A Comprehensive Review of Ibuprofen and Its Adverse Effects (Review Article)

Author(s): Geethanjaly N S*, Vignesh. C, Abhirami M R, Arya Pramod, Shamna M, Shifana C S, and Hima K H

Abstract: Non-steroidal anti-inflammatory drugs (NSAIDs), particularly ibuprofen, are widely used for analgesia and antipyresis but remain a major cause of gastrointestinal (GI) injury across age groups. Data derived from the FDA Adverse Event Reporting System and real-world pharmacovigilance analyses consistently identify safety signals linking ibuprofen to gastric, small-bowel, and intestinal barrier damage. Clinical reviews and case reports,including instances of acute hemorrhagic gastritis and pre-pyloric perforation in young children,highlight the spectrum of NSAID-induced pathology, ranging from mild dyspepsia to life-threatening complications. Studies examining mechanistic pathways show that ibuprofen increases biomarkers of intestinal permeability even when systemic inflammation is suppressed. Risk is further modulated by factors such as dose, duration, hypoxic stress, and postoperative use, prompting trials like PERISAFE to evaluate adverse outcomes after major orthopedic surgery. Pediatric-focused research underscores additional concerns, including hypersensitivity reactions, prescribing variability, and potential associations between ibuprofen administration and asthma development or exacerbation. Together, the evidence emphasizes the need for cautious NSAID use, appropriate patient selection, and implementation of preventive strategies such as gastro protective agents and enhanced monitoring to mitigate ibuprofen-related GI and systemic adverse effects.

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