We often think of over-the-counter (OTC) medications as safe medications that have a low risk of problems. But no medication is totally risk-free. All medications, including OTC products, have side effects to be aware of.
One well-known OTC pain reliever is ibuprofen (Advil, Motrin). This nonsteroidal anti-inflammatory drug (NSAID) is a common choice for fevers and mild aches or pains. But how much is OK to take? And is ibuprofen bad for your liver or kidneys?
Here, we’ll review some general information about how ibuprofen affects the liver and kidneys.
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Is ibuprofen bad for your liver?
Not usually. Ibuprofen and other NSAIDs rarely affect the liver. It’s estimated that between 1 and 10 out of every 100,000 people experience liver damage with NSAIDs. For most people, the NSAIDs available today pose little risk for liver damage.
Research is limited on whether certain people may have a higher risk of liver problems after taking NSAIDs. Currently, scientists believe liver problems with NSAIDs may be more likely for:
People with a history of hepatitis B or C
People with a history of metabolic dysfunction-associated steatotic liver disease (previously called nonalcoholic fatty liver disease)
People with a history of other liver problems
Women
Older adults
People who take other medications that can cause liver damage
People who drink alcohol regularly or in large amounts
If any of these risk factors apply to you, talk to a healthcare professional. They can help determine whether ibuprofen is likely safe for you.
How ibuprofen affects the liver
Ibuprofen can elevate liver enzymes (blood tests that help estimate your liver function). These elevations usually cause no symptoms and typically only happen when people are taking higher doses (2,400 mg per day or more). If a person stops taking ibuprofen, their liver enzyme levels should return to normal with no long-term harm done. But if you have existing liver problems, these changes could be more worrisome.
Is ibuprofen bad for your kidneys?
While it rarely affects the liver, ibuprofen can impact your kidneys. Here’s the science behind the problem.
Other side effects to consider: Kidney damage is a potentially serious side effect of ibuprofen (Advil, Motrin). Read more about ibuprofen’s potential side effects — from heartburn to swelling — and how to manage them.
The right dose: Taking too much ibuprofen raises your risk of kidney damage and other serious side effects. Taking the recommended ibuprofen dosage can help lower the risk of these complications.
Comparing pain relievers: Acetaminophen (Tylenol) may be safer than ibuprofen if you have kidney problems. Compare acetaminophen versus ibuprofen and when one might be a better option than the other.
Ibuprofen and other NSAIDs block a process in the body called the cyclooxygenase (COX) pathway. The COX pathway is involved in creating pain and swelling. But it’s also involved in helping blood to flow to the kidneys.
Blocking the COX pathway can narrow blood vessels leading to the kidneys. If this happens, then less oxygen reaches the kidneys. And that can cause acute (sudden) kidney injury.
Acute kidney injury can happen with any NSAID, including ibuprofen. And there are people that have a higher risk of this serious side effect, including:
People who take ibuprofen long-term or at high doses
People with chronic kidney disease (CKD)
People with heart failure
People with liver failure
People who are dehydrated
People who take medications that impact the kidneys, such as diuretics (water pills)
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The good news is these effects are typically reversible if you stop taking NSAIDs. But if you continue taking these medications after developing kidney damage, it can lead to CKD in the long term.
Acute kidney injury from NSAIDs may not cause any symptoms. If you’re taking ibuprofen for long periods of time, discuss with your healthcare team whether you should go for regular kidney function tests.
How much ibuprofen can you take?
The maximum dose of ibuprofen depends on whether you’re taking it on your own or following a healthcare professional’s instructions. It’s important to take all sources of ibuprofen into account when determining your total daily dose. Ibuprofen is a common ingredient in many combination cough, cold, and pain medications. Always check the label to see if ibuprofen or another NSAID is an active ingredient.
When taking ibuprofen OTC, adults and children, ages 12 and older, can take 200 mg to 400 mg by mouth every 4 to 6 hours as needed. You shouldn’t take more than 1,200 mg in a 24-hour period.
Ibuprofen dosages for children between ages 2 and 11 are based on their age and body weight. Follow the directions on the OTC label carefully. Ask your child’s pediatrician if you’re not sure how much to give your child. You should also contact their pediatrician if your child is under age 2. They can provide you with a safe dosage based on their age, body weight, and symptoms.
When a licensed healthcare professional recommends taking ibuprofen, the dose may be much higher than what’s suggested for OTC treatment. Adults may be instructed to take up to 3,200 mg per day. Follow your healthcare team’s instructions, and don’t take more than what they recommend.
Can you take ibuprofen every day?
