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Sold without a prescription, ibuprofen is a very common and relatively safe drug. It relieves pain and fever. Unlike acetaminophen, another over-the-counter painkiller, ibuprofen also reduces inflammation.

Inflammation is swelling and redness caused by the immune system’s response to a threat. An inflamed area is often red, warm, swollen, and painful.

But ibuprofen isn’t completely safe. It can cause stomach ulcers and heart problems, even when people stay within the maximum ibuprofen dosage. That’s why some people need to limit or avoid it.

Most people buy ibuprofen under the brand name Advil or Motrin. With this list from the U.S. National Library of Medicine, you can check if a drug has ibuprofen.

What Can Ibuprofen Treat?

Ibuprofen can treat:

• Fever.
• Pain, including headache, muscle or joint pain, and menstrual cramps.
• Swelling in the body.
• Arthritis.

Ibuprofen can treat the same problems as acetaminophen (Tylenol). However, ibuprofen treats inflammation. That makes it better than acetaminophen in treating muscle strain, joint sprains, and arthritis. “Aspirin is another medication some people use to treat pain-however, because it has a higher risk of bleeding, it should never be taken without consulting your doctor first,” says Jonathan Zuckerman, MD, of Renaissance Family Practice-UPMC.

How Much Ibuprofen Can I Take?

The over-the-counter ibuprofen dosage for adults is 400 milligrams at a time. You can take another dose of ibuprofen 4 to 6 hours after your last dose. Keep track of the amount of your last dose. When you take it, make a note on paper or your phone.

You shouldn’t take more than 1,200 milligrams of ibuprofen per day. That means no more than six 200-milligram doses in 24 hours. “This is specifically for over- the-counter ibuprofen. Sometimes your doctor may prescribe more than this in special circumstances (see below),” adds Dr. Zuckerman.

Because of the risk of stomach and heart problems, you shouldn’t take ibuprofen for more than ten days in a row. Check-in with your doctor if you still need it to treat pain. In addition, if you still have a fever after three days of taking ibuprofen, you should see a doctor anyway.

Children should take far less ibuprofen than adults, and children under six months shouldn’t take ibuprofen at all. The American Academy of Pediatrics provides an ibuprofen dosage chart based on children’s ages and weights.

What If I Need More Ibuprofen Than the Maximum Ibuprofen Dosage?

A doctor may prescribe ibuprofen in amounts higher than the suggested max dosages for over-the-counter use. With a doctor’s approval, you can also stay on the drug for longer than ten days.

Your doctor will weigh the need to treat your inflammation with the risk of side effects from ibuprofen. For example, people with rheumatoid arthritis or osteoarthritis may take ibuprofen in higher amounts for longer.

Your doctor may want to do routine tests to ensure you don’t develop an ulcer or other problems from ibuprofen. Your doctor may also prescribe medicine to prevent stomach ulcers.

Who Shouldn’t Take Ibuprofen?

Taking ibuprofen can cause stomach or digestive tract ulcers and bleeding, which can impair kidney function. Ibuprofen can also increase the risk of having a heart attack or stroke.

These bad outcomes are very rare. They happen mostly when people take high amounts of the drug or take it every day for many weeks or months. But people at higher risk of stomach, kidney, and heart issues should talk to their doctor before they take ibuprofen.

Plus, ibuprofen can interfere with a long list of medicines. If you’re on one of these medicines, talk to your doctor about what other pain relievers you can use instead of ibuprofen.

You should talk to your doctor before taking ibuprofen if you:

• Have heart disease.
• Have had a heart attack or stroke.
• Have a parent or sibling who has heart disease.
• Have a parent or sibling who suffered a heart attack or a stroke.
• Smoke.
• Consume high amounts of alcohol.
• Have high cholesterol.
• Have had stomach bleeding or a stomach ulcer.
• Have high blood pressure.
• Have swelling in your hands, arms, feet, ankles, or lower legs.
• Have lupus.
• Have asthma or allergies.
• Have a liver or kidney problem.
• Have Crohn’s disease or ulcerative colitis.
• Currently have chicken pox or shingles.
• Recently had heart surgery or will have heart surgery in the next week.
• Live with diabetes.
• Are 65 or older.
• Are pregnant or trying to get pregnant. Ibuprofen can pose a risk to the fetus or cause delivery problems if taken at or after 20 weeks of pregnancy.
• You are unsure if ibuprofen is safe based on your health issues or medicines.

If you meet one of the above criteria, your doctor may tell you not to take ibuprofen. Or your doctor may advise you to take a lower dose than the maximum dose or take it for a shorter period. Your doctor may also give you medicine to reduce your risk of stomach ulcers.

Can You Overdose on Ibuprofen?

Many people can take large amounts of ibuprofen at one time and not suffer serious problems. Ibuprofen overdose is less dangerous than acetaminophen overdose. But it can still cause serious health issues and rarely be fatal.

Many people who overdose on ibuprofen don’t experience symptoms. But they may still need treatment and fluids to avoid organ damage. If you have taken too much ibuprofen, call poison control at 1-800-222-1222 or visit the nearest emergency department.

Signs and symptoms of ibuprofen overdose usually occur four hours after taking too much. They include:

• Stomach pain.
• Agitation.
• Difficulty breathing.
• Dark, tarry stools from bleeding in the digestive tract.
• Blue lips or fingertips.
• Loss of appetite.
• Yellowish skin and eyes.
• Cold or clammy skin.
• Dizziness.
• High blood pressure.
• Sleepiness.
• Little urination.
• Memory loss.
• Nausea and vomiting.
• Low heart rate.
• Seizures.

Know the Signs of Stomach Ulcers

Ibuprofen affects a protein that helps make mucus lining the stomach. Because ibuprofen can thin the stomach’s mucus lining, people who take the drug have a higher risk of stomach ulcers. The risk increases with higher ibuprofen dosages, long-term usage, or both.

Signs of stomach ulcers include:

• Burning pain in the stomach.
• Bloating.
• Burping.
• Heartburn.

When ulcers tear, they can cause serious internal bleeding that can be fatal. If you have any of the following signs of a perforated ulcer, go straight to the emergency department:

• Severe abdominal pain.
• Vomiting a coffee grounds-like substance.
• Black, tarry stools.