7 Signs You’re Taking Too Much Ibuprofen

Too much ibuprofen can cause a wide range of symptoms, many of which can be dangerous.
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Many of us reach for ibuprofen to deal with daily aches and pains.


Probably because they're so effective at decreasing discomfort (whether you're struggling with a stiff lower back or a pounding headache) as well as conveniently accessible over the counter, nonsteroidal anti-inflammatory drugs (NSAIDs) like ibuprofen are one of the most commonly used medications worldwide.

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"NSAIDs can be of great utility for the treatment of inflammation and pain when used at safe doses and in the correct manner," says Harrison Linder, MD, an interventional pain management physician at Mercy Medical Center in Baltimore, Maryland.


The problem is, a lot of people are overdoing it with the doses. A recent study of 1,326 ibuprofen users found that 11 percent exceeded the daily dosing limit, according t January 2018 results in Pharmacoepidemiology and Drug Safety.

But we've all heard the phrase ​too much of a good thing.​ Meaning, anything in excess can be bad for you, and ibuprofen is no exception.


Here, Dr. Linder shares the warning signs that you're taking too much ibuprofen, plus provides tips on how to manage pain in a safer way.

First, How Does Ibuprofen Reduce Pain?

Ibuprofen inhibits an enzyme named cyclooxygenase (COX), which is responsible for producing substances including prostaglandins, prostacyclins and thromboxanes, Dr. Linder says. These substances are involved in the normal function of most tissues in the body, but they're also produced in the muscles and joints in response to stress and trauma, leading to inflammation and pain.

For this reason, NSAIDs are beneficial in the short-term for reducing inflammation and pain, but they may have negative effects on other systems of the body.

1. You've Got Stomach Problems

"In the gastrointestinal system, prostaglandins produced by the COX enzyme are involved in protecting the lining of the stomach and intestines from the harmful effects of the stomach acids used to digest food," Dr. Linder says.


But remember, ibuprofen halts production of these protective prostaglandins. And that can trigger a ton of trouble for your tummy.

"Without adequate prostaglandins, the gastrointestinal lining is exposed to chronic irritation from stomach acids, which can lead to worsening irritation and ultimately cause ulcers in the stomach and intestines," Dr. Linder explains.


This results in symptoms ranging from stomachache or abdominal pain to potentially dangerous internal bleeding.


If you experience stomach pain from taking too much ibuprofen, stop taking the drug right away and call your doctor, per the Hospital for Special Surgery. Ibuprofen can also cause bloating and diarrhea, and both are cause to check with your doctor, per the Mayo Clinic.

2. You Have Cardiovascular Issues

In the cardiovascular system, the COX enzyme is involved in blood clotting and controlling bleeding. That's why taking too much ibuprofen is risky for your heart.



"With long-term or overuse of NSAIDs, patients may be more at risk for increased or uncontrolled bleeding, along with other concerning cardiovascular outcomes, such as heart attack or stroke," Dr. Linder explains.

3. Your Kidneys Aren’t Functioning Properly

"In the renal system, prostaglandins [products of the COX enzyme] help regulate blood flow to the kidneys," Dr. Linder says.


But, as we know, excessive ibuprofen use can interrupt the production of the COX enzyme and prostaglandins.

But here's the thing: "With abnormal amounts of prostaglandins, the renal blood vessels constrict, leading to decreased blood flow and increased pressures," Dr. Linder says. This can cause hypertension (high blood pressure), electrolyte abnormalities and even go on to cause acute kidney failure.


Symptoms of an electrolyte imbalance include:

  • Feeling dizzy or lightheaded
  • Shortness of breath
  • Irregular or fast heartbeat
  • Nausea or stomachache

Signs of acute kidney failure warrant immediate medical help. They include the following, per the Mayo Clinic:

  • Decreased urine output
  • Swelling in the legs, ankles or feet
  • Shortness of breath
  • Feeling tired or weak
  • Confusion
  • Nausea
  • Irregular heartbeat
  • Pain or pressure in the chest
  • In severe cases, seizures or coma

4. Your Nervous System Is Impaired

Prostaglandins also play a pivotal part in how your central nervous system operates.

