Avoid These Dangerous Ibuprofen Mistakes If You're Over 50
Ibuprofen is a common over-the-counter medication used to alleviate common aches and pains. It's one of the most popular options available because it's been proven enormously effective in reducing the discomforts associated with toothaches, back pain, menstrual pain, and so many other distressing and often debilitating health concerns. In fact, a 2010 study published in the Oman Medical Journal revealed that it's both the most common choice of painkiller and the one that doctors most often prescribe to their patients. For all of its popularity, though, ibuprofen comes with its fair share of risks.
This may come as a surprise. However, just as doctors advise you of the potential side effects and risk factors associated with taking certain prescription medications, the same applies to virtually any type of over-the-counter pain medication, including one of the most popular painkillers available. These side effects and risks can apply to people of all ages, but those over 50 should take even more precautions to protect themselves from potential health repercussions linked to ibuprofen.
That's because older individuals are more likely to have other health issues that they treat and manage with prescription medications already. Ibuprofen could interact with those important drugs and potentially render them less effective, leading to long-term health problems. This isn't the only risk associated with taking ibuprofen. To be completely mindful, keep these mistakes in mind and do your best to avoid them if you plan to take ibuprofen to reduce your aches and pains.
Taking ibuprofen with other painkillers
While there are some circumstances that might warrant alternating between ibuprofen and acetaminophen, it's generally not safe to take this medication with other anti-inflammatory and painkilling medicines. In fact, mixing medicines could cause serious adverse health effects that affect everything from the stomach to the kidneys, especially among older individuals with compromised organ function.
It is safe to take ibuprofen and acetaminophen to combat challenging aches and pains, but only when you follow a specific schedule. "Both ibuprofen and acetaminophen are pain relievers and fever reducers. They both can reduce inflammation, but they work in slightly different ways and are processed by different parts of the body. You can alternate like that every three to four hours throughout the day," says Amy Horwitz, DO, a family physician, to the Cleveland Clinic. "If you have an injury, back pain or have a fever, you can alternate using both of them."
However, it's not safe to combine ibuprofen with other non-steroidal anti-inflammatory drugs (NSAIDs) like naproxen and aspirin. The kidneys process NSAIDs, so taking more than is advisable could have a traumatic effect on these vital organs. A 2021 study published in Pharmacology Research & Perspectives found that the drugs could especially affect the elderly, causing serious issues like fluid buildup, elevated sodium levels, and increased blood pressure. Limiting your intake to only one type of NSAID, and taking only what you need to manage the pain, is the safest way to avoid potential drug toxicity.
Neglecting the possibility that ibuprofen might interact with your medications
Older individuals are more likely to take multiple medications for various reasons, such as to treat high cholesterol, heart disease, high blood pressure, diabetes, and other chronic diseases. It's possible that ibuprofen may interact with some of these prescription medicines, leading to potentially harmful side effects or even reducing the efficacy of the treatments.
A Copenhagen University study found that people who have type 2 diabetes are more likely to develop heart failure if they take ibuprofen (via the European Society of Cardiology). People over the age of 65 were at greater risk of developing the cardiovascular problem. Dr. Faye Riley, a research communications manager at Diabetes UK, tells The Sun, "These findings emphasize the importance of careful consideration when it comes to prescribing NSAIDs to those who are already at a higher risk of heart problems, including people living with type 2 diabetes."
Another study conducted by the University of Waterloo found that some who took ibuprofen and hypertension medication could be at increased risk of developing kidney disease. It was detected among those who took a combination of ibuprofen, a diuretic, and a renin-angiotensin system (RSA) inhibitor. Explains Professor Anita Layton, "Diuretics are a family of drugs that make the body hold less water. Being dehydrated is a major factor in acute kidney injury, and then the RAS inhibitor and ibuprofen hit the kidney with this triple whammy. If you happen to be on these hypertension drugs and need a painkiller, consider acetaminophen instead."
Overlooking possible health conditions that could worsen with ibuprofen
Many older people have serious health issues that require medication and treatment. These include but aren't limited to heart disease, hypertension, kidney disease, and peptic ulcers, all of which have the potential to worsen over time. Taking ibuprofen could possibly aggravate the conditions and cause serious health complications. If you have any type of condition, it's crucial to talk to your doctor about the most suitable painkiller to take that is least likely to make matters worse.
