Helpful for pain, unsuitable for some people
Ibuprofen and diclofenac belong to a group called non-steroidal anti-inflammatory drugs, or NSAIDs. They reduce pain and inflammation, but choosing one involves more than finding the strongest relief. Your medical history, other medicines and how long you need treatment all matter. NHS: ibuprofen.
The side effects people notice first
Oral NSAIDs can cause indigestion, stomach discomfort, nausea, vomiting, diarrhoea, headache or dizziness. Diclofenac may also cause wind or reduced appetite. Mild symptoms can settle, but persistent symptoms should be discussed with a pharmacist or prescriber. Do not drive if you feel dizzy.
Gels and patches generally cause fewer whole-body side effects than oral treatment, although they still need to be used as directed. Taking tablets with food may ease irritation; it does not make serious stomach bleeding impossible. NHS: diclofenac side effects.
Stomach, kidney and heart risks
NSAIDs can cause ulcers and bleeding in the stomach or bowel. Kidney problems are another important risk. Previous ulcers, kidney disease and certain other medical conditions can make these medicines unsuitable. Check before use if you have asthma or have reacted to aspirin or another NSAID. NHS: who should check before use.
Non-aspirin NSAIDs can increase the risk of heart attack or stroke. This risk can occur even with short-term use and increases with higher doses or longer treatment. Having no previous heart disease does not remove the risk. NHS: cardiovascular risks.
Systemic diclofenac has specific restrictions for people with established heart disease, previous stroke or certain circulation problems, and some forms of heart failure. People with high blood pressure, diabetes, high cholesterol or who smoke need careful assessment. This MHRA warning concerns systemic forms such as tablets, not topical gels. If it applies to you, arrange a medication review rather than switching treatment yourself. MHRA: diclofenac precautions.
Check combinations and pregnancy
Do not combine ibuprofen and diclofenac, or add another NSAID such as naproxen, unless a clinician specifically directs you. Blood thinners, steroids, some antidepressants and blood-pressure medicines may interact. If you take prescribed low-dose aspirin, ask before adding an NSAID; do not independently stop your aspirin. NHS: medicine interactions.
Pregnancy requires special advice. FDA guidance advises avoiding NSAIDs from 20 weeks unless specifically recommended by a healthcare professional because they can affect the baby’s kidneys and amniotic fluid. Later pregnancy brings additional fetal heart risks. This warning does not mean you should stop clinician-prescribed low-dose aspirin used for pregnancy-related conditions. FDA: NSAIDs in pregnancy.
Know the warning signs
Seek emergency help for vomiting blood, chest pain, sudden one-sided weakness, slurred speech, breathing difficulty or swelling of the throat. Black, tar-like stools, severe stomach pain, new swelling, reduced urine or worsening breathlessness need urgent medical assessment. Bring your medicine list. NHS: serious reactions.
Aim for the smallest effective exposure
Use the lowest effective dose for the shortest necessary time, following the prescription or local label. If you need repeated treatment, ask whether the cause of pain, stomach protection or a different approach should be reviewed. A familiar painkiller still deserves regular reassessment. MHRA: safer NSAID use.
Educational disclaimer: Educational information for adults, not a diagnosis or personalised treatment plan. Follow your prescription and local product leaflet. Discuss treatment changes with your clinician; emergency symptoms need immediate care.
Featured image: Illustrative AI-generated image.
