PijnvizierPain relief in dental care
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NSAIDs and salicylates

Ibuprofen

Systemic NSAID.

Prescription options

Role in treatment

Ibuprofen is an NSAID option for acute nociceptive pain if the clinical situation and patient factors allow. Use the lowest effective dose for the shortest possible time.

Pre-use check

Check gastrointestinal, renal and cardiovascular risk, hypersensitivity and interactions. Ask about over-the-counter medicines. Do not combine two systemic NSAIDs.

Acetylsalicylic acid

Ibuprofen may affect the antiplatelet action of low-dose acetylsalicylic acid. Consult the interaction information and relevant periprocedural guidance.

Prescription options

Draft for your prescribing system. Check patient details, contraindications and medication safety before prescribing.

Ibuprofen alone

Adults with toothache, if an NSAID is appropriate

Checks before prescribing

KIMO advises against NSAID use after a dental procedure that causes bleeding in patients taking antithrombotics, even if antithrombotic therapy has been temporarily interrupted. Discuss over-the-counter NSAIDs as well. See When taking antithrombotics. Check gastrointestinal, renal and cardiovascular risk factors, pregnancy, hypersensitivity and interactions. Do not combine two NSAIDs. See Frailty, kidney or liver impairment.

  • R/ Ibuprofen 400 mg film-coated tablet (Spidifen)

    Per dose
    400 mg by mouth (1 tablet)
    Frequency and interval in this example
    If necessary up to 3 times a day, approximately 8 hours between intakes
    Spidifen SmPC §4.2: every 4 to 6 hours if necessary.
    Maximum per 24 hours
    1,200 mg (3 tablets)
    Quantity in this draft
    Maximum 6 tablets

Duration in this example: 2 days. Stop earlier if the medicine is no longer needed. Reassess if pain relief is inadequate or pain worsens.

Ibuprofen 400 mg RIA

Short-term example for adults with pain after a dental procedure or acute muscle or joint pain, when an NSAID is suitable.

Checks before prescribing

KIMO advises against NSAID use after a dental procedure that causes bleeding in patients taking antithrombotics, even if antithrombotic therapy has been temporarily interrupted. Discuss over-the-counter NSAIDs as well. See When taking antithrombotics. Check gastrointestinal, renal and cardiovascular risk factors, pregnancy, hypersensitivity and interactions. Do not combine two NSAIDs. See Frailty, kidney or liver impairment. Do not use Ibuprofen RIA in patients with active bleeding, a bleeding diathesis or receiving anticoagulant treatment. Full contraindications in the SmPC.

  • R/ Ibuprofen 400 mg RIA film-coated tablet

    Per dose
    400 mg by mouth (1 tablet)
    Frequency and interval in this example
    If necessary up to 3 times a day, approximately 8 hours between intakes
    Ibuprofen RIA SmPC §4.2: repeat every 4 to 6 hours, up to 3 tablets of 400 mg daily.
    Maximum per 24 hours
    1,200 mg (3 tablets)
    Quantity in this draft
    Maximum 6 tablets

Duration in this example: 2 days. Stop earlier if the medicine is no longer needed. Reassess if pain relief is inadequate or pain worsens.

Ibuprofen 600 mg · sachet after third molar surgery

Single-dose example for pain after surgical removal of a third molar in a suitable adult. For ordinary toothache, the product information lists 400 mg per dose.

Checks before prescribing

KIMO advises against NSAID use after a dental procedure that causes bleeding in patients taking antithrombotics, even if antithrombotic therapy has been temporarily interrupted. Discuss over-the-counter NSAIDs as well. See When taking antithrombotics. Check gastrointestinal, renal and cardiovascular risk factors, pregnancy, hypersensitivity and interactions. Do not combine two NSAIDs. See Frailty, kidney or liver impairment. Check any ibuprofen already taken and the sodium and sucrose content of this sachet.

