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# Ibuprofen
## Overview
Ibuprofen is a nonsteroidal anti-inflammatory drug (NSAID) that exhibits analgesic, anti-inflammatory, and antipyretic properties. It works by inhibiting cyclooxygenase (COX) enzymes, thereby reducing prostaglandin synthesis.
## Primary Indications
* Pain (mild to moderate)
* Fever
* Inflammation associated with conditions such as arthritis, gout, and menstrual cramps.
## Adult Dosing
* **Pain and Fever:** 200-400 mg every 4-6 hours as needed.
* **Inflammation (e.g., arthritis):** 400-800 mg three to four times daily.
* **Maximum Daily Dose:** 3200 mg.
## Pediatric Dosing
Dosing is typically weight-based. Consult product labeling or a pediatrician for specific recommendations.
* **Fever and Pain:** 5-10 mg/kg per dose every 6-8 hours.
* **Maximum Daily Dose:** 40 mg/kg, not to exceed the adult maximum daily dose.
* **Infants under 6 months:** Use is generally not recommended due to potential risks; consult a pediatrician.
## Dose Adjustments
No specific dose adjustments are typically required for renal or hepatic impairment, but caution and lower doses may be warranted in patients with severe dysfunction.
## 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 history of GI ulceration/bleeding.
## Adverse Effects
* **Common:** Nausea, vomiting, dyspepsia, abdominal pain, constipation, diarrhea, dizziness, headache.
* **Serious:** Gastrointestinal bleeding, ulceration, perforation; cardiovascular thrombotic events (myocardial infarction, stroke); renal toxicity; hepatic toxicity; hypersensitivity reactions (including anaphylaxis and severe skin reactions); exacerbation of asthma.
## Key Drug Interactions
* **Anticoagulants (e.g., warfarin) and Antiplatelets (e.g., aspirin, clopidogrel):** Increased risk of bleeding.
* **Corticosteroids:** Increased risk of GI ulceration and bleeding.
* **Diuretics and Antihypertensives:** May decrease their efficacy and increase risk of renal toxicity.
* **Lithium and Methotrexate:** Ibuprofen can increase serum concentrations of these drugs.
* **Selective Serotonin Reuptake Inhibitors (SSRIs):** Increased risk of GI bleeding.
## Monitoring
* Signs and symptoms of GI bleeding (e.g., melena, hematemesis).
* Renal function (especially in patients with pre-existing renal disease, dehydration, or heart failure).
* Liver function (especially with prolonged use or in patients with hepatic impairment).
* 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.
* Advise patients to avoid concurrent use with other NSAIDs or aspirin unless specifically directed by a healthcare professional.
* Ibuprofen is generally considered safer for the stomach than aspirin, but the risk of GI complications still exists, particularly at higher doses or with prolonged use.
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*This information is intended as a quick reference and does not replace comprehensive prescribing information. Always consult the current product labeling and/or a healthcare professional for complete and up-to-date information before making any clinical decisions.*
