Ibuprofen (Advil) is a nonsteroidal anti-inflammatory drug (NSAID) that’s commonly used to help reduce pain, fever, and inflammation. It has the potential to be harmful for your kidneys and liver, but the risk is higher in certain people.

Ibuprofen can cause acute kidney injury

Ibuprofen can reduce blood flow to the kidneys, which may lead to kidney damage. While you might not notice anything from mild kidney injury, as things get worse you could experience any of the following symptoms:

• Producing less urine or not urinating at all
• Swelling in your arms, legs, or feet
• Itchy skin
• Nausea
• Confusion
• Weakness

If you notice any of the above symptoms while taking ibuprofen, contact your doctor right away. Once ibuprofen is stopped, the kidneys usually recover in most people.

Ibuprofen can cause liver damage

Although rare, ibuprofen can sometimes cause liver damage. According to the product label, up to 15% of people taking NSAIDs (including ibuprofen) have had a rise in their liver enzyme tests. This suggests liver injury. However, only 1% of people during clinical studies experienced a significant rise of liver enzymes (≥3 X upper limit of normal). It’s estimated that there’s about 1-2 cases of liver injury due to ibuprofen out of 100,000 prescriptions. Occasionally, liver injury is seen after experiencing a severe allergic reaction from ibuprofen.

The risk of liver injury while taking ibuprofen appears to increase with higher doses of 2,400 to 3,200 mg daily. In most cases, the effects on the liver are reversible after stopping ibuprofen.

It’s not fully clear how ibuprofen causes liver damage. One theory is that it’s caused by a metabolite (a substance produced during the metabolism of ibuprofen in the body). Another is that it could be caused by an immune system reaction.

While taking ibuprofen, watch out for signs and symptoms of liver damage, which may include:

• Pain in the upper right side of your abdomen
• Nausea or vomiting
• Loss of appetite
• Feeling tired or weak
• Yellowing of your skin or whites of your eyes
• Dark urine

What raises my risk for kidney or liver damage from ibuprofen?

People who have certain medical conditions or who are taking other medications that can damage the liver or kidneys may be at a higher risk for kidney or liver damage from ibuprofen. Talk to your doctor before taking ibuprofen if you have a history of kidney or liver problems. It’s important to share a list of your current medications with your doctor. Taking higher doses of ibuprofen can also put you at a higher risk for kidney or liver damage.

A study done by researchers at Stanford University found that people who took an average of 1,200 mg of ibuprofen while running long distances had a greater risk of kidney injury. They found that there was about an 18% higher rate of kidney injury in those who took ibuprofen compared to those who didn’t. This suggests that taking ibuprofen during endurance exercise, such as ultramarathons, could raise your risk of kidney damage.

Can I take ibuprofen if I have kidney or liver problems?

If you have kidney or liver problems, ask your doctor if it’s safe for you to take ibuprofen. They might want to monitor you more closely to make sure it isn’t affecting your kidney or liver health. In some cases, they might suggest a safer alternative for you.