For example, researchers have found that taking ibuprofen could disturb the balance of bacteria in the gut. This imbalance could cause bacterial overgrowth, and potentially make conditions like rheumatoid arthritis and joint inflammation worse. Dr. Zoltán Zádori, a member of the Gastrointestinal Research Group at the Department of Pharmacology and Pharmacotherapy at Semmelweis University, told the Mirror, "We found that these bacterial deviations are similar to those caused by NSAIDs. This raises the possibility that drug-induced gut dysbiosis could worsen the underlying diseases and limit the therapeutic effect of non-steroidal anti-inflammatory drugs in the long run."
Similarly, people who take blood thinners may also be at risk if they take ibuprofen. That's because the NSAID could affect the efficacy of the medication, preventing blood from clotting properly. "That could raise the risk of bleeding, especially in the digestive tract. Taking them together with blood thinners raises the bleeding risk even more," explains Dr. Deepak L. Bhatt (via Harvard Health).
Assuming ibuprofen is safe because it's sold over the counter
While anyone can purchase a bottle of ibuprofen from the drugstore, that doesn't automatically make it a safe choice. There are just as many risks involved with taking this painkiller as with prescription medicines, and because older adults are likely to take prescriptions on a regular basis, it's important to be mindful of using ibuprofen improperly or without taking the right precautions.
Unfortunately, because it's so effective at tamping down aches and pains, it can be difficult to stop taking ibuprofen. While temporary use may be acceptable, it's important not to fall into the habit of taking it chronically. This could increase the chances of developing ailments like stomach ulcers, hypertension, nausea, and increased risk of heart and kidney damage. Family nurse practitioner Maegan Kiser says, "NSAIDs can irritate the lining of your stomach, so if you have a delicate stomach, talk to your provider before taking. And you shouldn't take any OTC pain reliever often and over a long period of time without first discussing with your doctor" (via Novant Health).
So what's a safe alternative when you absolutely can't do without a painkiller like ibuprofen? Applying a cold pack within the first three days of an injury can help. If your pain is chronic, using a warm pack may be effective. You can also try acetaminophen, as long as it's deemed safe for you to use by your healthcare provider.
Not drinking enough water when taking ibuprofen
It's incredibly important to stay hydrated when you take ibuprofen. Water ensures that the medication is swallowed properly, which can be an issue for some people as they age. Plus, since both ibuprofen and dehydration can affect kidney function, it's especially important to drink enough water because the kidneys naturally decline a little bit with age.
For older individuals who have difficulty swallowing pills, it's often advised to drink water before actually taking the medication. Drink a generous amount, then swallow the ibuprofen, and follow with some more water to make sure it's properly washed down. If you don't have water nearby, you may be tempted to "dry swallow," but medical professionals warn against this practice. Pharmacy student Trexie Olivar of Sharp Rees-Stealy Medical Centers says, "A pill making contact with the lining of the esophagus — the muscular tube that connects your mouth to your stomach — may cause tissue damage and inflammation." It could even lead to esophagitis, which occurs when the medication's coating irritates the throat and mucus lining, and which could result in irritation and constant throat clearing.
What's more, neglecting to drink enough water could even affect ibuprofen's efficacy. "Not drinking enough water may also cause throat irritation and, in some cases, prevent a medication from working properly," shares Olivar. Drinking water is also beneficial for protecting the kidneys, as these vital organs are more likely to suffer if you're dehydrated.
Neglecting to eat something with ibuprofen
It's a big mistake for anyone to take ibuprofen on an empty stomach, but older individuals are more prone to stomach sensitivity and irritation. Since ibuprofen can increase the risk of developing ulcers and other stomach issues (like gastrointestinal bleeding), it's especially important to take the medicine with a meal. Either snacks or larger meals will do, but the bottom line is that food should be considered essential when you take ibuprofen.
According to Dr. Joshua Russell, MD (via PopSugar), "These medications can seriously damage the lining of the stomach." That's due to a very specific decline in a compound that protects the stomach. "Ibuprofen decreases prostaglandin production, and one role of prostaglandin is to help lower stomach acid and increase production of protective stomach mucus," explains Dr. Jill Grimes, MD. "So as early as about a week, the ibuprofen can potentially cause gastritis (inflammation of the stomach lining) or even an ulcer (a hole in the lining)."
