I love ibuprofen. Advil in particular. I have been taking this pain-reliever for decades. Pretty much any kind of headache, pop 4 of them, and I’m good to go. And I’ve always known if something came out about long-term adverse effects, I would be in trouble. So in this episode, we’re going to learn a little about this wonder drug, its history, and most importantly, long-term effects on our health.

Ibuprofen was developed by the Boots Group in Nottingham, England, which is an interesting company, pharmacies which at one time included lending libraries. Now this company has been merged into Walgreens Boots Alliance which includes the Walgreens stores in the U.S. It is derived from propionic acid, and the name comes from the components isobutyl (ibu) propionic acid (pro), and phenyl (fen).

Initially one of the scientists who developed the drug, Stewart Adams, tested it as a treatment for his hangovers. He died in 2019 at the age of 95, presumably having taken ibuprofen since it was invented, which I think is a good sign for me. But we’re not done yet.

The drug was approved for use as a treatment for rheumatoid arthritis in 1969 in the UK and then in 1974 in the US, where it has been available as an over-the-counter drug since 1984 and is available in generic form, or under the brand names Advil and Motrin.

Side effects:

Ironically, the first listed side effect is headache. Huh? Yeah. Others are:

-dizziness
-drowsiness
-thirst and sweating
-tingling or numbness in hands and feet
-ringing in the ears
-blurred vision and eye irritation
-fluid retention and ankle swelling
-mild allergic reaction
-abdominal pain, nausea, vomiting, heartburn, diarrhea, and constipation
-bladder irritation and pain
-frequent urination

There’s an even bigger list at drugs.com Also an interesting note is that NSAIDS, that is non-steroidal anti-inflammatory drugs, such as ibuprofen, can increase the risk of heart attack or stroke in people with or without heart disease or the risk factors for heart disease.

However, ibuprofen is considered the most tolerable drug in its class, and the World Health Organization has put it on its Model List of Essential Medicines, which is a list of “minimum medicine needed for a basic health-care system, listing the most efficacious, safe and cost-effective medicines for priority conditions.” That’s a pretty good endorsement as well.

Long-term effects. This is what I was really interested in finding out.

Kidney and liver damage. This is related to the changes in your body’s production of prostaglandins caused by ibuprofen. Prostaglandins are hormones that regulate fluid pressure in your body and help maintain blood pressure. Ibuprofen changes the body’s production of these hormones and this can result in decreased kidney function and increased blood pressure. This is bad, of course, check out our episode on kidneys at runningafever.com/222. Symptoms include increased blood pressure, fluid buildup, dehydration, less frequent urination, and dizziness. The risk of this side effect is increased for older adults, people with kidney disease, and people who take blood pressure medications. I will, hopefully, be an older adult someday, if I’m not already. Nothing I can do about that. I also take blood pressure medication, but I think I can help that by keeping my weight down and eating a healthy diet. Good topic for another episode.

Bleeding in the stomach and bowels. This is rare and usually associated with a history of ulcers or bleeding in your stomach or intestines, older age, use of oral steroids or the blood thinners known as anticoagulants, smoking (what doesn’t that make worse), and alcohol use, specifically more than three drinks a day.

Increased risk of heart attack and stroke. This is also a rare side effect, but if you have other risk factors for heart attack and stroke, have a clotting disorder, or take other medications that affect how your blood clots, you are at increased risk.

Any of these complicating factors, you should discuss with your doctor of course, and it should be mentioned, for example, if the doc prescribes something that may conflict with ibuprofen because he should assume that pretty much everybody takes it.

However, knowing all this, I think it’s highly unlikely that I will stop taking ibuprofen, just be the sheer magnitude of its benefit as a pain reliever with mild or no side effects most of the time.

Overdose? Yes, you can overdose on ibuprofen. In fact, the low dose of the OTC version is thought to be one reason for its mildness and success. It is rarely fatal in overdose, but this does happen. The most likely result is damage to your stomach or intestines. Take it as prescribed. I weigh over 200 pounds, and I usually take 800mg. It is weight dependent for children, and age-dependent for adults. It’s recommended that you take as little as possible if you are over the age of 60, otherwise one or two 200mg tablets every 4-6 hours, with a maximum of 800mg per day.

Well, I don’t know about you, but I feel a lot better about ibuprofen, just knowing these things. I did not know I should avoid it after age 60. And I now know the other factors that put me at higher risk for the more detrimental side effects. I still love it though.

And I love you! I mean that. Check out the references in the show notes at http://RunningAFEVER.com/247.

References:
https://en.wikipedia.org/wiki/Ibuprofen#History
https://en.wikipedia.org/wiki/Boots_(company)
https://www.medscape.com/viewarticle/909349
https://adf.org.au/drug-facts/ibuprofen/
https://www.medicinenet.com/nonsteroidal_antiinflammatory_drugs/article.htm
https://www.drugs.com/sfx/ibuprofen-side-effects.html
https://www.healthline.com/health/pain-relief/ibuprofen-advil-side-effects#internal-bleeding