Please check your internet connection and try again.
# Ibuprofen
## Overview
Ibuprofen is a nonsteroidal anti-inflammatory drug (NSAID) used for pain relief, fever reduction, and inflammation management.
## Primary Indications
* Pain (mild to moderate)
* Fever
* Inflammation (e.g., arthritis)
* Primary dysmenorrhea
* Closure of patent ductus arteriosus (PDA) in premature infants
## Adult Dosing
* **Analgesia/Antipyresis:** 200-400 mg every 4-6 hours as needed. Maximum daily dose: 1200 mg (OTC), 3200 mg (prescription, under medical supervision).
* **Inflammation:** 400-800 mg every 6-8 hours. Maximum daily dose: 3200 mg (prescription, under medical supervision).
* **Primary Dysmenorrhea:** 200-400 mg every 4-6 hours as needed. Maximum daily dose: 1200 mg.
## Pediatric Dosing
* **Analgesia/Antipyresis:**
* **Oral:** 5-10 mg/kg/dose every 6-8 hours. Maximum pediatric dose: 40 mg/kg/day or 2400 mg/day, whichever is less.
* **Rectal:** 5-10 mg/kg/dose every 6-8 hours.
* **IV (Neonates/Pediatrics):** 10 mg/kg/dose, followed by 5 mg/kg/dose at 24 and 48 hours if needed (for PDA closure). For pain/fever, consult specific guidelines, as IV use in pediatrics for these indications is less common and requires careful consideration of renal function and fluid status.
## Dose Adjustments
* **Renal Impairment:** Use with caution; dose reduction may be necessary in severe impairment. Monitor renal function.
* **Hepatic Impairment:** Use with caution; dose reduction may be necessary in severe impairment. Monitor liver function.
## Contraindications
* Hypersensitivity to ibuprofen, aspirin, or other NSAIDs.
* History of bronchospasm, asthma, rhinitis, or urticaria induced by aspirin or other NSAIDs.
* Perioperative pain in the setting of coronary artery bypass graft (CABG) surgery.
* Active gastrointestinal bleeding or history of GI bleeding/ulceration.
* Severe heart failure, severe renal failure, severe hepatic failure.
* Last trimester of pregnancy.
## Adverse Effects
* **Common:** Nausea, vomiting, dyspepsia, abdominal pain, diarrhea, constipation, headache, dizziness, rash.
* **Serious:** Gastrointestinal bleeding/perforation, renal failure, hepatic injury, myocardial infarction, stroke, exacerbation of heart failure, hypertension, fluid retention, edema, hypersensitivity reactions (including anaphylaxis), Stevens-Johnson syndrome, toxic epidermal necrolysis.
## 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.
* **SSRIs/SNRIs:** Increased risk of bleeding.
* **ACE inhibitors, ARBs, Beta-blockers:** May reduce antihypertensive effect; increased risk of renal impairment.
* **Diuretics:** May reduce diuretic effect; increased risk of renal impairment.
* **Lithium, Methotrexate:** Increased serum levels and toxicity.
* **Other NSAIDs (including aspirin):** Increased risk of adverse effects.
## Monitoring
* Renal function (serum creatinine, BUN)
* Liver function tests (LFTs)
* Complete blood count (CBC), especially if used long-term or in patients with risk factors for bleeding.
* Blood pressure
* Signs and symptoms of GI bleeding.
## 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.
* Ibuprofen carries a black box warning regarding cardiovascular thrombotic events and gastrointestinal bleeding, ulceration, and perforation.
* Consider concomitant gastroprotection (e.g., PPI) in patients at high risk for GI complications.
* For PDA closure in neonates, renal function is critical; monitor urine output closely.
***
*Disclaimer: This information is intended for clinical use and is not a substitute for professional medical advice. Always consult the current prescribing information and relevant guidelines before making any treatment decisions.*
