include the following possibilities
- Impaired hearing
- Kidney and liver damage
- Bleeding in the stomach and bowels leading to ulcers and anaemia
- Increased risk of heart attack or strokes
- Habit-forming behaviour leading to moderate substance use disorder or even Ibuprofen dependence
- Possible overdose requiring emergency procedures.
When a person’s medical condition requires taking more Ibuprofen than normal, perhaps for controlling severe chronic pain or inflammation, then the advice of a primary care physician should always be sought. They may prescribe medicine to protect against such effects.
Taking too much Ibuprofen either accidentally or as a form of deliberate substance abuse, can leave you requiring immediate intervention. The symptoms of an Ibuprofen overdose include the following:
- Agitation and confusion
- Severe headache
- Blurred vision, ringing in the ears
- Diarrhoea, nausea and vomiting
- Low blood pressure
- Difficulty breathing
- Stomach pain
- Sweating and chills
- Unsteadiness and dizziness
- General weakness and drowsiness
Ibuprofen Addiction: Does it Exist?
While it is not as physically addictive as some drugs, too much Ibuprofen can lead to physical and psychological dependence. All drugs, including OTC medication like Ibuprofen, should be used responsibly and as directed by a healthcare provider to avoid potential health risks. Opioids and many other drugs may have a higher potential for addiction, but Ibuprofen is addictive too and is misused.
Physical addiction can build where people with chronic pain come to rely on the drug and may experience gradually more intense pain symptoms as it wears off, leading to repeated intake. This results in a cycle of addiction with classical signs of addiction identified in the DSM 5 (the American Psychiatric Association Diagnostic Manual):
- Developing a tolerance
- Using more ibuprofen than intended
- Inability to stop using ibuprofen
- Continuing to take the drug despite negative consequences
- Prioritising the use of the drug over other needs
- Obsessively thinking about using Ibuprofen
- Craving the drug
Psychological dependence occurs when a person believes they need a substance to cope with emotional or psychological issues. Some people may develop a psychological dependence if they rely on it excessively for pain relief. This can result in them taking Ibuprofen to alleviate an anxiety disorder, even when it may not be necessary to control pain, or in larger doses than recommended.
Why Do People Seek Comfort in Abusing Ibuprofen?
Factors that can lead to Ibuprofen abuse are the same as when other pain relieving medication (such as opioids) is used inappropriately:
- People find they gain comfort through the relief of pain and seek to recreate this good feeling even when they are not in pain.
- They are unaware of the building of the addictive cycle and potential risks.
- They are misinformed as to the side effects of the drug and think it is a safe option in any form.
What is the Connection Between Ibuprofen Addiction and Other Substance Use Disorders?
There is generally no direct connection between Ibuprofen addiction and other substance use disorders like those associated with opioids, alcohol, or illicit drugs. Ibuprofen use alone is not considered to be a substance with a significant potential for addiction or abuse. However, there are a few indirect connections and considerations to keep in mind:
- Polydrug Use: In cases where people are already struggling with substance use disorders, they may also be using OTC medications like Ibuprofen or Paracetamol. This can happen when multiple substances are used together (such as a cutting agent for heroin) or interchangeably, in planning to achieve certain effects for controlling pain or alleviating withdrawals.
- Self-Medication: Some individuals with substance use disorders may use Ibuprofen to self-medicate pain or discomfort associated with withdrawal symptoms or the physical consequences of their primary substance use. For example, they may use Ibuprofen to alleviate hangover headaches or body aches caused by heroin withdrawal.
- Behavioural Patterns: People with a history of addiction may have a predisposition to engage in risky or compulsive behaviours, including the misuse or overuse of medications like Ibuprofen.
What are the Risks Associated with Long-Term Ibuprofen Abuse?