  • R/ Brufen Bruis 600 mg, effervescent granules per sachet

    Per dose
    600 mg by mouth (1 sachet). Stir into a glass of water and drink all of the solution.
    Frequency and interval in this example
    Single dose. Reassess if further pain relief is needed.
    Maximum per 24 hours
    600 mg (1 sachet) in this example
    Quantity in this draft
    Maximum 1 sachet

Duration in this example: 1 day. Stop earlier if the medicine is no longer needed. Reassess if pain relief is inadequate or pain worsens.

Paracetamol with ibuprofen

For adults weighing over 55 kg without risk factors for hepatotoxicity, if paracetamol alone does not give adequate relief and an NSAID is appropriate. Both medicines can be taken at the same time. Track the dosing interval and daily maximum separately for each.

Checks before prescribing

KIMO advises against NSAID use after a dental procedure that causes bleeding in patients taking antithrombotics, even if antithrombotic therapy has been temporarily interrupted. Discuss over-the-counter NSAIDs as well. See When taking antithrombotics. Check gastrointestinal, renal and cardiovascular risk factors, pregnancy, hypersensitivity and interactions. Do not combine two NSAIDs. See Frailty, kidney or liver impairment. Count paracetamol from all products.

  • R/ Paracetamol 500 mg tablet

    Per dose
    1,000 mg by mouth (2 tablets)
    Frequency and interval in this example
    If necessary up to 3 times a day, approximately 8 hours between intakes
    Maximum per 24 hours
    3,000 mg (6 tablets)
    Quantity in this draft
    Maximum 12 tablets

  • R/ Ibuprofen 400 mg film-coated tablet (Spidifen)

    Per dose
    400 mg by mouth (1 tablet)
    Frequency and interval in this example
    If necessary up to 3 times a day, approximately 8 hours between intakes
    Spidifen SmPC §4.2: every 4 to 6 hours if necessary.
    Maximum per 24 hours
    1,200 mg (3 tablets)
    Quantity in this draft
    Maximum 6 tablets

Duration in this example: 2 days. Stop earlier if the medicine is no longer needed. Reassess if pain relief is inadequate or pain worsens.

Paracetamol with ibuprofen after a procedure

For adults weighing more than 55 kg without risk factors for hepatotoxicity when both medicines are indicated after the dental procedure. Track each medicine's dosing interval and maximum daily dose separately.

Checks before prescribing

KIMO advises against NSAID use after a dental procedure that causes bleeding in patients taking antithrombotics, even if antithrombotic therapy has been temporarily interrupted. Discuss over-the-counter NSAIDs as well. See When taking antithrombotics. Check gastrointestinal, renal and cardiovascular risk factors, pregnancy, hypersensitivity and interactions. Do not combine two NSAIDs. See Frailty, kidney or liver impairment. Do not use Ibuprofen RIA in patients with active bleeding, a bleeding diathesis or receiving anticoagulant treatment. Full contraindications in the SmPC. Count paracetamol from all products.

  • R/ Paracetamol 500 mg tablet

    Per dose
    1,000 mg by mouth (2 tablets)
    Frequency and interval in this example
    If necessary up to 3 times a day, approximately 8 hours between intakes
    Maximum per 24 hours
    3,000 mg (6 tablets)
    Quantity in this draft
    Maximum 12 tablets

  • R/ Ibuprofen 400 mg RIA film-coated tablet

    Per dose
    400 mg by mouth (1 tablet)
    Frequency and interval in this example
    If necessary up to 3 times a day, approximately 8 hours between intakes
    Ibuprofen RIA SmPC §4.2: repeat every 4 to 6 hours, up to 3 tablets of 400 mg daily.
    Maximum per 24 hours
    1,200 mg (3 tablets)
    Quantity in this draft
    Maximum 6 tablets

Duration in this example: 2 days. Stop earlier if the medicine is no longer needed. Reassess if pain relief is inadequate or pain worsens.

A fixed-dose combination may replace the separate medicines if the selected product is suitable.

Sources for this topic

Reference for dentists on acute dental pain and pain after treatment.