Ibuprofen 400 mg,
does it really help with Single-dose pain relief for four to six hours in moderate or severe acute postoperative pain?
research showsA single 400-mg dose of ibuprofen provides clinically meaningful relief for moderate or severe postoperative pain and is graded B. The Cochrane review included 72 randomized double-blind placebo-controlled trials and 9,186 participants; among 6,475 participants contributing 400-mg data, the NNT for achieving at least 50% pain relief over four to six hours was 2.5 (95% CI 2.4 to 2.6). Pain is a patient-reported treatment target. The necessarily short single-dose design produces a B1 ceiling.
ads claimA strong single-dose analgesic effect does not establish faster surgical healing or safe long-term repeated use.
Useful facts when choosing a product
- The 400-mg Cochrane estimate concerns one oral dose and four to six hours of follow-up.
- Verdict 1683, which is B with 68 points, concerns acute migraine, and verdict 857, which is B with 75 points, concerns primary dysmenorrhea. Their evidence was not pooled into postoperative pain.
- Verdict 1407, which is D with 28 points, concerns prevention of delayed-onset muscle soreness and recovery of strength, a different endpoint.
What the research actually shows
The Derry Cochrane review pooled 72 randomized double-blind placebo-controlled studies and 9,186 participants. The analyzed 400-mg dataset comprised 6,475 participants, with an NNT of 2.5 (2.4 to 2.6) for at least 50% relief over four to six hours. Kyselovic 2020 randomized and analyzed 351 participants; TOTPAR6 was 19.96 versus 8.27, P<0.001, meeting the placebo comparison for the primary efficacy endpoint. Sanofi funded the study and employees were coauthors.
Why this is classified as B (76)
The profile is P, R2, I1, E+, and B1. Multiple trials consistently achieved patient-important relief, with an NNT of 2.5 for achieving at least 50% pain relief over four to six hours, while the short single-dose design caps the derived grade at B with 76 points.
Counterpoint. Gastrointestinal ulcer or bleeding risk, kidney disease, cardiovascular disease, late pregnancy, and concurrent NSAIDs can change whether use is appropriate.
Rejudgment record. Cross-check applied — A precise NNT for a prespecified four-to-six-hour high-level pain response across many double-blind randomized trials
| Endpoint | P | Patient-reported treatment goal - the symptom is the goal |
| Replication | R2 | Independently replicated across trials |
| Independence | I1 | Mixed funding sources |
| Effect size | E+ | Meets the clinically important threshold |
The scoring table and the verdict agree (B).
Sub-claim grades by effect
This ingredient is marketed for several effects. A single overall grade blends strong and weak claims together, so each effect is graded separately here. The overall grade reflects the strongest disconfirming or core claim.
| Effect (sub-claim) | Grade | Basis |
|---|---|---|
| At least 50% pain relief over four to six hours with one 400-mg dose | B | Among 6,475 participants, the NNT for achieving at least 50% pain relief over four to six hours was 2.5. |
| Delay in postoperative rescue-medication use | B | Median time to remedication with 400 mg was about 5.4 hours. |
| Improved six-hour total pain relief after dental surgery | B | The primary endpoint succeeded in a modern randomized trial. |
Cross-check — Codex and Claude
Evidence Table
| Study | Design | Sample | Funding | Endpoint | Result | Weight |
|---|---|---|---|---|---|---|
| Derry CJ et al. 2009 Cochrane | Systematic review of 72 randomized double-blind placebo-controlled trials | 6,475 | Oxford Pain Research Funds and NHS research-and-development support; mixed funding across component trials | At least 50% total pain relief over four to six hours | For achieving at least 50% pain relief over four to six hours with 400 mg, NNT was 2.5 (95% CI 2.4 to 2.6) and response rate was 54%; pooled primary efficacy outcome successful. | Core large replicated evidence |
| Kyselovic J et al. 2020 | Randomized double-blind placebo- and active-controlled trial | 351 | Manufacturer funding from Sanofi with company employees as coauthors | Total pain relief over six hours (TOTPAR6) | Ibuprofen acid 19.96 versus placebo 8.27, P<0.001; placebo comparison for the primary efficacy endpoint successful. | Modern formulation confirmation |
Receipt — 2 References
All 2 cited sources were verified for existence at the original page (as of 2026-07-24).
Reviewed and approved: Chamgap Editorial Team · Approval date: 2026-07-24 · Corrections: none
Cite this verdict
[Chamgap] Ibuprofen 400 mg x acute postoperative pain relief — Evidence Grade B·76. 2 cited sources checked. Source: https://chamgap.com/en/verdicts/general/ibuprofen-400mg-acute-postoperative-pain-relief/ · CC BY 4.0CC BY 4.0 — free to use with attribution; do not distort grades, numbers, or verdict meaning.
What this document does and does not do
Chamgap is an information source. It reports what research has and has not confirmed; it does not tell readers what to take or buy. That decision belongs to readers and, when needed, medical or legal professionals. This verdict reflects literature available up to the search date and may change as new research appears. Nothing here is medical advice.