Ibuprofen is one of the most widely used non-steroidal anti-inflammatory drug (NSAID) for
management of mild -to moderate pain in the ED (acute musculo-skeletal pain, headache, dental
pain). Ibuprofen as a representative of NSAID's as a class follows the analgesic ceiling
concept that postulates that there is a dose of a drug beyond which any further dosage
increase results in no additional analgesic effect. Despite this fact, Ibuprofen may commonly
be used at doses above its analgesic ceiling, although this may not offer an incremental
analgesic advantage and potentially adds risk of harm. The analgesic ceiling dose for
ibuprofen is only 200-400mg/dose, and about 1200 mg/day. Thus, we hypothesize that
administration of Ibuprofen in a dose of 400 mg in the ED is as effective in treating
mild-to-moderate acute pain in patients presenting to the ED as 600 mg and 800 mg