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Common brand names: Advil, Nuprin, Motrin and many others

Description: Ibuprofen is a nonsteroidal anti-inflammatory drug (NSAID). It relieves pain, reduces fever and decreases swelling.

Dental uses: In dentistry, ibuprofen is prescribed to treat mild to moderate pain. The pain can be from dental surgery, toothache or the temporomandibular joint (TMJ). A 200-milligram dose of ibuprofen in liquid-gel form has been shown to work better than 1,000 milligrams of acetaminophen. For more severe dental pain, 400 milligrams of ibuprofen works better than 650 milligrams of aspirin, or 650 milligrams of acetaminophen plus 60 milligrams of codeine.

Dosages for dental purposes: The prescription for ibuprofen after dental surgery is usually 400 milligrams every 4 to 6 hours, as needed. Or your dentist may prescribe ibuprofen on a scheduled dosing for 2 to 3 days after surgery. This means you would take it by the clock and not just "as needed."

As with all medicines prescribed, take as ordered for maximum benefit. The maximum daily dose should not exceed 2,400 milligrams. For pain after surgery, ibuprofen is usually given for fewer than 5 days.

For TMJ pain related to arthritis, higher doses (600 to 800 milligrams every 6 to 8 hours) may be needed. The maximum daily dose is 3,200 milligrams.

Daily dosing for children is based on age and body weight. Prescription dosages are different from "over-the-counter" dosages.

Concerns and possible side effects: Tell your dentist and physician about all the medicines you take. This should include over-the-counter vitamins and herbal supplements. Also, let your dentist know if you have had a sensitive or allergic reaction to any medicine. If you are pregnant or nursing, or might be pregnant, talk to your primary care doctor before starting any new medicine. This also includes vitamins and supplements.

For dental uses of a week or less, ibuprofen is a very safe, well-tolerated and effective pain reliever. Side effects include abdominal pain, nausea and increased bleeding time. Ibuprofen is less likely to cause side effects than aspirin.

NSAIDs have some black-box warnings. These are warnings on the package insert about possible serious side effects. For ibuprofen, these include:

  • "NSAIDs are associated with an increased risk of adverse cardiovascular events, including MI [heart attack], stroke, and new onset or worsening of pre-existing hypertension [high blood pressure]."
  • "NSAIDs may increase risk of gastrointestinal irritation, ulceration, bleeding and perforation."

Some people may take ibuprofen for many weeks or months. For example, people with TMJ pain may need to take this drug for a long time. With long-term use, more serious side effects can occur. They include:

  • Bleeding ulcers
  • Perforations of the stomach and small intestine (in 1% to 4% of patients)
  • Reduced kidney function

Blood pressure should be monitored in patients taking ibuprofen.

Ibuprofen should not be given to:

  • People who are allergic to aspirin or other NSAIDs
  • Certain people with asthma who are sensitive to NSAIDs — In these people, these drugs can bring on an asthma attack.
  • Pregnant women, especially during the last three months of pregnancy
  • People with kidney disease
  • People with ulcers of the stomach or the small intestine

Avoid drinking alcohol if you are taking ibuprofen. Alcohol increases the risk of stomach ulcers and bleeding. Ibuprofen also may interact with other drugs, including:

  • Aspirin — People taking both aspirin and ibuprofen may lose the heart-protective effects of aspirin and increase their risk of bleeding.
  • Lithium (Eskalith) — If this drug is combined with ibuprofen, it can lead to lithium toxicity.
  • Warfarin (Coumadin) and other anticoagulants — Taking these with ibuprofen can lead to increased bleeding.
  • Some high blood pressure medicines, including beta blockers, ACE inhibitors and diuretics — Combining any of these with ibuprofen may increase blood pressure.

These interactions can be serious. Tell your doctor about any reaction to a prescribed medicine, no matter how minor it might be.

Ibuprofen also comes combined with other medicines. For example, it is in over-the-counter cold and allergy medicines and prescription drugs. Make sure to read the ingredients of any medicine you take.

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