Drugs & MedicationsSurgery

IBUPROFEN FOR ACUTE PAIN: How much is enough?


That’s a good question. If you go by the old saying, “if a little helps, a lot will help even more!” a higher dose should be better. It’s like comparing the more, the merrier with the more, the better. Often that’s very true, but not always.

Ibuprofen is frequently prescribed by physicians for the relief of acute, short term pain. Emergency rooms and urgent care centers use it like candy. It works quite well and is relatively safe. Ibuprofen is classed as an NSAID—non-steroidal anti-inflammatory drug. It has the same properties as aspirin. It is…

Anti-pyretic—it lowers body temperature (fever)

Anti-inflammatory—it reduces inflammation

Analgesic—it reduces pain

Over-the-counter Ibuprofen is dispensed in 200 mg doses.

Prescription ibuprofen is dispensed in 400 mg, 600 mg, and 800 mg strengths.

The question posed in the title of this blog didn’t have a good answer until an article was published in The Annals of Emergency Medicine last Fall. The authors studied 225 adult, emergency department patients who came in with an acute painful condition. On a scale of 1-10 with 10 being the worst, their average pain level was 6 to 7. Patients were randomly given doses of 400 mg, 600 mg, and 800 mg of Ibuprofen for treatment of their pain. After 60 minutes, their pain was reassessed. The levels of pain dropped to 4.36 to 4.5, a reduction of 1.5 to 2.5 points. The interesting conclusion from this study is that 400, 600, and 800 mg doses of ibuprofen, had nearly the same pain-reducing effect. One strength was not superior to another. 400mg worked just as well as 800 mg.

So, despite the “…more is better” adage, in the case of Ibuprofen, more is NOT BETTER. The standard dose is enough. Taking 400 mg of Ibuprofen for acute pain has almost the same benefit but much less risk than 800 mg. Other variables such as patient height and weight, drug absorption, and drug interactions have to be considered, but the random assignment of ibuprofen doses would eliminate that as a concern, here. The shape and size of people did not effect outcome.

Dr. G’s Opinion: I’ve always ascribed to the more is better approach, but now, knowing what this study concluded, I will accept that the safer dose is a good dose. So the next time you stub your toe or hit your thumb with a hammer, remember, a single 400 mg pill will give you just as much relief as a handful of pills.

Reference: Motov S, et al. Comparison of oral ibuprofen at three single-dose regimens for treating acute pain in the emergency dept.: a randomized controlled trial. Ann Emerg Med 2019;74(4):530-537.

Related Articles

Leave a Reply

Your email address will not be published. Required fields are marked *

This site uses Akismet to reduce spam. Learn how your comment data is processed.

Back to top button