Ibuprofen and Confusion: What You Should Know

Ibuprofen can cause confusion as a neurological side effect, although this appears to be uncommon. ^[1] Ibuprofen’s official drug labeling lists central nervous system reactions such as dizziness, headache, nervousness, depression, insomnia, and specifically confusion. ^[2] These effects are part of the medicine’s potential impact on the brain and nerves and are noted across multiple ibuprofen tablet labels. ^[3]

How Often Does Confusion Happen?

Confusion is considered a less common side effect compared with stomach-related issues, which are the most frequently reported reactions with ibuprofen. ^[4] Labels emphasize gastrointestinal complaints occur in 4% to 16% of users in trials, while neurological effects like confusion are reported but less frequent. ^[5] Because product labels consistently include confusion among possible central nervous system reactions, it is medically plausible and documented, even if rare. ^[6]

Who Is More at Risk?

• Older adults (65+) should be treated with extra caution when using NSAIDs like ibuprofen, as they can be more sensitive to adverse effects. ^[7]
• People with underlying brain conditions, dehydration, or concurrent use of interacting medicines may have an increased chance of cognitive side effects. ^[7]
• Certain drug interactions (for example, with lithium) can increase toxicity risks and may indirectly contribute to neurological symptoms; careful monitoring is recommended. ^{[8] [9]}

Why Might Ibuprofen Cause Confusion?

Ibuprofen (a nonsteroidal anti-inflammatory drug, NSAID) can affect the central nervous system, leading to symptoms such as dizziness, somnolence (sleepiness), mood changes, and confusion. ^[1] These effects are cataloged in the adverse reactions section of standard ibuprofen labels and reflect rare but possible brain-related side effects observed in postmarketing reports and clinical experience. ^[2] In unusual scenarios, severe neurological events like hallucinations have also been reported in association with ibuprofen. ^[3]

Warning Signs to Watch For

• New confusion, disorientation, or trouble concentrating. ^[2]
• Excessive sleepiness, dizziness, or unusual mood changes. ^[1]
• Hallucinations or markedly abnormal dreams. ^[3]

If any of these occur soon after starting or increasing ibuprofen, it could be related to the medicine. Stop the drug and seek medical advice, especially if symptoms are severe or persist. ^[2]

Practical Steps to Cope Safely

• Stop or reduce dose: If confusion starts, discontinue ibuprofen and discuss alternatives with a clinician; symptoms often resolve once the drug is stopped. ^[2]
• Hydrate and rest: Mild neurological symptoms may improve with good hydration and rest after stopping ibuprofen. ^[2]
• Check all medicines: Review other drugs (including over-the-counter products) for interactions that can worsen cognitive effects, such as lithium. Monitoring is advised when NSAIDs and lithium are used together. ^{[8] [9]}
• Use the lowest effective dose: When restarting pain control with another option, aim for the smallest effective dose and shortest duration. ^[4]
• Consider alternatives: Depending on your health status, non-NSAID options (like acetaminophen) or non-drug measures (ice, heat, physical therapy) may be appropriate; discuss with your clinician. ^[4]
• Extra caution for older adults: Adults over 65 should use NSAIDs carefully and under guidance due to higher sensitivity to side effects. ^[7]

When to Seek Urgent Care

Seek urgent care if confusion is accompanied by severe symptoms such as intense drowsiness, hallucinations, fainting, or signs of an overdose. ^[3] While serious complications like coma are rare, labels list them among possible extreme central nervous system events, and immediate medical evaluation is warranted in severe cases. ^[1] If large doses were taken or multiple medicines are involved, medical teams usually follow supportive care protocols as there are no specific antidotes for NSAID toxicity. ^[10] In overdose management, clinicians may use decontamination methods like activated charcoal within a limited time window based on clinical judgment. ^{[11] [12]}

Key Takeaway

Ibuprofen can, albeit rarely, cause confusion and other brain-related side effects. ^[1] The risk is higher in older adults and with certain drug interactions. ^[7] If confusion occurs, stop the medicine, review other medications, and seek medical advice to choose safer pain control options. ^{[2] [4]}