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By Adam Rosenbluth, AARP, March 2025
A doctor's advice on taking nonsteroidal anti-inflammatory (NSAID) medications for aches and pains.
I take ibuprofen (Advil) nearly every day for muscle aches, headaches and pain. Is that a problem?
Like you, a lot of people rely on NSAIDs (nonsteroidal anti-inflammatory drugs) such as ibuprofen, naproxen or aspirin to relieve their pain, lower fever or reduce inflammation. You may recognize the brand names of these drugs as Advil, Motrin, Aleve and Bayer.
Several of my patients have told me, “Dr. Adam, these pills are the best. I won’t start my day without taking them.”
But that can be a problem. There’s a perception that just because medications are sold over the counter, they’re always safe. This is simply not the case. Even though these drugs are effective, they can have serious side effects, particularly if you don’t follow the dosing limitations.
For instance, ibuprofen can be hard on your tummy. If you’ve been taking this drug for longer than a few weeks or are taking more than the recommended daily amount, you’re leaving yourself open to gastrointestinal problems.
Even a single dose of non-steroidal therapy can cause gastritis, which is an inflammation or irritation of the stomach lining. You might experience heartburn or acid reflux. In extreme cases, NSAIDs can lead to bleeding in your stomach or esophageal ulcers; either can be life-threatening.
To help protect the tummy, I tell my patients they should always eat something before taking ibuprofen. If you know that you’re prone to acid reflux or indigestion, you might want to pre-empt problems by combining the non-steroidal with an over-the-counter antacid medication.
Ibuprofen can also cause kidney problems, especially if you become dehydrated. I know this firsthand. My mother was hospitalized because she wasn’t drinking enough water while she was taking a lot of Advil for arthritis pain. NSAIDs can increase your risk of dehydration because they may make it harder for your kidneys to maintain fluid balance, and you may sweat more when you’re taking the drug.
When my mom began to feel unwell, we checked her blood and found out she was in kidney failure. So, the lesson we learned was that staying hydrated is extremely important, especially when taking a drug like ibuprofen.
Your blood pressure can also be affected by a non-steroidal. I’ve had a number of patients whose hypertension increased because they were taking NSAID therapy for pain. Once they came off the medication, their blood pressure improved.
If you’re on blood thinners, you’ll want to avoid these drugs. NSAIDs affect the way our blood’s platelets work and can interfere with clotting in a similar way that blood thinners do. If you take them together, you’ll increase your bleeding risk, especially in the digestive tract.
Other less serious yet more common side effects from these drugs include nausea, constipation, headache, dizziness, shortness of breath and skin problems. Some people have developed tinnitus or ringing in their ears from frequent use of NSAIDs.
Be sure to read the directions and warning label on the bottle and never take more than the recommended daily dosage. It’s a good idea to check with your health care provider to be sure this category of drug is safe for you to take. If you have severe heart or liver issues, for instance, they’re not an option.
Depending on why you use ibuprofen, you might try substituting it with anti-pain topical creams, corticosteroids or acetaminophen (Tylenol). Some people get relief with acupuncture and cognitive or behavioral therapies. You don’t want to live with pain.
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