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Large doses of ibuprofen are often used for emergency department (ED) patients, despite evidence that doses above 400 mg increase rates of side effects without improving pain control. To test the hypothesis that the analgesic ceiling of ibuprofen is 400 mg in an ED population, researchers randomized a convenience sample of 225 adults with acute pain to doses of 400 mg, 600 mg, or 800 mg. Exclusion criteria included pregnancy or breast-feeding, history of gastrointestinal hemorrhage, renal or hepatic insufficiency, and altered mental status.
Most patients had musculoskeletal or cutaneous pain. The mean baseline pain scores on a 10-point scale were 6.5, 6.4, and 6.5 in the 400 mg, 600 mg, and 800 mg groups, respectively. At 60 minutes, mean pa…