ADVIL 200MG TAB

Indications

Approved Uses

OTC indications: temporary relief of minor aches and pains (e.g., headache, toothache, backache, muscular aches, minor arthritis pain, menstrual cramps) and reduction of fever.

Off-Label Uses

Acute pericarditis (adjunct/anti-inflammatory dosing under clinician supervision).

Dosage & Administration

Dosing by Condition

OTC pain/fever (adults and ≥12 years): 200 mg every 4-6 hours as needed; may take 400 mg per dose if needed; maximum 1,200 mg/day OTC unless directed by a clinician.

Initial Dose

200mg to 400mg.

Maintenance Dose

200mg to 400mg every 4 to 6 hours as needed.

Maximum Dose

1200mg per day (OTC); 3200mg per day (prescription under medical supervision)

Children's Dosage

Children 6 months to 12 years: 5-10mg/kg every 6-8 hours, max 40mg/kg/day. Not recommended under 6 months of age

Dose Adjustment Notes

Use the lowest effective dose for the shortest duration. Use caution in older adults and in mild-moderate renal impairment; avoid use in severe renal impairment. No routine dose adjustment is required for mild hepatic impairment, but avoid in severe hepatic failure and use caution with significant liver disease.

How to Take

Oral: swallow the 200 mg tablet with a full glass of water; may take with food or milk to reduce GI upset. Do not exceed labeled dose. If the product is film/sugar-coated, do not crush or chew unless the label allows it.

Side Effects

Common Side Effects

Nausea, heartburn, indigestion, abdominal pain, diarrhea, constipation, headache, dizziness, rash.

Safety & Warnings

Contraindications

Contraindications: hypersensitivity to ibuprofen/other NSAIDs; history of NSAID/aspirin-induced asthma, urticaria, or other allergic-type reactions; active GI bleeding or active peptic ulcer disease; perioperative pain in the setting of CABG surgery; third trimester of pregnancy. Avoid/use only with specialist direction in severe heart failure, severe renal impairment, or severe hepatic impairment.

Warnings & Precautions

Warnings/precautions: use lowest effective dose for shortest duration; increased risk of CV thrombotic events (higher with longer use and in patients with CV disease/risk factors); serious GI bleeding/ulceration can occur without warning (higher risk in older adults, prior ulcer/GI bleed, anticoagulants/SSRIs/steroids, smoking/alcohol); renal risk in CKD, dehydration, heart failure, diuretics/ACEi/ARB use; bronchospasm risk in aspirin-sensitive asthma; risk of severe skin reactions and hypersensitivity-stop if rash/allergic symptoms occur.

Age Restriction

Not for use in infants under 6 months unless directed by a doctor.

Driving Warning

Safe

Drug Interactions

Drug Interactions

Key interactions: anticoagulants/antiplatelets (e.g., warfarin, DOACs, clopidogrel-↑ bleeding); aspirin (may reduce aspirin’s antiplatelet effect and ↑ GI risk); other NSAIDs (additive toxicity); SSRIs/SNRIs and corticosteroids (↑ GI bleeding); ACE inhibitors/ARBs and diuretics (↓ antihypertensive/diuretic effect, ↑ AKI risk-“triple whammy”); lithium (↑ levels); methotrexate (↑ toxicity); cyclosporine/tacrolimus (↑ nephrotoxicity).

Interaction Severity

MAJOR/clinically significant: anticoagulants/antiplatelets (e.g., warfarin, DOACs, clopidogrel) and other NSAIDs (including high-dose aspirin) → increased bleeding/GI risk; lithium → increased lithium levels/toxicity; methotrexate (especially high-dose) → increased toxicity. MODERATE: ACE inhibitors/ARBs and diuretics → reduced antihypertensive/diuretic effect and increased AKI risk; SSRIs/SNRIs or systemic corticosteroids → increased GI bleeding risk. NOTE: low-dose aspirin cardioprotection may be attenuated if ibuprofen is taken near the aspirin dose.

Food Interaction

Take with food

Alcohol Interaction

Avoid

Special Populations

Pregnancy

Avoid in third trimester; use in first and second trimesters only if benefit outweighs risk (no traditional FDA category; contraindicated third trimester).

Children

Children 6 months to 12 years: 5-10mg/kg every 6-8 hours, max 40mg/kg/day. Not recommended under 6 months of age

Elderly

Start at lowest effective dose (200mg), use for shortest duration, monitor renal function and GI tolerance closely. Increased risk of GI bleeding and renal impairment

Kidney Impairment

Mild-moderate renal impairment: use with caution and lowest effective dose; severe renal impairment (e.g., eGFR/CrCl <30 mL/min) or active AKI: avoid.

Liver Impairment

Mild-moderate hepatic impairment: use with caution at the lowest effective dose; severe hepatic impairment: avoid (generally not recommended).

Storage & Patient Advice

Missed Dose

Take as soon as remembered; skip if near next scheduled dose. Do not double the dose

Stopping the Medicine

Safe to stop anytime for short-term OTC use; if used long-term or at high doses, consult a clinician before stopping/changing therapy.

Overdose

Symptoms: nausea/vomiting, abdominal pain, drowsiness/dizziness, headache, tinnitus; severe toxicity may include GI bleeding, metabolic acidosis, seizures, coma, hypotension, and acute kidney injury. Management: seek urgent medical care/poison center; consider activated charcoal if early after large ingestion; supportive care with monitoring of vitals, renal function, electrolytes, and acid-base status.

Patient Counseling

Take with food or milk if stomach upset occurs; swallow with water. Do not exceed 1,200 mg/day OTC unless directed by a clinician. Do not use >3 days for fever or >10 days for pain unless advised by a doctor. Avoid combining with other NSAIDs; ask a clinician before use with blood thinners, steroids, SSRIs/SNRIs, lithium, methotrexate, or if you have ulcer/GI bleeding history, kidney disease, uncontrolled hypertension/heart disease, or asthma sensitive to NSAIDs. Stop and seek care for signs of GI bleeding (black stools, vomiting blood), severe allergic reaction, or symptoms of heart attack/stroke. Avoid in the 3rd trimester of pregnancy.

Monitoring Requirements

Short-term OTC use: no routine labs; counsel to monitor for GI bleeding, allergic reactions, and worsening pain/fever. Longer-term or higher-risk use: monitor blood pressure, renal function (SCr/eGFR), and for GI bleeding; consider CBC and liver enzymes if prolonged therapy or clinical concern.

Pharmacology

Mechanism of Action

Reversible, non-selective inhibition of cyclooxygenase (COX-1 and COX-2), decreasing prostaglandin synthesis to reduce pain, inflammation, and fever.

Onset of Action

30-60 minutes.

Duration of Effect

4-6 hours.

Half-Life

1.9-2.2 hours.

Bioavailability

Approximately 80% (often cited range ~80-100% for immediate-release oral ibuprofen).

Metabolism

Hepatic metabolism primarily via CYP2C9 (with minor contributions from other pathways) to inactive metabolites.

Excretion

Primarily renal excretion as metabolites (majority in urine), with a small amount in feces.

Protein Binding

>99%.

Product Information

Available Dosage Forms

For this specific product: oral tablet (200 mg) in blister pack.

Composition per Dose

Each tablet: 200mg ibuprofen

Generic Availability

Yes

OTC Alternatives

Paracetamol (acetaminophen) for pain/fever; naproxen sodium OTC for pain; topical diclofenac for localized musculoskeletal pain (where available OTC).

Pain Type

General/Muscular/Joint

Nsaid

Yes

Opioid

No

Reviewed by Al Mujtama Pharmacy Medical Review Team. Last reviewed 30-06-2026