Please check your internet connection and try again.
# Ibuprofen (Nurofen, Advil, Motrin)
## Overview
Ibuprofen is a nonsteroidal anti-inflammatory drug (NSAID) that possesses analgesic, anti-inflammatory, and antipyretic properties.
## Primary Indications
* Pain management (e.g., headache, dental pain, menstrual cramps, muscle aches, back pain)
* Fever reduction
* Inflammation reduction (e.g., arthritis)
## Adult Dosing
* **Analgesia/Antipyresis:** 200 mg to 400 mg every 4 to 6 hours as needed.
* **Rheumatoid Arthritis/Osteoarthritis:** 400 mg to 800 mg three to four times daily.
* **Maximum Daily Dose:** 3200 mg. Doses exceeding 2400 mg daily should be reserved for patients with severe inflammatory conditions requiring high doses and under close medical supervision.
## Pediatric Dosing
Dosing is typically based on weight. Consult product labeling or a pediatrician for exact dosing.
* **Fever/Pain:** 5 mg/kg to 10 mg/kg orally every 6 to 8 hours.
* **Maximum Daily Dose:** 40 mg/kg/day or 2400 mg/day, whichever is less.
## Dose Adjustments
No specific dose adjustments are routinely recommended for hepatic or renal impairment, but caution is advised. In patients with severe renal impairment, use should be avoided.
## Contraindications
* Known hypersensitivity to ibuprofen, aspirin, or other NSAIDs.
* History of asthma, urticaria, or allergic-type reactions after taking aspirin or other NSAIDs.
* Perioperative pain in the setting of coronary artery bypass graft (CABG) surgery.
* Active gastrointestinal (GI) bleeding or history of GI bleeding/perforation.
## Adverse Effects
* **Common:** Nausea, dyspepsia, abdominal pain, constipation, diarrhea, dizziness, headache.
* **Serious:** Cardiovascular thrombotic events (myocardial infarction, stroke), GI bleeding, ulceration, perforation, renal toxicity, hepatic toxicity, hypersensitivity reactions, exacerbation of asthma.
## Key Drug Interactions
* **Anticoagulants (e.g., warfarin):** Increased risk of bleeding.
* **Aspirin:** May decrease cardioprotective effect of low-dose aspirin.
* **Corticosteroids:** Increased risk of GI ulceration and bleeding.
* **Diuretics and Antihypertensives (e.g., ACE inhibitors, ARBs):** May decrease antihypertensive effect and increase risk of renal toxicity.
* **Lithium:** Increased serum lithium levels.
* **Methotrexate:** Increased risk of methotrexate toxicity.
## Monitoring
* Monitor for signs and symptoms of GI bleeding or ulceration.
* Assess renal function (BUN, creatinine) and electrolytes, especially in patients with pre-existing renal disease or those receiving diuretics.
* Monitor liver function tests (ALT, AST) if therapy is prolonged or in patients with liver disease.
* Monitor blood pressure.
## Clinical Pearls
* Administer with food or milk to minimize GI upset.
* Use the lowest effective dose for the shortest duration necessary to minimize risks.
* Patients with cardiovascular disease or risk factors for it should use ibuprofen with caution and at the lowest effective dose.
* NSAIDs can mask signs of infection.
**Please consult the most current prescribing information and relevant guidelines for complete and up-to-date details.**
