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Ibuprofen Side Effects: What to Expect and When to Worry

Last reviewed: December 2025

Overview

Ibuprofen is generally well-tolerated when used as directed for short-term relief of pain, inflammation, and fever. However, like all medications, it can cause side effects. Understanding the potential side effects, their frequency, and when they warrant medical attention can help people use ibuprofen safely.

As a nonsteroidal anti-inflammatory drug (NSAID), ibuprofen’s side effect profile is related to its mechanism of action—blocking prostaglandins throughout the body. While this provides pain relief and reduces inflammation, it can also affect the stomach, kidneys, cardiovascular system, and other organs.

This page provides detailed information about ibuprofen’s side effects, organized by frequency and severity, along with information about risk factors and when to seek medical care.

Common Side Effects

The most frequently reported side effects of ibuprofen involve the gastrointestinal system. These effects are related to ibuprofen’s inhibition of protective prostaglandins in the stomach lining.

Stomach Upset and Nausea

Stomach discomfort is the most common side effect of ibuprofen, occurring in approximately 5-15% of people.

Symptoms may include:

  • Nausea
  • Stomach pain or cramping
  • Feeling of fullness or bloating
  • Stomach burning sensation
  • General stomach discomfort

Managing stomach upset:

  • Take ibuprofen with food or milk
  • Take with a full glass of water
  • Avoid lying down immediately after taking
  • Consider taking a lower dose if possible
  • If persistent, consider acetaminophen as an alternative

Heartburn and Indigestion

Ibuprofen can cause or worsen heartburn and acid reflux symptoms. This occurs because prostaglandins help protect the stomach lining, and blocking them reduces this protection.

Symptoms may include:

  • Burning sensation in chest or upper abdomen
  • Acid reflux or regurgitation
  • Sour taste in mouth

Managing heartburn:

  • Take with food
  • Avoid spicy or acidic foods when taking ibuprofen
  • Consider using an antacid if needed
  • Do not lie down immediately after taking

Diarrhea

Some people experience loose stools or diarrhea when taking ibuprofen. This is usually mild and temporary.

Constipation

Less commonly, ibuprofen may cause constipation in some individuals.

Dizziness and Lightheadedness

Some people experience mild dizziness when taking ibuprofen. This is usually temporary and resolves on its own.

Managing dizziness:

  • Stand up slowly from sitting or lying positions
  • Avoid driving or operating machinery if dizzy
  • Stay hydrated

Headache

Paradoxically, ibuprofen can occasionally cause headaches in some people, even though it is used to treat them.

Drowsiness

Mild drowsiness may occur in some people, though this is less common than with some other pain medications.

Gastrointestinal Side Effects (More Serious)

NSAIDs including ibuprofen can cause serious gastrointestinal complications, particularly with longer-term use or in people with risk factors.

Stomach Ulcers

Ibuprofen can cause ulcers in the stomach or small intestine. This occurs because prostaglandin inhibition reduces the protective mucus layer in the digestive tract.

Risk factors for ulcers:

  • Age over 65
  • History of stomach ulcers or GI bleeding
  • Taking corticosteroids concurrently
  • Taking blood thinners
  • Higher doses of ibuprofen
  • Longer duration of use
  • Alcohol use
  • Smoking

Signs of possible ulcers:

  • Persistent stomach pain or burning
  • Pain that improves or worsens with eating
  • Unexplained weight loss
  • Loss of appetite

Gastrointestinal Bleeding

A serious complication of NSAID use is bleeding in the stomach or intestines. This can occur with or without warning symptoms.

Warning signs of GI bleeding:

  • Black, tarry stools (indicates bleeding in upper GI tract)
  • Blood in stool (may be red or maroon)
  • Vomiting blood or material that looks like coffee grounds
  • Severe stomach pain
  • Weakness or fatigue
  • Dizziness or fainting

This is a medical emergency requiring immediate care.

Stomach Perforation

Rarely, NSAIDs can cause a hole in the stomach or intestine. This is a medical emergency.

Symptoms may include:

  • Sudden, severe abdominal pain
  • Rigid, board-like abdomen
  • Fever
  • Rapid heartbeat

Seek emergency care immediately if these symptoms occur.

Cardiovascular Side Effects

NSAIDs including ibuprofen can increase the risk of cardiovascular events, particularly with higher doses and longer duration of use.

Increased Blood Pressure

Ibuprofen can raise blood pressure in some people, particularly those with existing hypertension.

Considerations:

  • Monitor blood pressure if using ibuprofen regularly
  • May reduce effectiveness of blood pressure medications
  • Use lowest effective dose for shortest duration

Heart Attack and Stroke Risk

Research has shown that NSAIDs can increase the risk of heart attack and stroke. The FDA has strengthened warnings about this risk.

Risk is higher with:

  • Higher doses
  • Longer duration of use
  • Existing heart disease or risk factors
  • First weeks of use (risk begins early)

People with heart disease should:

  • Consult healthcare provider before using ibuprofen
  • Consider acetaminophen as an alternative when appropriate
  • Use lowest effective dose for shortest duration if ibuprofen is needed

Fluid Retention and Edema

Ibuprofen can cause the body to retain fluid, leading to swelling.

