Ibuprofen (Advil, Motrin, Nuprin) and Black patients

Ibuprofen efficacy does not differ meaningfully by race. But several use-related concerns map disproportionately onto Black adults:

• Blood pressure. All NSAIDs raise blood pressure by 3–5 mm Hg and can blunt antihypertensive drug effects — particularly ACE inhibitors, ARBs, and diuretics. Black adults already have higher hypertension prevalence and worse BP control; chronic NSAID use can substantially worsen this picture.
• Kidney function. NSAIDs cause afferent arteriole constriction and can trigger acute kidney injury, especially with dehydration, ACE-inhibitor/ARB co-therapy, or underlying CKD. APOL1-related kidney risk in Black adults makes this risk non-trivial.
• Sickle cell disease. NSAIDs can be useful adjuncts for pain crisis management but carry specific AKI and GI risk in SCD patients who may be chronically volume-depleted. Monitor closely.
• Pain under-treatment. Black patients are more likely to be offered an OTC NSAID when an opioid is clinically indicated, or to be prescribed a lower dose (Hoffman et al., PNAS 2016;113:4296–301, PMID 27044069). Using ibuprofen is appropriate in its own right — being told to use ibuprofen instead of an indicated stronger analgesic is not.