While food alone can't prevent this remarkable decline in prostaglandin, it can create a protective barrier that tamps down irritation. Dr. Grimes suggests eating foods that contain fat or protein, as these are slower to digest and therefore have longer-lasting effects. Try "[a] few slices of an apple with some peanut butter, or cheese and crackers." According to the NHS, this approach works more effectively than taking the medicine after food, a habit that could prevent the ibuprofen from working as quickly as it would normally.
Taking more than the recommended dose of ibuprofen
Safety is a huge issue where any medication is concerned, but taking more ibuprofen than necessary could have especially serious ramifications and lead to serious issues that affect the heart, stomach, and kidneys. All of these are especially vulnerable among older individuals.
To begin, it's important to remember that the standard adult dosage for ibuprofen is a single 200 milligram tablet taken every four to six hours. It's fine to increase that to two if the pain does not respond to a single tablet. Given this recommendation, drug manufacturers typically state that adults shouldn't exceed more than six ibuprofen tablets daily, or 1,200 milligrams. Anything greater than this could be harmful. Mandy Leonard, a head at the Department of Pharmacy Drug Information Service at Cleveland Clinic, tells USA Today, "I wouldn't go any higher than that unless you were under advisement of a physician."
It's not just that taking more could compel older individuals to rely on that amount as a regular habit instead of using the recommended dose to manage their pain. Leonard explains, "The concern is that you could develop ulcers and bleeding in your GI tract, especially if you take these 800 milligrams three times a day for a longer period of time without being under the supervision of a physician." If your pain doesn't respond to the lowest dose of ibuprofen, see your medical provider for alternatives that are gentler on the stomach.
Taking too much ibuprofen for too long
Ibuprofen is an enormously effective painkiller, but its efficacy can also be a drawback, as people may be more likely to take it regularly to combat their aches and discomfort. This is detrimental, because there is such a thing as taking ibuprofen for too long. It's something doctors warn against for many reasons, from its potentially harmful effects on the stomach and the kidneys to the possibility that it could interact with other prescription medications. While these risks are very real, you can do your part to reduce your chances of developing a problem by limiting how often you take ibuprofen.
Dr. Sarah Ruff, MD, of UNC Family Medicine, tells The New York Times, "If you are needing it for more than two weeks, that's a good sign that you need to go see your doctor." And Dr. Gerard Isenberg, MD, the Chief Medical Quality Hospital at the University Hospitals Digestive Health Institute in Cleveland, OH, adds that taking too much ibuprofen could be considerably more dangerous than people realize. "People who take it chronically are at risk of developing problems. A recent study showed that incorrect use of NSAIDs is estimated to account for 107,000 hospitalizations and 15,600 deaths annually in the United States."
Dr. Isenberg recommends taking the lowest dose possible and consulting with your healthcare provider if you have heart, kidney, or stomach concerns. He says that your doctor may advise you to try another type of NSAID instead.
Not being mindful of ibuprofen's effect on blood pressure
With age comes a greater likelihood of developing hypertension or high blood pressure. Sometimes it's due to thyroid or kidney issues, but often it's simply the result of naturally stiffened arteries. No matter the source of this increased pressure, taking ibuprofen can actually aggravate the problem and cause those numbers to spike. This is why it's critical to manage your intake of the painkiller while also taking other protective measures like reducing dietary sodium and minimizing stress levels.
Data retrieved from the National Health and Nutrition Examination Survey found that some 20% of people with high blood pressure could aggravate the condition by taking ibuprofen. The findings also revealed that people who took medications that could potentially spike blood pressure, like ibuprofen, were more likely to take elevated doses of prescription medications to manage their hypertension. Dr. Anne Arikian, MD, a family medicine physician at UCLA, explains that "[w]on't raise your blood pressure when taken just occasionally for pain or headache, but they can if you take them chronically on a daily or near-daily basis" (via UCLA Health). Given the propensity for the NSAID to affect blood pressure or even interact with prescribed medicines, it's smart to check with a medical provider before taking this popular painkiller.
It's equally important to note that other over-the-counter products, like cold medicines, may contain ibuprofen. Always check the label before taking anything to prevent a possible increase in your blood pressure.