Symptoms may include:

  • Swelling in ankles, feet, or legs
  • Weight gain
  • Puffiness in face or hands

This effect is usually mild but can worsen heart failure in susceptible individuals.

Kidney Side Effects

Prostaglandins play an important role in maintaining kidney blood flow. Blocking them with ibuprofen can affect kidney function.

Reduced Kidney Function

Ibuprofen can reduce blood flow to the kidneys, potentially causing:

  • Decreased urine output
  • Elevated creatinine and BUN (laboratory markers)
  • Fluid retention

Risk factors:

  • Existing kidney disease
  • Dehydration
  • Taking diuretics or ACE inhibitors
  • Older age
  • Heart failure

Acute Kidney Injury

In some cases, ibuprofen can cause sudden, significant kidney damage. This is more likely in people with risk factors.

Warning signs:

  • Decreased urination
  • Swelling in legs or feet
  • Fatigue
  • Confusion

People with kidney disease should avoid ibuprofen or use it only with healthcare provider guidance.

Allergic Reactions

Some people are allergic to ibuprofen or other NSAIDs.

Mild Allergic Reactions

  • Skin rash or hives
  • Itching
  • Mild facial swelling

Severe Allergic Reactions (Anaphylaxis)

Severe allergic reactions are rare but can be life-threatening.

Symptoms requiring emergency care:

  • Difficulty breathing or wheezing
  • Swelling of face, lips, tongue, or throat
  • Severe dizziness or fainting
  • Rapid heartbeat
  • Severe rash

Seek emergency care immediately if these symptoms occur.

NSAID-Sensitive Asthma

Some people with asthma are sensitive to NSAIDs, which can trigger bronchospasm and asthma attacks.

At higher risk:

  • People with asthma
  • People with nasal polyps
  • People with a history of aspirin or NSAID sensitivity

Skin Reactions

Mild Skin Reactions

  • Rash
  • Itching
  • Hives

Serious Skin Reactions (Rare)

Rarely, NSAIDs can cause severe skin reactions including:

  • Stevens-Johnson syndrome
  • Toxic epidermal necrolysis

Warning signs:

  • Blistering or peeling skin
  • Mouth sores
  • Fever with rash
  • Extensive rash

Stop ibuprofen and seek immediate medical care if these occur.

Other Side Effects

Ringing in the Ears (Tinnitus)

Some people experience ringing in the ears, particularly at higher doses. This usually resolves when the dose is reduced or ibuprofen is stopped.

Vision Changes

Rarely, ibuprofen may cause blurred vision or other visual disturbances.

Liver Effects

Liver problems from ibuprofen are rare but can occur. Symptoms may include:

  • Yellowing of skin or eyes (jaundice)
  • Dark urine
  • Severe fatigue
  • Abdominal pain

Central Nervous System Effects

Uncommon effects may include:

  • Confusion
  • Depression
  • Nervousness
  • Insomnia

Risk Factors for Side Effects

Certain factors increase the likelihood of experiencing side effects from ibuprofen.

Age

People over 65 are at higher risk for:

  • Gastrointestinal bleeding
  • Kidney problems
  • Cardiovascular events

Dose and Duration

Higher doses and longer duration of use increase all risks.

Medical Conditions

Higher risk with:

  • Heart disease
  • High blood pressure
  • Kidney disease
  • Liver disease
  • History of ulcers or GI bleeding
  • Asthma (NSAID-sensitive)

Medications

Concurrent use of certain medications increases risk:

  • Blood thinners (warfarin, aspirin)
  • Corticosteroids
  • Other NSAIDs
  • ACE inhibitors or ARBs
  • Diuretics
  • SSRIs

Lifestyle Factors

  • Alcohol use (increases GI bleeding risk)
  • Smoking (increases ulcer risk)
  • Dehydration (increases kidney risk)

Minimizing Side Effects

To reduce the risk of side effects:

  • Use the lowest effective dose
  • Use for the shortest duration necessary
  • Take with food or milk
  • Stay well-hydrated
  • Avoid alcohol
  • Do not combine with other NSAIDs
  • Inform healthcare providers about all medications

When to Stop Taking Ibuprofen

Stop ibuprofen and contact a healthcare provider if:

  • Stomach pain becomes severe or persistent
  • Signs of GI bleeding occur
  • Chest pain or shortness of breath develops
  • Swelling in legs or decreased urination occurs
  • Allergic reaction symptoms appear
  • Rash develops

When to Seek Emergency Care

Seek immediate emergency care if:

  • Black, tarry stools or bloody stools
  • Vomiting blood
  • Severe stomach pain
  • Chest pain or sudden weakness on one side
  • Difficulty breathing or swelling of throat
  • Severe skin blistering
  • Signs of severe allergic reaction

Sources

This information is based on data from the following authoritative sources:

  • U.S. Food and Drug Administration (FDA). NSAID Drug Safety Communication.
  • MedlinePlus, U.S. National Library of Medicine. Ibuprofen.
  • National Institutes of Health (NIH). NSAID Adverse Effects Profile.
  • American Gastroenterological Association. NSAID and Gastrointestinal Safety.
  • American Heart Association. NSAIDs and Cardiovascular Risk.
  • FDA Adverse Event Reporting System (FAERS). Ibuprofen Safety Data.
Last reviewed: December 2025