Why is the maximum daily dosage of over-the-counter ibuprofen 1200mg but the maximum for a prescription is 2000mg?

Answer 1

• As a pharmacist I see a lot of stomach problems due to excessive ibuprofen use. The maximum daily dose should be 600mg up to three times a day. Thus 1,800mg should be the limit. Latest evidence shows no gain in therapeutic relief when going to 800mg three times a day. It doesn't matter how you obtain the ibuprofen, OTC or prescription, the maximum is the same.
• 1200 is safe, more should be monitered, like by a doctor, maybe.
• Actually, no one should be taking 2000mg of ibuprofen. The OTC dosage is 400mg, and the prescription dosage is 800mg. Because toxicity is directly related to dosage a doctor is needed to monitor higher levels of dosing. To even be an OTC drug, safety and efficacy must be proven to a much higher standard than prescription drugs.
• Actually, the maximum daily dose is 2400mg in healthy adults. This shouldn't be used long term however as it can precipitate more serious side effects such as renal insufficiency and gastric irritation (stomach ulcers.
• To answer your question however, OTC ibuprofen has a different license to prescribed ibuprofen. This limits what can be included on the instructions and what uses it can be sold for. A standard starting dose is 400mg 3-4 times daily, increasing to 800mg 3 times daily if required. If someone is going to be taking ibuprofen longer term, doses of 200mg three times daily may be adequate.
• OTC DRUGS always carry a lower dosing instuction than prescription drugs simply because when prescribed, a medication and your health is monitored by a physician. They know your medical background, any diseases or weakness in your system. They also monitor liver, kidney functions and can do blood tests to determine if there is a problem. When you self medicate with OTC (over-the counter) medication, you are basically ON YOUR OWN. Hope this helps clarify the issue for you.
• I agree that nobody should exceed the OTC dose recommendation. I work with dialysis patients and you wouldn't believe the number of ppl who end up with kidney failure because they have been using excessive amounts of drugs like Advil. Some have factors that have helped lead to dialysis such as high blood pressure, Diabetes or an underlying genetic predisposition for kidney problems but either way I cannot emphasize more on using caution when taking OTC ibuprofen above the recommended dosage.
• The maximum dose of ibuprofen in 24 hours is 3,200mg or 3.2gm. This is rarely seen even in a pharmacy setting. The OTC (over the counter) dose is only 200mg per tablet/capsule. Prescription strengths include 400mg, 600mg, and 800mg. There really is no reason someone should have to take that much ibuprofen though. Just be cautious because ibuprofen taken without food can cause ulcers and bleeding of the stomach.
• "There really is no reason someone should have to take that much ibuprofen though"
• Yes, there is- the sheer horror of impacted lower wisdom tooth removal. I've been forced up to the 3200mg dose two consecutive days by the worst agony of my life, combining it with a ton of paracetamol too. This has barely controlled the pain. It's foolhardy but unavoidable with this degree of discomfort... i am in Germany where you cannot get any codeine medicine whatsoever without prescription, and they simply will not prescribe- i was sent back from my traumatic wisdom surgery (done in a chair under local anaesthetic) armed with TWO PARACETAMOL. That's it. I've been forced to take this huge dosage because I simply cannot bear the agony. I'm hoping I've done no permanent damage... i drank 3-4 litres of water a day, and used a can of soup and a smoothie to line my stomach along with each large dose. I had a wave of side effects last night... vertigo, whining tinnitus and heat itching on my legs, but it passed. I'm halving the dose today to see if the pain level has dropped.