Oral Ibuprofen doses above 400 mg do not provide additional pain control in adults

Oral ibuprofen administered at dosage 800 mg is no better than 400 mg for short-term pain relief in adults, revealed a randomized control trial published Annals of Emergency Medicine.

Ibuprofen is a commonly used analgesic given to people who are presented at the Emergency Department (ED) for short term pain relief. Large doses of ibuprofen are often used for emergency department (ED) patients, despite evidence that doses above 400 mg increase rates of side effects without improving pain control. When acute pain is managed, however, the analgesic ceiling dose of ibuprofen at 400 mg is sufficient to reduce pain and inflammation.

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To compare the efficacy of smaller dose of the drug with bigger doses a team of scientists led by Sergey Motov of Department of Emergency Medicine, Maimonides Medical Center, Brooklyn, NY conducted a randomized control including 225 subjects presented at the emergency department with acute painful conditions.

Primary outcome included a difference in pain scores between the 3 groups at 60 minutes.

Key observations

• The difference in mean pain scores at 60 minutes between the 400- and 600-mg groups was –0.14 .


• between the 400- and 800-mg groups, 0.14


• between the 600- and 800-mg groups, 0.00.


• Reductions in pain scores from baseline to 60 minutes were similar for all subjects in each of the 3 groups. No adverse events occurred in any group.

Based on the results of the study the authors concluded that