Med of the Month: Ibuprofen

Dentists frequently recommend Ibuprofen for managing dental pain and inflammation due to its effectiveness as a nonsteroidal anti-inflammatory drug (NSAID). It helps reduce swelling and discomfort after procedures like extractions or root canals. However, proper dosing is essential to minimize risks such as gastrointestinal irritation and kidney issues, especially in patients with underlying conditions. Always consider patient history and potential drug interactions when prescribing or recommending Ibuprofen. Explore what you really need to know about Ibuprofen:

Generic Name: Ibuprofen

Brand Name(s): Motrin, Advil

Pronunciation: EYE bue PROE fen

About this drug:

• Ibuprofen is a non-steroidal anti-inflammatory drug (NSAID) used to reduce fever and treat pain and inflammation caused by many conditions.

Dentistry-related tidbits:

• Monitor blood pressure when administering local anesthetic with Epinephrine to a patient taking Ibuprofen as this combination may increase the risk of hypertension. 

• Ibuprofen may increase bleeding. Make sure the patient is not taking blood thinners (e.g. warfarin), steroids, Aspirin-containing products, or other NSAIDs before prescribing this medication. 

  • If needed for pain control, select an Acetaminophen-based pain medication (avoid long-term use to avoid liver problems).

  • If the patient is using Aspirin for cardioprotection, give Ibuprofen 8 hours before or 2 to 4 hours after Aspirin.

• The risk of renal problems may increase when Ibuprofen is combined with antivirals such as Valacyclovir, the lincosamide antibiotic Clindamycin, or aminoglycoside antibiotics such as Tobramycin (this combination may also increase the risk of ototoxic  side effects).

• Combining Ibuprofen with quinolone antibiotics such as Ciprofloxacin may increase the risk of CNS stimulation and seizures.

• Before prescribing any medication, use the Rx Check tool to prevent potential drug interactions or adverse effects.

Fun facts:

• Ibuprofen blocks cyclooxygenase (COX) enzymes, reducing the prostaglandin precursors—a key driver of pain, fever, and inflammation.

• Taking Ibuprofen and drinking alcohol may increase the risk of dizziness, drowsiness, GI bleeding, and liver problems, which can be life-threatening.

• Consuming large quantities of caffeine with Ibuprofen may increase the risk of hypertension.

• Ibuprofen may make the skin burn more easily in the sunlight. Advise patients to use a sunscreen with SPF 30 or higher when outdoors.

• The following are the medication’s Black Box Warnings:  

  • Ibuprofen increases the risk of heart attacks, strokes, and ulcers in the stomach or intestines without warning which may cause death. The risk is higher when patients are older, have poor health, are taking for a longer period, or drink three or more alcoholic drinks per day.

  • Ibuprofen is contraindicated before and after a coronary artery bypass graft (CABG) procedure.

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