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# Ibuprofen
## Overview
Ibuprofen is a non-steroidal anti-inflammatory drug (NSAID) that provides analgesic, anti-inflammatory, and antipyretic effects.
## Primary Indications
* Pain management (mild to moderate)
* Fever reduction
* Inflammation reduction (e.g., 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.
* **Maximum Daily Dose:** 3200 mg orally per day for short-term use under strict medical supervision; typically, 1200 mg daily for over-the-counter use.
## Pediatric Dosing
* **Fever/Pain:** 5 mg/kg to 10 mg/kg orally every 6 to 8 hours.
* **Maximum Dose per administration:** 400 mg.
* **Maximum Daily Dose:** 40 mg/kg or 2400 mg, whichever is less.
* **Note:** Dosing may vary based on product formulation (e.g., infant drops, children's suspension). Always follow product-specific instructions or local protocol.
## Dose Adjustments
* **Renal Impairment:** Use with caution; reduced doses may be necessary in severe impairment.
* **Hepatic Impairment:** Use with caution; reduced doses may be necessary in severe impairment.
## 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.
* Severe heart failure, renal failure, or hepatic failure.
## Adverse Effects
* **Common:** Nausea, vomiting, dyspepsia, abdominal pain, diarrhea, constipation, dizziness, headache.
* **Serious:** Gastrointestinal bleeding/perforation, myocardial infarction, stroke, hypertension, renal impairment/failure, hypersensitivity reactions, exacerbation of asthma.
## Key Drug Interactions
* **Anticoagulants (e.g., warfarin):** Increased risk of bleeding.
* **Antiplatelets (e.g., aspirin, clopidogrel):** Increased risk of bleeding.
* **Corticosteroids:** Increased risk of gastrointestinal ulcers and bleeding.
* **ACE Inhibitors, ARBs, Diuretics:** May reduce antihypertensive effect and increase risk of renal impairment.
* **Lithium:** May increase lithium levels.
* **Methotrexate:** May increase methotrexate toxicity.
## Monitoring
* Signs and symptoms of gastrointestinal bleeding.
* Renal function (BUN, creatinine).
* Liver function (LFTs) with long-term use or in patients with pre-existing liver disease.
* Blood pressure.
* Signs of cardiovascular events.
## Clinical Pearls
* Administer with food or milk to minimize gastrointestinal upset.
* Lowest effective dose for the shortest duration necessary should be used to minimize risks.
* Risk of cardiovascular thrombotic events, myocardial infarction, and stroke may increase with dose and duration of use.
* NSAIDs can mask signs of infection.
* In pediatric patients, monitor for signs of dehydration, especially with fever and vomiting.
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*This information is intended for healthcare professionals. Always consult the most current prescribing information and relevant clinical guidelines before making therapeutic decisions.*
