Please check your internet connection and try again.
# Ibuprofen
## Overview
Ibuprofen is a non-steroidal anti-inflammatory drug (NSAID) used for its analgesic, anti-inflammatory, and antipyretic properties.
## Primary Indications
* Pain management (mild to moderate)
* Inflammation (e.g., arthritis)
* Fever reduction
* Closure of patent ductus arteriosus (PDA) in premature infants
## Adult Dosing
* **Pain/Inflammation:** 200-400 mg orally every 4-6 hours as needed. Maximum daily dose: 1200 mg for over-the-counter use; up to 3200 mg/day under medical supervision for inflammatory conditions.
* **Fever:** 200-400 mg orally every 4-6 hours as needed. Maximum daily dose: 1200 mg.
## Pediatric Dosing
* **Pain/Fever:** 5-10 mg/kg orally every 6-8 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.
* **Patent Ductus Arteriosus (PDA) in Premature Infants:** Intravenous (IV) dosing is typically given in a series of doses. Common regimens include:
* **First dose:** 10 mg/kg.
* **Second and third doses:** 5 mg/kg each, given 24 and 48 hours after the first dose.
* Dosing may vary based on gestational age and clinical status; consult specific institutional protocols.
## Dose Adjustments
No dose adjustment is typically needed for renal or hepatic impairment in adults, but caution is advised and lower doses may be considered, especially in moderate to severe impairment, due to potential for renal toxicity.
## Contraindications
* Hypersensitivity to ibuprofen, aspirin, or other NSAIDs.
* History of bronchospasm, urticaria, or allergic-type reactions after taking aspirin or other NSAIDs.
* Perioperative pain in the setting of coronary artery bypass graft (CABG) surgery.
* Late third trimester of pregnancy.
## Adverse Effects
Common: Nausea, vomiting, dyspepsia, abdominal pain, diarrhea, constipation, dizziness, headache.
Serious: Gastrointestinal bleeding/perforation, cardiovascular thrombotic events (MI, stroke), renal toxicity, hepatic impairment, hypersensitivity reactions, exacerbation of asthma.
## Key Drug Interactions
* **Anticoagulants (e.g., warfarin, DOACs):** Increased risk of bleeding.
* **Aspirin (low-dose):** May decrease the cardioprotective effect of aspirin.
* **Other NSAIDs/Salicylates:** Increased risk of adverse effects.
* **ACE inhibitors/ARBs/Diuretics:** May reduce antihypertensive effect and increase risk of renal impairment.
* **Lithium/Methotrexate:** Increased serum levels and toxicity.
* **Corticosteroids:** Increased risk of GI ulceration and bleeding.
* **SSRIs/SNRIs:** Increased risk of GI bleeding.
## Monitoring
* Renal function (BUN, creatinine)
* Liver function tests (ALT, AST)
* Complete blood count (CBC) for signs of GI bleeding
* Blood pressure
* Signs and symptoms of GI distress or bleeding
## Clinical Pearls
* Administer with food or milk to minimize gastrointestinal upset.
* Use the lowest effective dose for the shortest duration necessary to minimize risk.
* Patients with a history of GI ulceration or bleeding should use with extreme caution and consider concomitant gastroprotective agents.
* Risk of cardiovascular events may increase with higher doses and longer duration of use.
* Ibuprofen can mask signs of infection.
* For PDA closure in neonates, IV ibuprofen is often preferred over indomethacin due to a potentially lower risk of renal and gastrointestinal adverse effects, though efficacy can be variable.
***
*Disclaimer: This information is intended for healthcare professionals. Always consult the most current prescribing information and institutional guidelines before making clinical decisions.*