In fact, "prostaglandins are thought to be involved in multiple different facets of 'normal' function and coordination," Dr. Linder says. For instance, they have a role in body temperature control and overall blood flow, he says.


"There are even studies linking their involvement in control of impulsive behavior," he adds.

"Thus, with the known effects of NSAIDs leading to the decreased production of these substances, it is thought that this leads to dysregulation, which may present as [psychosis,] confusion and cognitive dysfunction," Dr. Linder explains.

Cognitive dysfunction may look like problems with attention, memory, language or problem-solving, according to the Weill Cornell Brain and Spine Center.

5. Your Hearing Is Compromised

Habitual use of ibuprofen can even harm your hearing.

That's because "NSAIDs have been linked to decreased blood flow to the cochlea in the inner ear," Dr. Linder says. And this may result in tinnitus and/or hearing loss, he explains.

6. You Have Trouble Breathing or Other Respiratory Complications

Excessive or prolonged use of ibuprofen can even wreak havoc on your respiratory system.

"In some patients, especially those with a history of asthma, NSAIDs can induce bronchospasm [when muscles in your airways tighten], rhinorrhea [i.e., runny nose] and nasal obstruction," Dr. Linder says.

This goes back to the COX enzyme again. Inhibiting this enzyme leads to the increased release of leukotrienes in the lungs and nasal airways, which are substances that can potentially cause the closure of the airways," Dr. Linder says.

7. Your Vision Is Worse

If you suddenly start having problems seeing, your excessive use of ibuprofen may be to blame.


"Once again, this can be related to the way NSAIDs work by inhibition of the COX enzymes," Dr. Linder says.

Here's why: COX enzymes help regulate blood flow to the eyes, so interference with this normal pathway can lead to acute, temporary vision changes, he explains.

As a matter of fact, "a variety of visual changes have been reported in relation to NSAID use, ranging from simply blurred vision to temporary, complete vision loss," Dr. Linder adds.

How Much Is Too Much Ibuprofen?

“Dosing can range from 400 to 800 mg up to four times a day, with a daily maximum of 3,200 mg per day,” Dr. Linder says. But it’s best to limit daily ibuprofen use to no more than 30 days, he adds.

“Above this limit, the negative effects of COX inhibition begin to outweigh the desired benefits of decreased discomfort and pain,” Dr. Linder says.

Safer Ways to Manage Pain

While popping a pain pill is a quick fix, as we've seen, it's not a sustainable or healthy way to deal with chronic discomfort. Fortunately, there are other safer remedies available to help you handle prolonged pain issues.

"As always, if safe use of over-the-counter medications is not helping with discomfort or causing side effects, patients should contact a medical professional for further management," Dr. Linder says. Together, you can come up with a plan to prevent and manage your pain.

Some alternative pain management strategies include, per Dr. Linder:

1. Rest and recovery:​ Sometimes the best medicine for an achy body is rest. For example, if you twisted your back or went too hard at the gym, giving yourself adequate time to recharge and recover is essential to the healing process (and to prevent re-injury).

2. Activity modification:​ A little tweak to your routine can result in big benefits for pain reduction. For instance, if you sit at a desk all day, try standing and stretching every half hour or so, which can help keep your muscles loose and back pain at bay. Conversely, if your job requires you to be on your feet frequently, take quick sitting breaks often and make sure to wear supportive shoes.

3. Physical therapy:​ If your pain is a product of an injury, mobility issues or age-related aches and pains, physical therapy is an effective way to help restore your body's function to an optimal level. Indeed, you'll have a better outcome if you treat the source of the pain rather than just the symptoms.

4. Other medicines:​ "There may be other simple medications, such as muscle relaxants or nerve stabilizers, that may be able to offer more targeted symptomatic relief with a different side effect profile that may be safer for a specific patient's individual situation," Dr. Linder says. Any medication comes with potential side effects, though, so talk to your doctor about the best option for you.




Is this an emergency? If you are experiencing serious medical symptoms, please see the National Library of Medicine’s list of signs you need emergency medical attention or call 911.