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# Ibuprofen (Nurofen, Advil, Motrin)
## Overview
Ibuprofen is a nonsteroidal anti-inflammatory drug (NSAID) that reduces inflammation, pain, and fever.
## Primary Indications
* Pain (mild to moderate)
* Fever
* Inflammation (e.g., arthritis)
## Adult Dosing
* **Pain/Fever:** 200 mg to 400 mg every 4 to 6 hours as needed.
* **Inflammation:** 400 mg to 800 mg every 6 to 8 hours as needed.
* **Maximum Daily Dose:** 3200 mg for inflammatory conditions under close medical supervision. For over-the-counter use, the maximum is typically 1200 mg per day.
## Pediatric Dosing
Dosing is typically based on weight.
* **Pain/Fever:** 5 mg/kg to 10 mg/kg per dose every 6 to 8 hours.
* **Maximum Pediatric Dose:** 40 mg/kg per day or 4000 mg per day, whichever is less.
* **Age Restriction:** Generally not recommended for infants under 6 months of age without physician guidance.
## Dose Adjustments
No specific dose adjustments are typically required for renal or hepatic impairment, but caution is advised. Maximum doses should not be exceeded, especially in patients with pre-existing conditions.
## Contraindications
* 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 bleeding or ulceration.
## Adverse Effects
Common: Nausea, vomiting, dyspepsia, heartburn, abdominal pain, dizziness, headache.
Serious: Gastrointestinal bleeding/ulceration, myocardial infarction, stroke, renal failure, hypersensitivity reactions, Stevens-Johnson syndrome.
## Key Drug Interactions
* **Anticoagulants (e.g., warfarin):** Increased risk of bleeding.
* **Aspirin (low-dose):** May reduce the cardioprotective effect of aspirin.
* **Diuretics:** Reduced antihypertensive and diuretic effect.
* **Lithium:** Increased serum lithium levels.
* **Methotrexate:** Increased methotrexate toxicity.
* **Other NSAIDs/COX-2 Inhibitors:** Increased risk of adverse effects.
* **Selective Serotonin Reuptake Inhibitors (SSRIs):** Increased risk of bleeding.
## Monitoring
* Signs and symptoms of GI bleeding (e.g., melena, hematemesis).
* Renal function (especially in elderly or those with pre-existing renal disease).
* Blood pressure.
* Signs of cardiovascular events.
## Clinical Pearls
* Take with food or milk to minimize GI upset.
* Use the lowest effective dose for the shortest duration necessary.
* Caution in patients with a history of GI disease, cardiovascular disease, hypertension, or renal impairment.
* Avoid concurrent use with other NSAIDs.
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*This information is intended for healthcare professionals. Always consult the current prescribing information and relevant clinical guidelines for complete details. Local protocols may dictate specific dosing or management strategies.*
