Pharmacists are warning five groups of people to take extra care when using ibuprofen during hot weather. The common painkiller may not be suitable for everyone, especially during prolonged high temperatures when dehydration can put additional strain on the body.
The Medicines and Healthcare products Regulatory Agency (MHRA) has also warned that medicines including ibuprofen and naproxen can make people more sensitive to sunlight, potentially increasing the risk of sunburn. The MHRA advises people taking such medicines to take extra care in the sun.
Who is at higher risk?
Ibuprofen belongs to a group of medicines called non-steroidal anti-inflammatory drugs (NSAIDs) and is commonly used for headaches, muscle and joint pain, inflammation and fever. However, NHS guidance says ibuprofen is not suitable for everyone and can cause more side effects than paracetamol.
Hanna Yusuf, prescribing pharmacist at Chemist4U, said some people may find their joints become more swollen, stiff or uncomfortable during hot weather. She said: “Ibuprofen is one of the most reached-for painkillers in the country, and for most people, taking it occasionally isn’t something to worry about.”
“The problem is that hot weather can increase your risk of becoming dehydrated, and dehydration is one of the factors that can make ibuprofen harder on your kidneys.”
The five groups warned
The first group is pregnant women, particularly from 20 weeks onwards. NHS guidance advises avoiding ibuprofen during pregnancy unless a doctor or pharmacist recommends it. Specialist pharmacy guidance says systemic NSAIDs should generally be avoided from 20 weeks unless clinically necessary because of risks including reduced amniotic fluid and problems with fetal kidney function.
The second group is people living with heart failure or liver disease. Ibuprofen may not be suitable for people with heart, liver or kidney conditions, and NHS guidance recommends checking with a healthcare professional before taking it.
The third group is those living with kidney disease. NSAIDs can affect kidney function, with NHS guidance specifically warning that people with kidney problems may need to avoid them unless advised otherwise by a doctor or pharmacist.
The fourth group is people taking certain medicines for high blood pressure, including ACE inhibitors, ARBs or diuretics. Taking an NSAID alongside an ACE inhibitor or ARB and a diuretic is sometimes known as the “triple whammy”, because the combination can increase the risk of acute kidney injury. NHS guidance also lists medicines used to lower blood pressure among drugs that can interact with NSAIDs.
The fifth group is anyone who has previously reacted badly to ibuprofen, aspirin or another NSAID. NHS advice says ibuprofen may not be suitable for people who have previously experienced an allergic reaction to ibuprofen, aspirin or another NSAID.
What to do instead
Yusuf said people in these groups should not simply stop prescribed medicines because temperatures have risen. “We’re not saying that people should stop taking prescribed medication or throw away their ibuprofen,” she said. “The key thing is that if you’re one of these higher-risk groups, it’s worth speaking to a pharmacist about the safest option for you during a heatwave.”
The pharmacist said paracetamol may be a more suitable option for some people, although anyone with an existing health condition should check which painkiller is appropriate for them.
Staying hydrated is also important during hot weather. The MHRA advises people to drink water regularly and watch for signs of dehydration such as dizziness, confusion, headaches and dark urine. People taking ibuprofen should also be alert for possible signs of kidney problems, including shortness of breath, blood in the urine and swelling around the ankles, feet or hands.
For a localised injury or painful joint, a topical treatment may sometimes be considered instead of tablets, although people should still check the product information and speak to a pharmacist if they are unsure. Anyone taking regular medication should also check before adding ibuprofen, as NSAIDs can interact with a number of commonly used medicines, including blood thinners, steroids, antidepressants and some blood-pressure treatments.
The warning does not mean that everyone needs to avoid ibuprofen. Most adults can take NSAIDs, but the NHS recommends checking the medicine is suitable and following the instructions on the packet or leaflet. With temperatures rising, people in higher-risk groups are being urged to speak to a pharmacist or doctor before taking ibuprofen rather than assuming a commonly used painkiller is safe for them.
