Patients with active peptic ulcers or gastrointestinal bleeding, or patients with the angioedema syndrome, nasal polyps or bronchospastic reactivity to ASA or other nonsteroidal anti-inflammatory agents. Aseptic meningitis, fever and rash have been reported in connection with ibuprofen therapy in patients with systemic lupus erythematosus. Peptic ulcerations and gastrointestinal bleeding, sometimes severe, have been reported in patients receiving prescription doses of ibuprofen. Like other nonsteroidal anti-inflammatory agents, ibuprofen can inhibit platelet aggregation, therefore should be avoided in persons with intrinsic coagulation defects and those on anticoagulant therapy. However, compared to ASA, the effect is quantitatively less, or shorter duration, and is reversible upon discontinuation of ibuprofen.
Conditions associated with dehydration appear to increase the risk of renal toxicity.
Ibuprofen should therefore be used with caution in patients with diminished renal function, congestive heart disease or hypertension being treated with diuretics. Fluid retention generally responds promptly to drug discontinuation. In cases of acute overdosage, the stomach should be emptied by vomiting or lavage, though little drug will likely be recovered if more than one hour has elapsed since ingestion. Because the drug is acidic and is excreted in the urine, it is theoretically beneficial to administer alkali and induce diuresis.