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Long-term treatment with ibuprofen at a dose of 1200 mg/day does not increase the risk of renal impairment in elderly people (Griffin et al, 2000). Ibuprofen is associated with a low risk of renal toxicity in overdose (Jenkinson et al, 1988; Volans and Fitzpatrick, 1999).
Nonsteroidal anti-inflammatory drugs (NSAIDs) are most commonly used for relief of mild to moderately severe pain. Although the pain-relieving effects tend to be patient-specific, ibuprofen is usually used for initial therapy. All NSAIDs now have the black box warning for increased cardiovascular risk, even with short-term use, with naproxen having the least risk. Topical diclofenac has been used and may be the only topical NSAID manufactured in the United States,although a compounding pharmacy can compound any NSAID into a topical form.