Ibuprofen

Ibuprofen remains a standard nonsteroidal anti-inflammatory drug available over-the-counter at 200 mg or by prescription at higher strengths. Ibuprofen treats both pain and fever offering the same relief as aspirin or acetaminophen. Only at higher dosages does ibuprofen demonstrate significant anti-inflammatory activity. Americans seem especially inclined to treat minor maladies with medicines when nature might actually not require pharmaceutical assistance. Questions exist regarding the wisdom of treating fever which may actually interfere with the body’s ability to contain infection. While generally safe, the FDA mandated a special black box warning that ibuprofen may increase the risk of serious cardiovascular events heightening the likelihood of a heart attack or stroke. Unfortunately no evidence exists that low dose aspirin eliminates this complication. Additionally ibuprofen increases the potential for gastrointestinal adverse effects ranging from superficial irritation to ulceration with bleeding. Intestinal perforation with the potential for a fatal outcome may also occur. In this regard ibuprofen seems safer than aspirin. Asthmatics must exercise caution with ibuprofen and seem especially prone to develop severe bronchospasm related to the drug. Through it all ibuprofen performs admirably and remains a mainstay of our therapeutic regime.