This is a question best answered by your healthcare team. There are health conditions that require people to take NSAIDs most days or every day. But if you’re taking ibuprofen OTC, the FDA recommends only taking it for a short period of time without talking to your prescriber.
It’s best to take OTC ibuprofen for no more than 10 days at a time for pain and no more than 3 days for a fever. If your symptoms get worse after starting ibuprofen, contact a healthcare professional.
Tylenol (acetaminophen) vs. NSAIDs: Which is safer for the liver and kidneys?
Many people confuse acetaminophen (Tylenol) and ibuprofen. This is because they can treat many of the same symptoms. But there are key differences between ibuprofen and acetaminophen, especially when it comes to how they affect the liver and kidneys.
Which pain reliever is safer for the liver?
Ibuprofen is safer for the liver than acetaminophen.
The liver is the main organ responsible for breaking down acetaminophen. When taken occasionally, and at recommended doses (no more than 4,000 mg per day for most adults), it shouldn’t cause liver damage. But if you have a history of liver problems, it’s usually recommended to avoid acetaminophen.
Which pain reliever is safer for the kidneys?
Acetaminophen is safer for the kidneys than ibuprofen.
Acetaminophen doesn’t have the same effect on the COX pathway as ibuprofen. So kidney damage is much more rare. Kidney issues are typically only reported when a person has taken too much acetaminophen or has existing liver problems. If you have CKD or other kidney problems, consider acetaminophen as a safer alternative to ibuprofen.
So, is ibuprofen bad for you?
For most people, occasional use of ibuprofen is considered safe. Just make sure to stick within the recommended doses and only use it for a few days. If you have kidney problems or take other medications that can cause kidney damage, discuss whether ibuprofen is right for you with your healthcare team. You should also talk with a healthcare professional if you have a history of liver problems or take medications that cause liver damage.
Frequently asked questions
If you’re taking it OTC, you should only take ibuprofen for up to 10 days in a row for pain. If you have a fever, you should only take it for up to 3 days in a row. After that, you should talk to a healthcare professional. They can let you know if you’re OK to continue taking ibuprofen for longer.
For many people who can’t take NSAIDs, acetaminophen is a good alternative to ibuprofen. Acetaminophen treats many of the same symptoms as ibuprofen, but it’s unlikely to cause kidney problems.
If you can take NSAIDs, Naproxen (Aleve, Naprosyn) is another OTC alternative to ibuprofen. Naproxen is an NSAID that works similarly to ibuprofen, but its effects last longer. Many people only take doses every 8 to 12 hours. This is about half as frequent compared to ibuprofen doses, which you may need to take every 4 to 6 hours.
If you’re taking it OTC, you should only take ibuprofen for up to 10 days in a row for pain. If you have a fever, you should only take it for up to 3 days in a row. After that, you should talk to a healthcare professional. They can let you know if you’re OK to continue taking ibuprofen for longer.
For many people who can’t take NSAIDs, acetaminophen is a good alternative to ibuprofen. Acetaminophen treats many of the same symptoms as ibuprofen, but it’s unlikely to cause kidney problems.
If you can take NSAIDs, Naproxen (Aleve, Naprosyn) is another OTC alternative to ibuprofen. Naproxen is an NSAID that works similarly to ibuprofen, but its effects last longer. Many people only take doses every 8 to 12 hours. This is about half as frequent compared to ibuprofen doses, which you may need to take every 4 to 6 hours.
The bottom line
Ibuprofen (Advil, Motrin) is a common over-the-counter (OTC) medication. While it doesn’t usually cause liver damage, it can have a negative impact on the kidneys. It’s important to follow OTC dosage instructions, as this can help lower your risk of side effects, including kidney damage. Keep in mind that ibuprofen isn’t right for everyone. If you’re unsure, it’s always best to speak with a healthcare professional. They’ll be able to tell you whether ibuprofen is safe for you.
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References
Ahsan, M. U., et al. (2025). Nsaid-associated renal injury: Mechanisms, risks, and safer strategies. Archives of Nephrology and Renal Studies.
LiverTox. (2020). Nonsteroidal antiinflammatory drugs (NSAIDs).
LiverTox. (2025). Ibuprofen.
Park, W. Y. (2020). Controversies in acetaminophen nephrotoxicity. Kidney Research and Clinical Practice.
Tayyab, H., et al. (2025). Therapeutic levels of acetaminophen causing aki: A case report and literature review. Clinical Case Reports.
U.S. Food and Drug Administration. (2016). Ibuprofen drug facts label.
Wong, K., et al. (2023). Case of ibuprofen-induced liver injury. Annals of Internal Medicine.
