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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
* Mild to moderate pain (e.g., headache, dental pain, menstrual cramps, muscle aches)
* Fever
* Inflammation associated with conditions like arthritis
### Adult Dosing
* **Pain/Fever:** 200 mg to 400 mg orally every 4 to 6 hours as needed.
* **Rheumatoid Arthritis/Osteoarthritis:** 400 mg to 800 mg orally three to four times daily.
* **Maximum Daily Dose:** 3200 mg. Doses higher than 2400 mg daily should be reserved for patients with severe rheumatoid arthritis who have not responded to lower doses.
### Pediatric Dosing
Dosing is typically based on weight. Consult current pediatric dosing guidelines or a pediatrician for specific recommendations.
* **Fever/Pain:** 5 mg/kg to 10 mg/kg orally every 6 to 8 hours as needed.
* **Maximum Pediatric Dose:** 40 mg/kg per day, not to exceed the adult maximum.
### Dose Adjustments
* **Renal Impairment:** Use with caution. May require dose reduction in severe impairment.
* **Hepatic Impairment:** Use with caution. May require dose reduction in severe impairment.
### Contraindications
* Known hypersensitivity to ibuprofen, aspirin, or other NSAIDs.
* History of asthma, urticaria, or other allergic-type reactions after taking aspirin or other NSAIDs.
* Peri-operative pain in the setting of coronary artery bypass graft (CABG) surgery.
* Use in the third trimester of pregnancy.
### Adverse Effects
Common: Nausea, vomiting, dyspepsia, diarrhea, constipation, abdominal pain, dizziness, headache.
Serious: Gastrointestinal bleeding, ulceration, perforation; cardiovascular thrombotic events (MI, stroke); renal failure; hepatic failure; hypersensitivity reactions.
### Key Drug Interactions
* **Anticoagulants (e.g., warfarin):** Increased risk of bleeding.
* **Aspirin:** Concurrent use may reduce the cardioprotective effect of low-dose aspirin.
* **Corticosteroids:** Increased risk of gastrointestinal ulceration and bleeding.
* **Diuretics, ACE inhibitors, ARBs:** May reduce antihypertensive effect and increase risk of renal impairment.
* **Lithium:** Increased serum lithium levels.
* **Methotrexate:** Increased risk of methotrexate toxicity.
### Monitoring
* Monitor for signs and symptoms of gastrointestinal bleeding (e.g., melena, hematemesis).
* Monitor for signs of cardiovascular events.
* Renal and hepatic function may be monitored, especially with prolonged use or in patients with risk factors.
### Clinical Pearls
* Administer with food or milk to minimize gastrointestinal upset.
* Use the lowest effective dose for the shortest duration necessary to reduce the risk of adverse events.
* Consider NSAID-induced gastrointestinal toxicity in patients presenting with abdominal pain.
* Avoid in patients with a history of NSAID-induced bronchospasm.
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*Disclaimer: This information is intended for healthcare professionals and is not a substitute for professional medical advice. Always consult the most current prescribing information and relevant guidelines before administering or prescribing any medication.*
