Warnings and precautions: Talk to your doctor or pharmacist before taking Ibuprofen:
if you have recently had major surgery
if you have or have had asthma or allergic disease as shortness of breath may occur
if you suffer from hayfever, nasal polyps or chronic obstructive respiratory disorders as an increased risk of allergic reactions exists. The allergic reactions may present as asthma attacks (so-called analgesic asthma), Quincke’s oedema or urticaria
if you have heart problems
if you have a history of gastrointestinal disease (such as ulcerative colitis, Crohn’s disease)
if you have systemic lupus erythematosus or mixed connective tissue disease (a disease affecting the skin, joints and kidneys)
if you have certain hereditary blood formation disorders (e.g. acute intermittent porphyria)
if you have a blood clotting disorder
if you are taking other NSAIDs. The use with concomitant NSAIDs, including cyclo-oxygenase-2 specific inhibitors, increases the risk of adverse reactions (see section “Other medicines and Ibuprofen” below) and should be avoided
if you have chicken pox (varicella) it is advisable to avoid use of Ibuprofen
if you are elderly. Patients with kidney or liver problems should first consult a doctor before taking ibuprofen tablets. Anti-inflammatory/pain-killer medicines like ibuprofen may be associated with a small increased risk of heart attack (“myocardial infarction”) or stroke, particularly when used at high doses. Do not exceed the recommended dose or duration of treatment (see section 3).
You should discuss your treatment with your doctor or pharmacist before taking ibuprofen if you: have heart problems including heart failure, angina (chest pain), or if you have had a heart attack, bypass surgery, peripheral artery disease (poor circulation in the legs or feet due to narrow or blocked arteries), or any kind of stroke (including ‘mini-stroke’ or transient ischaemic attack, ‘TIA’)
have high blood pressure, diabetes, high cholesterol, have a family history of heart disease or stroke, or if you are a smoker. Very rare reports of potentially life-threatening skin rashes (Stevens-Johnson syndrome, toxic epidermal necrolysis) have been reported with the use of ibuprofen. Patients are at higher risk of such reactions during the first month of therapy.
Stop taking Ibuprofen and talk to your doctor or pharmacist if you notice a skin rash, mucosal lesions, or any other signs of allergic reactions (see section 4). Undesirable effects may be minimised by using the minimum effective dose for the shortest period of time. The elderly are at increased risk of side effects. In general the habitual use of (several sorts of) analgesics can lead to lasting severe kidney problems. This risk may be increased under physical strain associated with loss of salt and dehydration. Therefore it should be avoided.
There is a risk of renal impairment in dehydrated children and adolescents. Prolonged use of any type of painkiller for headaches can make them worse. If this situation is experienced or suspected, medical advice should be obtained and treatment should be discontinued. The diagnosis of medication overuse headache (MOH) should be suspected in patients who have frequent or daily headaches despite (or because of) the regular use of headache medications. NSAIDs may mask symptoms of infection and fever. In prolonged administration of Ibuprofen regular checking of your liver values, the kidney function, as well as the blood count, is required. Your doctor may ask you to have blood tests during treatment.
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