Many people mistakenly assume that over-the-counter drugs are harmless, but some of these preparations can harm people who are at risk for certain diseases. For persons who already have kidney disease or are vulnerable because of excessive alcohol consumption or old age, ibuprofen can be particularly dangerous.
Availability
Ibuprofen is commonly sold over the counter. It is the active ingredient in Motrin, Advil and Dristan Sinus Caplets. Stronger ibuprofen in 400, 600, 800 or 1000 mg tablets is available by prescription. It is also found in combination with hydrocodone under the brand name Vicoprofen. Regardless of how it is marketed, ibuprofen has the potential to cause serious kidney damage.
Classification
Like aspirin and acetaminophen, ibuprofen is classified as a nonsteroidal anti-inflammatory drug, also called an NSAID. Unlike aspirin, it is a COX inhibitor, meaning that it blocks the synthesis of cyclooxygenase, an enzyme involved in producing prostaglandins. The National Kidney Foundation reports that NSAIDs are usually safe for occasional use but may cause an increased risk of "sudden kidney failure and even progressive kidney damage" in persons at risk.
Acute Kidney Failure
The National Institute of Diabetes, Digestive and Kidney Diseases reports that sudden-onset acute kidney failure has been attributed to the use of ibuprofen. Risk factors for such acute failure include systemic lupus erythematosus, advanced age, chronic kidney disease or recent heavy alcohol consumption. Although this case of acute kidney failure necessitated emergency dialysis, it was reversible, and the patient was able to stop dialysis.
Chronic Damage
The National Kidney Foundation and the National Institute of Diabetes, Digestive and Kidney Diseases both speak to the chronic effects of ibuprofen on the kidneys. These effects include tubulointerstitial nephritis, a condition that involves permanent scarring. Although this condition can be acute, it can also be chronic if the patient's cumulative lifetime history of NSAID use is high.
Benefits
The World Health Organization considers ibuprofen so important that it is on their Essential Drugs List. While kidney patients should never minimize the problems associated with analgesic nephropathy, the very real benefits of this drug for treating pain and fevers should not be discounted.
In some instances, ibuprofen may be preferred over other drugs. Unlike acetaminophen, ibuprofen relieves inflammation. Moreover, it does not have the gastrointestinal effects of naproxen and other NSAIDs. The National Institutes of Diabetes, Digestive and Kidney Diseases says the potential of ibuprofen for causing renal damage is very small if the patient has healthy kidneys.
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