Ibuprofen and Its Side Effects: Key Insights for Safe Use in Clinical Practice Regarding NSAIDs, Gastrointestinal Reactions, and Nephrotoxicity

Ibuprofen is one of the most widely used non-steroidal anti-inflammatory drugs (NSAIDs) in clinical practice due to its analgesic, anti-inflammatory, and antipyretic properties. However, its use is not without risks, and it is crucial for physicians to understand the potential side effects to ensure safe and effective use in their patients.

Diving into the Side Effects of Ibuprofen

Ibuprofen, like other NSAIDs, works by inhibiting cyclooxygenase enzymes (COX-1 and COX-2), which reduces the synthesis of prostaglandins responsible for pain and inflammation. Nevertheless, this inhibition can also lead to adverse gastrointestinal reactions, such as ulcers and gastrointestinal bleeding. A systematic study has shown that the risk of upper gastrointestinal complications varies among different NSAIDs, with ibuprofen presenting a lower relative risk compared to others like diclofenac or naproxen [1].

In addition to gastrointestinal effects, ibuprofen can cause nephrotoxicity, particularly in patients with pre-existing risk factors such as renal insufficiency or dehydration. The inhibition of renal prostaglandins can lead to decreased renal blood flow, resulting in impaired renal function [2].

Another aspect to consider is the cardiovascular risk associated with NSAID use. While low doses of ibuprofen are considered relatively safe, higher doses may increase the risk of cardiovascular events, such as myocardial infarction, especially in patients with a history of cardiovascular disease [3].

Conclusions and Recommendations for Safe Use

To minimize the risks associated with ibuprofen use, it is essential for physicians to carefully assess the individual risk factors of each patient before prescribing this medication. It is recommended to use the lowest effective dose for the shortest duration necessary to control symptoms. Additionally, in patients at high risk for gastrointestinal complications, the concomitant use of gastric protectants such as proton pump inhibitors may be considered [4].

In conclusion, ibuprofen remains a valuable option in the management of pain and inflammation, but its use must be closely monitored to avoid significant adverse effects. Continuous education and risk-benefit assessment are fundamental to optimizing patient safety in clinical practice.

Referencias

• [1] Individual NSAIDs and upper gastrointestinal complications: a systematic review and meta-analysis of observational studies (the SOS project)
• [2] Ibuprofen: safety and efficiency of its use in wide clinical practice
• [3] Cardiovascular risk of non-steroidal anti-inflammatory drugs
• [4] Concomitant use of ibuprofen and paracetamol and the risk of major clinical safety outcomes

Created 6/1/2025