Ibuprofen vs. Indomethacin
See how Ibuprofen and Indomethacin compare on approved uses, dosing, side effects, and cost.
Key Takeaways
Ibuprofen is sold over the counter for everyday pain and fever, while indomethacin is prescription-only and reserved for specific inflammatory conditions like gout and bursitis.
Ibuprofen is usually taken every four to six hours, while indomethacin is taken two to three times a day and slowly increased to find the lowest effective dose.
Both carry FDA boxed warnings for cardiovascular and gastrointestinal risks, but indomethacin has higher reported rates of headache and dizziness.
Ibuprofen vs. Indomethacin Drug Summary
Ibuprofen
Ibuprofen is a propionic acid NSAID used for pain, fever, and inflammation from conditions like osteoarthritis, rheumatoid arthritis, and menstrual cramps. It's sold over the counter in doses up to 400 mg and by prescription up to 800 mg, taken every four to six hours as needed.
Indomethacin
Indomethacin is an indole acetic acid NSAID used for moderate to severe rheumatoid arthritis, ankylosing spondylitis, osteoarthritis, acute gout, and bursitis or tendinitis pain. It's taken two to three times daily starting at 25 mg, with the dose raised gradually to a maximum of 150 to 200 mg a day.
Ibuprofen vs. Indomethacin Side Effects
Ibuprofen
Indomethacin
Ibuprofen vs. Indomethacin Dosage
Ibuprofen
Indomethacin
| STAGE | DOSE | WHEN |
| Starting dose | 400 mg every 4-6 hours | At the start |
| Maximum dose | 300-800 mg 3-4x daily | If needed |
| Dose changes | 1 increase | As tolerated |
| STAGE | DOSE | WHEN |
| Starting dose | 25mg 2-3x daily | At the start |
| Maximum dose | 75-150mg/day divided | If needed |
| Dose changes | 3 increases | As tolerated |
Ibuprofen
| STAGE | DOSE | WHEN |
| Starting dose | 400 mg every 4-6 hours | At the start |
| Maximum dose | 300-800 mg 3-4x daily | If needed |
| Dose changes | 1 increase | As tolerated |
Indomethacin
| STAGE | DOSE | WHEN |
| Starting dose | 25mg 2-3x daily | At the start |
| Maximum dose | 75-150mg/day divided | If needed |
| Dose changes | 3 increases | As tolerated |
Ibuprofen vs. Indomethacin Indications
Ibuprofen
Ibuprofen treats mild to moderate pain, fever, and inflammation, and it's commonly used for headaches, muscle aches, menstrual cramps, and arthritis flares. It's available over the counter for everyday aches and by prescription at higher doses for ongoing joint conditions.
Rheumatoid arthritis
Osteoarthritis
Mild to moderate pain
Primary dysmenorrhea
Fever reduction
Indomethacin
Indomethacin treats more severe, specific inflammatory conditions, including active rheumatoid arthritis, ankylosing spondylitis, osteoarthritis, acute gout attacks, and bursitis or tendinitis pain. It's typically reserved for flares that haven't responded well to gentler NSAIDs.
Moderate to severe rheumatoid arthritis
Moderate to severe ankylosing spondylitis
Moderate to severe osteoarthritis
Acute painful shoulder (bursitis/tendinitis)
Acute gouty arthritis
Ibuprofen vs. Indomethacin Pros and Cons
Ibuprofen
Ibuprofen's short half-life and over-the-counter availability make it a flexible first choice for everyday pain, fever, and mild inflammation. It's one of the most extensively studied and widely stocked NSAIDs, with generic versions available almost everywhere.
Pros
Available over the counter at lower doses
Short half-life allows quick dose adjustments
Extensive long-term safety track record
Cons
Needs dosing every 4-6 hours for pain control
Not FDA-approved for gout or bursitis/tendinitis
Less potent anti-inflammatory effect for severe flares
Indomethacin
Indomethacin's stronger anti-inflammatory action and specific approval for gout and bursitis make it a go-to option when other NSAIDs haven't worked well enough. It requires a prescription and tends to cause more headache and dizziness than gentler NSAIDs.
Pros
FDA-approved specifically for acute gout attacks
FDA-approved for bursitis/tendinitis pain
Longer acting, taken only 2-3 times daily
Cons
Prescription-only, no OTC option
Higher reported rates of headache and dizziness
Not approved for fever or general mild pain relief
Common Symptoms and Related Diseases You Can Explore
Explore a range of common symptoms the Doctronic Symptom Checker can help you understand.