Which life-threatening complication may occur in clients taking high-dose or long-term ibuprofen

To ease a nagging headache or a sore back, many people take Advil or another brand of ibuprofen. While it's often effective for easing pain and inflammation and generally well-tolerated, Advil, and similar medications like Motrin, are associated with a number of possible side effects.

Some of these are very serious, such as an increased risk of heart attack, stroke, and stomach bleeding. By learning about the benefits and potential dangers of taking Advil, you will have an idea of whether it is likely to be safe and effective for you. Talk to your doctor before using any medication, including over-the-counter medications like Advil.

Uses

Advil is a nonsteroidal anti-inflammatory drug (NSAID). NSAIDs reduce the symptoms of inflammation—pain, fever, and swelling.

They work by blocking cyclooxygenase enzymes called COX-1 and COX-2. These enzymes normally assist in the formation of prostaglandins. Prostaglandins are fatty, hormone-like substances that mediate the body's inflammatory and healing processes. By blocking prostaglandin formation, NSAIDs reduce symptoms of inflammation.

Since the symptoms of inflammation are associated with many different ailments, Advil is a common go-to for all sorts of conditions, including:

• Headaches and migraine
• Menstrual cramps
• Backache
• Toothaches
• Muscle aches
• Minor pain of arthritis

Ibuprofen is also used to reduce fever and body aches of the common cold or flu.

Advil is available both over the counter and as a prescription at higher doses. It comes in many different forms, including tablets, gel caplets, and liquid-filled capsules.

Combined Formulations

Some formulations are combined with other drugs to treat combined symptoms.

Examples of Advil combination medication products include:

• Advil Multi-Symptom Cold & Flu: A cold and flu drugthat contains Advil, chlorpheniramine maleate (an antihistamine), and phenylephrine (a nasal decongestant)
• Advil PM Liqui-Gels: A nighttime sleep-aid that contains Advil and Benadryl (diphenhydramine HCl)
• Advil Dual Action With Acetaminophen: A formula that contains acetaminophen and ibuprofen

Advil can be administered to infants (over 6 months old) and children in different dosages and formulations (e.g., drops, suspension, and chewable). Ask your pharmacist or pediatrician if you have any questions about administering appropriate doses of Advil for children (the dose is based on weight).

Side Effects

Advil can have some side effects, and it's important that you are aware of them so you can stop taking it and contact your doctor if you experience serious side effects.

Common Side Effects

These common side effects may not affect everyone and can often be prevented by taking Advil with milk or food.

Common side effects of Advil include:

• Stomach upset
• Heartburn
• Nausea and vomiting
• Diarrhea
• Gas or bloating
• Constipation

Serious Side Effects

Advil may also cause rare, but serious, side effects. Many of these serious side effects can be avoided by taking Advil only as recommended. Taking Advil for too long or taking too much can make these more grave side effects more likely.

Cardiovascular

Advil and other NSAIDs (with the exception of aspirin) increase a person's chances of developing a heart attack or stroke. This risk (while present for everyone) is even higher in people who have a history of or risk factors for heart disease.

Examples of such risk factors include:

• Diabetes
• A history of smoking
• High blood pressure
• High cholesterol
• Taking other medications that affect how your blood clots

Seek Emergent Medical Care

When taking Advil, if you experience symptoms of a heart attack or stroke, such as chest pain, trouble breathing, sudden weakness or numbness, or difficulty speaking, seek medical attention right away.

Advil and other NSAIDs may also increase blood pressure, and increase their risk of fluid retention and heart failure.

Gastrointestinal

While Advil is associated with a range of mild gastrointestinal side effects, with prolonged use, Advil and other NSAIDs can cause gastrointestinal bleeding or peptic ulcer disease.

Bleeding and peptic ulcer disease may cause symptoms such as black or bloody stools, abdominal pain, weight loss, heartburn, nausea, and vomiting.

People at the highest risk for serious stomach-related side effects include those who:

• Are over 60 years of age
• Are taking another NSAID in addition to Advil
• Have a history of stomach ulcers or bleeding problems
• Drink three or more alcoholic drinks every day while taking Advil
• Take Advil at a higher dose or for a longer duration than advised
• Are also taking aspirin, an antiplatelet like Plavix (clopidogrel), a corticosteroid, or an anticoagulant (blood thinner) like Coumadin (warfarin)

Liver

In rare instances, Advil may lead to liver injury, and this risk is increased with high daily use. Symptoms and signs of liver injury may include:

• Nausea
• Tiredness, lack of energy
• Itchiness
• An elevation in liver enzymes (seen on a blood test)
• Abdominal pain (pain in the upper right area of your abdomen)
• Jaundice (yellowing of the skin and whites of the eyes)
• Flu-like symptoms

Kidney

Advil, like other NSAIDs, may also cause kidney injury, and dehydration may increase the risk of developing this complication. Symptoms of decreased kidney function include increased blood pressure, fluid buildup, urinating less frequently, and dizziness.

Your risk is increased if you are an older adult, take blood pressure medications, and have kidney disease.

Allergy

Allergic reactions may also occur with taking Advil. Symptoms may include hives, facial swelling, wheezing, rash, skin reddening, blisters, and anaphylactic shock.

Considerations

If you are considering taking Advil, it's important to first speak with your healthcare provider to ensure it is safe and right for you.

If you are in certain high-risk populations—you are older, or have diabetes, heart disease, high blood pressure, kidney disease, or a history of ulcers or stomach bleeding—your healthcare provider may recommend an alternative medicine for you, such as Tylenol (acetaminophen).

Advil and other NSAIDs may cause harm to an unborn baby if taken during the third trimester. If you are pregnant, do not take Advil unless directed by your healthcare provider.

To avoid drug interactions, be sure to tell your healthcare provider all of the medications you are taking before starting Advil. This includes prescription and over-the-counter medications, supplements, vitamins, and herbs.

Safe Use

If you take Advil, it's important that you use the lowest effective dose for the shortest duration possible. Follow the recommended dosing and speak with your healthcare provider if the symptoms you are treating are still not well-managed.

Do not take more than one NSAID at a time, as this increases your chances of side effects.

Finally, ask your healthcare provider if you need monitoring while taking Advil, especially if you are taking it long-term (for example, a blood creatinine level to check your kidney function).

A Word From Verywell

Ibuprofen is a commonly used drug. While effective in reducing inflammation, pain, and fever, it is associated with many different toxicities—some of which can be potentially life-threatening. While uncommon, they are important to consider.

For healthy individuals, taking Advil, another form of ibuprofen, or another NSAID now and then is probably safe. However, people with underlying health conditions and/or people who require long-term use or high doses, the benefits may not outweigh the risks. In these cases, an alternative drug should be strongly considered.