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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 (mild to moderate)
* Fever
* Inflammation (e.g., arthritis)
* Primary dysmenorrhea
### Adult Dosing
* **Analgesia/Antipyresis:** 200-400 mg orally every 4-6 hours as needed.
* **Inflammation:** 400-800 mg orally every 6-8 hours.
* **Maximum Daily Dose:** 3200 mg orally.
### Pediatric Dosing
* **Analgesia/Antipyresis:** 5-10 mg/kg orally every 6-8 hours.
* **Maximum Daily Dose:** 40 mg/kg/day or 2400 mg/day, whichever is less.
* Dosing is typically based on weight. Consult specific pediatric guidelines for precise dosing based on age and weight.
### Dose Adjustments
No specific dose adjustment is typically required for renal or hepatic impairment, but caution is advised, especially in severe dysfunction, due to potential for increased toxicity. Monitor closely.
### 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.
* Severe renal or hepatic impairment.
* Third trimester of pregnancy.
### Adverse Effects
* **Common:** Nausea, vomiting, dyspepsia, heartburn, abdominal pain, diarrhea, constipation, dizziness, headache.
* **Serious:** Gastrointestinal bleeding/perforation, myocardial infarction, stroke, hypertension, renal failure, hepatic failure, hypersensitivity reactions, Stevens-Johnson syndrome.
### Key Drug Interactions
* **Anticoagulants (e.g., warfarin, heparin):** Increased risk of bleeding.
* **Aspirin:** May reduce the cardioprotective effect of low-dose aspirin; increased risk of GI adverse effects.
* **Corticosteroids:** Increased risk of GI ulceration and bleeding.
* **Diuretics and Antihypertensives:** May decrease their efficacy and increase risk of renal impairment.
* **Lithium:** May increase lithium levels.
* **Methotrexate:** May increase methotrexate toxicity.
### Monitoring
* Signs and symptoms of GI bleeding (melena, hematemesis).
* Renal function (BUN, creatinine), especially in patients with pre-existing renal disease or those at risk.
* Liver function tests (LFTs), especially with prolonged use or in patients with hepatic impairment.
* Blood pressure.
### Clinical Pearls
* Administer with food or milk to minimize gastrointestinal upset.
* Use the lowest effective dose for the shortest duration necessary to minimize risks.
* Consider gastroprotection (e.g., PPI) for patients at high risk of GI bleeding.
* Avoid in patients with known NSAID-exacerbated respiratory disease (NERD).
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**Disclaimer:** This information is intended for educational purposes only and does not substitute for professional medical advice. Always verify current prescribing information and consult with a healthcare provider for any health concerns or before making any decisions related to your health or treatment.
