Over-the-counter (OTC) medications are affordable and easy to get, but if you have diabetes, you might wonder what’s safe to take. For example, nearly half of all adults with diabetes have arthritis, and they may be wondering if they could take ibuprofen to relieve the pain in their joints.

To some degree, it’ll depend on what kinds of other medications you might be taking for your diabetes, along with other risk factors that come along with having diabetes.

Your kidney health may actually be one of the biggest factors in helping you decide what anti-inflammatory meds to take.

Regardless of what type of diabetes you have, if you have kidney disease, your doctor is likely to recommend that you avoid taking ibuprofen. It could lead to acute renal failure.

If you have type 1 diabetes

The peak age for diagnosis with type 1 diabetes is about 13 or 14, according to the Centers for Disease Control and Prevention (CDC).

This means that people with type 1 can live with diabetes throughout the course of their lives. Over time, uncontrolled blood sugar levels can damage the kidneys.

Chronic kidney disease

If you develop chronic kidney disease, your kidneys can no longer filter substances out of your blood at a normal rate. Meanwhile, taking OTC drugs like ibuprofen for a long period of time or in high doses can also lead to kidney damage.

Talk with a medical professional about whether ibuprofen is safe for you to take occasionally.

Hypoglycemia

Another concern to consider if you have type 1 diabetes is hypoglycemia. NSAIDs like ibuprofen have a hypoglycemic effect when given in large doses.

While it’s not typically an issue, if you’re already predisposed to developing hypoglycemia, you might want to consult your doctor about when it might be appropriate to use ibuprofen and in what dosage amount.

Your doctor may also recommend that you check your blood glucose levels with your blood glucose monitor frequently if you’re sick and taking any medication. Being sick can make your levels fluctuate more than usual.

If you have type 2 diabetes

There are few factors that you should consider if you have type 2 diabetes and are wondering if it’s okay to take a couple of ibuprofen for your headache, backache, or fever.

Metformin use

Many people with type 2 diabetes take metformin to help them control their blood sugar levels. Metformin belongs to a class of drugs known as biguanides.

Metformin lowers the amount of glucose that your liver makes and the amount of glucose that you absorb from the food you eat. It also has some anti-inflammatory effects. Some research suggests that metformin may interact with ibuprofen and other analgesics.

One 2017 study suggested that they actually interacted “synergistically” and that lower doses of ibuprofen would be adequate for a person already taking metformin to get the pain relief they needed. But that study was conducted with animals, and more research is needed.

Chronic kidney disease

You may also need to steer clear of ibuprofen if you have kidney disease. A large retrospective study published in 2014 found that people with type 2 diabetes who took NSAIDs for at least 90 days were more likely to develop chronic kidney disease than people who didn’t take any NSAIDs.

Hypoglycemia

Hypoglycemia may also be a concern for people with type 2 diabetes. Research suggests that people who are receiving treatment with sulfonylureas, which is used to stimulate the beta cells in your pancreas to release more insulin, might be at increased risk for hypoglycemia.

Since sulfonylureas can potentially lead to low blood sugar anyway, ibuprofen might compound the effect.

If you’re not already a label reader, it’s time to become one. Reading medication labels carefully will help you know exactly what ingredients are contained within a drug that you might be considering.

It’ll also help you avoid the ones that might be potentially dangerous or risky for you to take. It can also prevent you from accidentally doubling up on the same drug.

Keep an eye out for products sold under these brand names in the U.S., as they all contain ibuprofen:

  • Addaprin
  • Advil
  • Cedaprin
  • Midol
  • Motrin
  • Profen
  • Proprinal
  • Ultraprin

There are also some combination products on the market that incorporate ibuprofen along with other ingredients, including:

  • famotidine, sold under the name Duexis
  • hydrocodone, sold under the name Ibudone
  • phenylephrine, which includes several products that combat sinus congestion under the brand names of Advil or Sudafed

Additionally, many drugstores, grocery stores and big box stores sell products that contain ibuprofen under a store-specific label or name. Always check the labels when making a purchase. Some injectable medications contain ibuprofen, too.

Other NSAIDs, like naproxen, should also not be combined with ibuprofen. A person taking any sort of steroid, like prednisone, should talk with their doctor before taking any NSAIDs.

If you’re hesitating about taking ibuprofen, you might be wondering what other medications in your medicine cabinet might be a better choice. Many people also keep some acetaminophen on hand, and for a lot of them, that might be a safe option.

Unlike ibuprofen, acetaminophen isn’t an NSAID. It’s an analgesic that combats pain, not inflammation, and some experts recommend choosing acetaminophen instead of NSAIDs if you have a condition like chronic kidney disease.

One 2019 study found the possibility of an increased risk of stroke among people with diabetes who took acetaminophen. The study examined data from more than 5,400 older adults living in nursing homes and ran six computerized models.

The researchers found that, overall, acetaminophen at therapeutic dosage levels seemed to be safe. But one of the six models found a significant increase in the risk of stroke among the residents with diabetes, and called for more research into acetaminophen use in older people with diabetes.

When in doubt about which med to use, talk with a medical professional.

Ibuprofen can cause some side effects, including:

Those are often mild and don’t last long, but there are also some more serious side effects. For example, some people are already at elevated risk for heart attack and stroke, so if you notice any warning signs like chest pain or shortness of breath, seek immediate medical attention.

Since decreased kidney function is also a potential side effect of taking ibuprofen, you should also seek out medical care right away if you develop any of these side effects after taking ibuprofen:

Other potential serious side effects from taking ibuprofen include:

For people with diabetes

People with diabetes need to be vigilant about potential side effects that are specific to diabetes, like hypoglycemia. You may already be familiar with the warning signs of hypoglycemia, like:

If you start feeling any of these symptoms, check your blood sugar and then address the hypoglycemia.

15-15 rule for hypoglycemia

The American Diabetes Association suggests embracing the 15-15 rule: take 15 grams of carbohydrates (think: glucose tablets, a tablespoon of sugar or honey, or 4 ounces of juice) and wait 15 minutes. Repeat as necessary until your blood sugar is at least 70 mg/dL.

For a severe episode, you’ll need someone to give you an injection of glucagon, which is a hormone used to treat severe low blood sugar.

It’s a good idea to educate your friends and family about hypoglycemia in case you need them to take action. This may include the glucagon injection and calling 911.

Ultimately, it’s a good idea to have a conversation with your doctor about what pain relievers or anti-inflammatory medications are best for you.

You can discuss any other underlying health conditions you have or medications you’re taking to determine what’s safe, and what amount to take, when necessary.