Can you take ibuprofen on an empty stomach?

Ibuprofen, commonly referred to by its brand names Advil and Motrin, is a nonsteroidal anti-inflammatory drug (NSAID) used to reduce pain and inflammation in the body. Although it may relieve pain symptoms faster, taking ibuprofen on an empty stomach may not be the safest option for everyone. NSAIDs can irritate the lining of the stomach and make existing gastrointestinal issues worse. Luckily, there are a few simple ways you can minimize the impact of ibuprofen on your stomach. 

Is it safe to take ibuprofen on an empty stomach?

Taking ibuprofen on an empty stomach can irritate the lining of the stomach and lead to gastrointestinal (GI) upset, says Michael Green, MD, co-founder of Winona. It is recommended to take ibuprofen after eating food rather than on an empty stomach.

NSAIDs decrease the production of prostaglandins by blocking certain enzymes. Prostaglandins can cause fevers, pain, and inflammation, but one of their major functions is to protect your stomach lining. NSAIDs can damage your gut by decreasing the production of prostaglandins. Taking NSAIDs on an empty stomach, especially if you have existing gastrointestinal issues, can be dangerous. Potential side effects of ibuprofen include: 

• Indigestion 
• Bloating
• Gastroesophageal reflux disease (GERD)
• Stomach ulcers
• Acute colitis 
• High blood pressure 
• Headache 

Ibuprofen can be especially hard on the stomach in people with a sensitivity to NSAIDs, says Sean Ormond, MD, board-certified interventional pain management physician with Atlas Pain Specialists in Glendale, Arizona. People with pre-existing health conditions, such as ulcers, gastritis, or kidney problems, have increased vulnerability to NSAID irritation, explains Dr. Ormond. Additionally, adults over the age of 60 and those who have a history of chronic NSAID use are at a higher risk for experiencing NSAID-related gastrointestinal issues while taking ibuprofen. 

What is the best way to take ibuprofen?

The best way to take ibuprofen is after eating a meal or snack, with a full glass of water or milk. “Food helps buffer the stomach lining from the drug’s effects [and reduce] the risk of irritation,” Dr. Ormond says. 

Taking ibuprofen after eating may result in a slower absorption rate, meaning ibuprofen may take a little longer to work than on an empty stomach—but waiting a little bit for pain relief is likely worth mitigating any gastritis side effects.

Be sure to follow the recommended dosage for your age and not exceed the maximum daily dose. A typical over-the-counter (OTC) ibuprofen dose for adults is 100 mg to 200 mg every four to six hours as needed, with a maximum daily dose of 1,200 per day. Prescription ibuprofen is 400 mg to 800 mg every four to six hours as needed, with a maximum daily dosage of 3,200 mg. However, you may be instructed to take a different dosage by a healthcare provider.

If you find yourself taking ibuprofen every day for pain relief, contact a healthcare provider. Even if you take it with food in your stomach, you may see adverse symptoms over time. “Taking ibuprofen regularly for chronic pain or inflammation may increase the risk of side effects, including gastrointestinal issues, kidney disease, and cardiovascular events,” Dr. Green says. 

There may be a better medication for pain relief that will work for you. In addition, you may want to consider alternatives if you do experience GI side effects from NSAIDs. 

“If you require long-term pain management, your healthcare provider may recommend alternative medications or therapies to minimize the potential risks associated with daily ibuprofen use,” says Dr. Green. This may include treating your GI issues directly before continuing with frequent ibuprofen use or taking prescribed painkillers if your pain is a chronic issue. 

How to reduce the risk of GI side effects with NSAIDs

There are a few ways you can reduce the risk of GI side effects with NSAIDs. Different techniques will work depending on your needs, but experts recommend the following strategies to help prevent adverse effects. 

• Take the lowest effective dose to relieve your pain symptoms.
• Avoid combining ibuprofen with other NSAIDs, such as aspirin or Celebrex (celecoxib), which can increase the risk of stomach irritation or bleeding, according to Dr. Green.
• Choose short-acting forms by opting for NSAIDs with shorter half-lives, like ibuprofen 200 mg every four to six hours. Dr. Ormond recommends. 
• Seek out alternative pain relief methods to NSAIDs, like acetaminophen. There are certain natural remedies, like arnica and bromelain, that some people use in place of NSAIDs. However, many of these natural alternatives have not been studied thoroughly and are not FDA approved. Certain supplements for painful conditions, like glucosamine chondroitin for osteoarthritis, may assist with daily aches over time, but remember to check with your provider before trying a new supplement. 
• Consider taking gastroprotective medications, recommends Dr. Ormond. If you require the use of long-term NSAIDs, speak with your healthcare provider about proton pump inhibitors (PPI) or H2 blockers. These medications decrease the production of stomach acid and can reduce the risk of peptic ulcer disease and other NSAID-related stomach problems.  

The bottom line: Always follow the recommended dosage

For most adults without pre-existing conditions, taking two ibuprofen daily for short periods (a few days at a time) is generally safe, says Dr. Ormond. Just be sure to have something in your stomach before you take it, even if it’s just a glass of milk or a snack. Avoid higher doses of ibuprofen if you experience moderate stomach pain or other serious side effects. If you are regularly exceeding the daily maximum dosage or take ibuprofen daily for moderate pain, talk to your healthcare provider about finding a pain medication that works for you. 

Ibuprofen is a common and effective pain reliever, but it should still be taken with caution. Even though having food in your stomach can help reduce your risk of GI side effects, NSAIDs may still not work for you. “Stop taking ibuprofen and consult your healthcare provider if you experience any stomach discomfort, heartburn, or bleeding,” Dr. Ormond says.