title: Gastrointestinal safety and tolerance of ibuprofen at maximum over-the-counter dose.
abstract: BACKGROUND
  Delineation of non-steroidal anti-inflammatory drug (NSAID) gastrointestinal toxicity has largely depended on retrospective epidemiologic studies which demonstrate that lower doses of NSAIDs pose a lower risk of gastrointestinal toxicity. Ibuprofen, a propionic acid NSAID, has, in most such studies, exhibited a favourable profile in terms of gastrointestinal bleeding. Since 1984, ibuprofen has been available as a non-prescription analgesic/antipyretic with a limit of 1200 mg/day for 10 days of continuous use. Trials and spontaneously reported adverse experiences suggest that gastrointestinal symptoms and bleeding are rare.
  
  
  METHODS
  This study prospectively evaluated the gastrointestinal tolerability, as compared to placebo, of the maximum non-prescription dose and duration of ibuprofen use in healthy subjects representative of a non-prescription analgesic user population.
  
  
  RESULTS
  Gastrointestinal adverse experiences were similar in the placebo and ibuprofen groups (67 out of 413, 16% with placebo vs. 161 out of 833, 19% with ibuprofen). There was no difference between the two groups in the proportion discontinuing due to a gastrointestinal event. Gastrointestinal adverse experiences reported by >/= 1% of subjects were: dyspepsia, abdominal pain, nausea, diarrhoea, flatulence, and constipation. Seventeen (1.4%) subjects had positive occult blood tests: their frequency was comparable between treatments.
  
  
  CONCLUSIONS
  When used as directed to treat episodic pain, non-prescription ibuprofen at the maximum dose of 1200 mg/day for 10 days, is well-tolerated.
authors.affiliation: Clinical Research Department, Whitehall-Robins Healthcare, Madison, New Jersey, USA.
authors.forename: G
authors.initials: G
authors.lastname: Doyle
authors.forename: S
authors.initials: S
authors.lastname: Furey
authors.forename: R
authors.initials: R
authors.lastname: Berlin
authors.forename: S
authors.initials: S
authors.lastname: Cooper
authors.forename: S
authors.initials: S
authors.lastname: Jayawardena
authors.forename: E
authors.initials: E
authors.lastname: Ashraf
authors.forename: L
authors.initials: L
authors.lastname: Baird
mesh_terms: D000293:Adolescent; D000328:Adult; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D000894:Anti-Inflammatory Agents, Non-Steroidal / Q000008:administration & dosage* / Q000009:adverse effects*; D002648:Child; D004311:Double-Blind Method; D005260:Female; D005767:Gastrointestinal Diseases / Q000139:chemically induced*; D006801:Humans; D007052:Ibuprofen / Q000008:administration & dosage* / Q000009:adverse effects*; D008297:Male; D008875:Middle Aged; D004366:Nonprescription Drugs / Q000008:administration & dosage / Q000009:adverse effects; D009780:Occult Blood; D011446:Prospective Studies; D012737:Sex Factors
chemical_list: D000894:Anti-Inflammatory Agents, Non-Steroidal; D004366:Nonprescription Drugs; D007052:Ibuprofen