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# Ibuprofen
## Overview
Ibuprofen is a nonsteroidal anti-inflammatory drug (NSAID) used for pain relief, fever reduction, and inflammation management.
## Primary Indications
* Pain (e.g., headache, dental pain, menstrual cramps, muscle aches)
* Fever
* Inflammation (e.g., arthritis)
## Adult Dosing
* **Pain/Fever:** 200 mg to 400 mg every 4 to 6 hours as needed.
* **Rheumatoid Arthritis/Osteoarthritis:** 400 mg to 800 mg three times daily.
**Maximum Daily Dose:** 3200 mg (higher doses reserved for specific inflammatory conditions under close medical supervision).
## Pediatric Dosing
Dosing is typically based on weight. Oral suspension and chewable tablets are common.
* **Fever/Pain:** 5 mg/kg to 10 mg/kg per dose every 6 to 8 hours as needed.
* **Maximum pediatric dose:** 40 mg/kg per day or 4000 mg per day, whichever is less.
*Note: Specific concentrations of oral suspensions vary. Always calculate dose based on the available concentration and the patient's weight.*
## Dose Adjustments
* **Renal Impairment:** Use with caution. Dose reduction may be necessary in severe impairment.
* **Hepatic Impairment:** Use with caution. Dose reduction may be necessary in severe impairment.
## Contraindications
* Known hypersensitivity to ibuprofen, aspirin, or other NSAIDs.
* History of asthma, urticaria, or allergic-type reactions after taking aspirin or other NSAIDs.
* Peri-operative pain in the setting of coronary artery bypass graft (CABG) surgery.
* Active gastrointestinal (GI) bleeding.
* Advanced renal disease.
## Adverse Effects
* **Common:** GI upset (nausea, dyspepsia, abdominal pain), dizziness, headache.
* **Serious:** GI bleeding/perforation, cardiovascular thrombotic events (MI, stroke), renal toxicity, hepatic injury, hypersensitivity reactions, bronchospasm.
## Key Drug Interactions
* **Anticoagulants (e.g., warfarin), Antiplatelets (e.g., aspirin, clopidogrel):** Increased risk of bleeding.
* **Corticosteroids:** Increased risk of GI bleeding.
* **ACE Inhibitors, ARBs, Diuretics:** Reduced antihypertensive effect, increased risk of renal impairment.
* **Lithium:** Increased serum lithium levels.
* **Methotrexate:** Increased risk of methotrexate toxicity.
## Monitoring
* Monitor for signs and symptoms of GI bleeding (e.g., melena, hematemesis).
* Monitor renal function, especially in patients with pre-existing renal disease or those taking concomitant nephrotoxic agents.
* Monitor blood pressure, particularly in patients with hypertension.
* Monitor for signs of cardiovascular events.
## Clinical Pearls
* Administer with food or milk to minimize GI upset.
* Lowest effective dose for the shortest duration necessary should be used to minimize risks.
* Risk of cardiovascular events and GI bleeding increases with dose and duration of use.
* Use with caution in elderly patients and those with pre-existing GI disease, cardiovascular disease, or renal impairment.
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***Disclaimer:** This information is intended for healthcare professionals. Always consult the official prescribing information and relevant clinical guidelines before making treatment decisions. Dosing may vary based on specific patient factors and local protocols.*
