Which to choose?
Neither NSAID is "stronger" at equivalent doses: dexketoprofen acts a little sooner and is kept for acute pain and short courses; ibuprofen also covers fever, children and breastfeeding. Both share the same contraindications (ulcer, anticoagulants, renal impairment, 3rd trimester) and are never combined. Dexketoprofen is not widely marketed in the UK.
Point-by-point comparison
Brands: Nurofen · Brufen
| Ibuprofen | Dexketoprofen | |
|---|---|---|
| Mechanism | Inhibits COX-1 and COX-2: analgesic, anti-inflammatory and antipyretic. | Inhibits COX-1 and COX-2. It is the active enantiomer of ketoprofen. |
| Indications | Mild to moderate pain, fever, inflammation, period pain. | Mild to moderate acute pain: musculoskeletal, dental, period pain. |
| Adult dose | 400-600 mg every 6-8 h. Max 2400 mg/day (1200 mg/day over the counter). | 12.5 mg every 4-6 h or 25 mg every 8 h. Max 75 mg/day. Short courses only. |
| Onset of effect | 30-60 min | 30 min |
| Duration of effect | 6-8 h | 4-6 h |
| Pregnancy | Avoid from week 20; contraindicated in the 3rd trimester. | Contraindicated in the 3rd trimester; avoid from week 20. |
| Breastfeeding | Compatible (the NSAID of choice when breastfeeding). | Contraindicated in the SmPC for lack of data. |
| Paediatric use | From 3 months (suspension), by weight. | Not recommended under 18. |
| Advantages | Wide experience, paediatric presentations, first choice when breastfeeding, one of the gentler NSAIDs on the stomach at low doses. | Fast onset, useful for acute pain. Low milligram doses. |
| Disadvantages | Gastric irritation, renal and cardiovascular risk at high doses. Interferes with cardioprotective aspirin. | Short courses only. The same gastric, renal and bleeding risk as any NSAID. No paediatric presentations. |
Source: Spanish SmPC (AEMPS), BNF
Frequently asked questions
Which is better, ibuprofen or dexketoprofen?
Neither NSAID is "stronger" at equivalent doses: dexketoprofen acts a little sooner and is kept for acute pain and short courses; ibuprofen also covers fever, children and breastfeeding. Both share the same contraindications (ulcer, anticoagulants, renal impairment, 3rd trimester) and are never combined. Dexketoprofen is not widely marketed in the UK.
Can ibuprofen or dexketoprofen be taken in pregnancy?
Ibuprofen: Avoid from week 20; contraindicated in the 3rd trimester. Dexketoprofen: Contraindicated in the 3rd trimester; avoid from week 20. Always ask a doctor or pharmacist before taking a medicine in pregnancy.
And while breastfeeding?
Ibuprofen: Compatible (the NSAID of choice when breastfeeding). Dexketoprofen: Contraindicated in the SmPC for lack of data.