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# Ibuprofen
## Overview
Ibuprofen is a nonsteroidal anti-inflammatory drug (NSAID) used for pain relief, fever reduction, and to reduce inflammation.
## Primary Indications
* Pain management (mild to moderate)
* Fever reduction
* Inflammation associated with conditions like arthritis
## Adult Dosing
* **Pain/Fever:** 200 mg to 400 mg orally every 4 to 6 hours as needed.
* **Inflammation:** 400 mg to 800 mg orally every 6 to 8 hours as needed.
* **Maximum Daily Dose:** 3200 mg/day (for short-term use under medical supervision). For over-the-counter use, the maximum is typically 1200 mg/day.
## Pediatric Dosing
Dosing is typically based on weight. Consult specific pediatric guidelines or product labeling for precise dosing.
* **Fever/Pain:** 5 mg/kg to 10 mg/kg orally every 6 to 8 hours.
* **Maximum Single Dose:** 40 mg/kg or 400 mg, whichever is less.
* **Maximum Daily Dose:** 40 mg/kg or 2400 mg, whichever is less.
* **Infants < 6 months:** Safety and efficacy not established. Use with caution under medical guidance.
## Dose Adjustments
No specific dose adjustments are typically required for renal or hepatic impairment in adults, but caution is advised due to potential for renal toxicity and hepatic effects. In elderly patients, lower doses may be considered due to increased risk of adverse effects.
## 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 ulcer disease.
* Severe renal, hepatic, or heart failure.
## Adverse Effects
Common: Nausea, dyspepsia, abdominal pain, dizziness, headache.
Serious: Gastrointestinal bleeding/perforation, cardiovascular thrombotic events, myocardial infarction, stroke, renal failure, hepatic failure, Stevens-Johnson syndrome, toxic epidermal necrolysis.
## Key Drug Interactions
* **Anticoagulants (e.g., warfarin, apixaban):** Increased risk of bleeding.
* **Other NSAIDs/Aspirin:** Increased risk of gastrointestinal toxicity and bleeding.
* **Corticosteroids:** Increased risk of gastrointestinal bleeding.
* **ACE inhibitors, ARBs, Beta-blockers:** May reduce antihypertensive effect and increase risk of renal impairment.
* **Diuretics:** May reduce diuretic effect and increase risk of renal impairment.
* **Lithium:** Increased lithium levels.
* **Methotrexate:** Increased risk of methotrexate toxicity.
## Monitoring
* **Renal function:** Especially in patients with pre-existing renal disease, dehydration, or those on concomitant nephrotoxic medications.
* **Gastrointestinal symptoms:** Monitor for signs of bleeding or ulceration.
* **Cardiovascular risk factors:** Assess and monitor as appropriate.
* **Hepatic function:** In patients with known liver disease or prolonged therapy.
## Clinical Pearls
* Administer with food or milk to minimize gastrointestinal upset.
* Use the lowest effective dose for the shortest duration necessary to minimize risks.
* Ibuprofen can increase blood pressure.
* Avoid concurrent use with other NSAIDs.
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***Disclaimer:** This information is intended for healthcare professionals. Always consult the official prescribing information and current clinical guidelines for the most up-to-date and comprehensive details before prescribing or administering any medication.*