It’s important to note that ibuprofen is intended for short-term use to relieve pain, reduce inflammation, and lower fever. When used as directed and for short durations, it is generally safe for most people. However, chronic or excessive use can lead to the following risks:
- Gastrointestinal Problems: increase in the risk of developing stomach ulcers, bleeding, and other gastrointestinal issues.
- Kidney Damage: serious damage or even kidney failure through nephrotoxicity.
- Cardiovascular Effects: the risk is more significant in individuals with pre-existing cardiovascular conditions.
- Hypertension (High Blood Pressure): fluid retention and increased blood pressure, which may be problematic for individuals with hypertension.
- Liver Damage: Ibuprofen is less likely to cause liver problems compared to some other medications, but chronic overuse can still affect liver function.
- Bleeding Disorders: Ibuprofen can inhibit blood clotting, which can be problematic for individuals with bleeding disorders.
- Rebound Headaches: Overusing to manage headaches can lead to a phenomenon known as “rebound headaches.”
- Bone Health: Ibuprofen addiction can increase the risk of osteoporosis and fractures.
- Addiction including overdose
Mixing Ibuprofen with Other OTC Medications
Mixing ibuprofen with other over-the-counter (OTC) medications or substances can potentially lead to various risks and complications. It’s essential to be aware of these potential dangers and to consult with a healthcare professional or pharmacist before combining medications. Some of the concerns when mixing ibuprofen with other OTC medications include:
- Increased Risk of Gastrointestinal Irritation: Ibuprofen is an NSAID (nonsteroidal anti-inflammatory drug), and taking it alongside other NSAIDs, such as aspirin or naproxen, can increase the risk of gastrointestinal irritation, stomach ulcers, and bleeding.
- Interactions with Blood Thinners: Combining ibuprofen with blood-thinning medications (anticoagulants) like warfarin or antiplatelet drugs like aspirin can increase the risk of bleeding. These combinations should be closely monitored by a healthcare provider.
- Interaction with Other Pain Relievers: Mixing ibuprofen with acetaminophen (Tylenol) or other OTC pain relievers may not necessarily enhance pain relief and can increase the risk of exceeding the recommended dosage, leading to potential liver damage (in the case of acetaminophen) or gastrointestinal issues.
- Increased Blood Pressure: Ibuprofen can raise blood pressure, and taking it with decongestants or other cold medications containing sympathomimetic agents (e.g., pseudoephedrine) can further elevate blood pressure, potentially leading to hypertension or worsening existing hypertension.
- Kidney Damage: Combining ibuprofen with other medications that can affect kidney function, such as certain diuretics, can increase the risk of kidney damage.
- Exacerbation of Existing Health Conditions: Some OTC medications can interact with ibuprofen and exacerbate preexisting health conditions. For example, certain antihypertensive medications may be less effective when taken with ibuprofen.
- Increased Risk of Gastrointestinal Bleeding: Alcohol, when combined with ibuprofen, can significantly increase the risk of gastrointestinal bleeding and ulcers. Both ibuprofen and alcohol can individually irritate the stomach lining, and their combined use can intensify this effect.
- Allergic Reactions: Combining different OTC medications increases the risk of allergic reactions, especially if you have allergies or sensitivities to any of the ingredients. Be sure to check the labels for potential allergens and consult a healthcare provider if you have concerns.
- Overdose Risk: Mixing multiple OTC medications can increase the risk of accidentally exceeding the recommended dosage for any of them, potentially leading to overdose and severe health consequences.
To avoid these dangers, it’s crucial to:
- Consult with a healthcare provider or pharmacist before combining OTC medications, especially if you have underlying medical conditions or are taking other prescription medications.
- Read the labels of OTC medications carefully to understand their ingredients and potential interactions.
- Follow the recommended dosages and instructions for each medication.
- Be cautious about using multiple medications to address the same symptoms. Sometimes, a single medication or a combination product specifically designed for your needs may be a safer option.
- If you experience adverse effects or have concerns about medication interactions, seek medical attention promptly.
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