A recent study of ibuprofen users provides evidence that a significant proportion of people taking over-the-counter (OTC) ibuprofen may be exceeding the recommended daily dose, increasing their risk of gastrointestinal bleeding and other serious dose-related adverse effects. Researchers conducted the study of a nationally representative sample of 1,326 adults who used ibuprofen and recorded their use of nonsteroidal antiinflammatory drugs (NSAIDs) daily in an online diary for one week. During that week, 87% took only OTC ibuprofen, 9.5% took only prescription ibuprofen, and 3.8% took both types. Among the ibuprofen users, 37% also took other types of NSAIDs, including naproxen, but only 39% were aware that all the products they were taking were NSAIDs.
Overall, 11% of the ibuprofen users exceeded the daily limit on at least one day, as did 12% of the only OTC ibuprofen users, compared with 2.4% of the only prescription ibuprofen users. The proportion of those who exceeded the daily limit of naproxen was even higher: 23%. The daily dose limit was exceeded for at least one NSAID on 9.1% of the days an NSAID was used-and 7.5% of the days ibuprofen was used-mostly with OTC use. "Days over the limit were almost always marked by other deviations from label directions, including re-dosing too soon, concomitant use of multiple NSAID medications, and exceeding the recommended one-time dose," the authors wrote. They also observed that having the attitude that it wasn't necessary to start with the lowest dose to see if that worked before increasing the dose (as recommended on the labels of many OTC NSAIDs), and being able to choose one's dose were also associated with a greater likelihood of exceeding the daily limit.
The results, the authors concluded, "are important in providing, for the first time, diary-based estimates of how often and how NSAID dosing over the daily recommended limit occurs among users of ibuprofen, the most frequently taken drug in this class and one of the most commonly taken medications in the [United States]."-Elizabeth Mechcatie, MA, BSN
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