Please check your internet connection and try again.
## Ibuprofen
### Overview
Ibuprofen is a nonsteroidal anti-inflammatory drug (NSAID) with 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 (e.g., in rheumatoid arthritis, osteoarthritis)
* Dysmenorrhea
### Adult Dosing
* **Pain/Fever:** 200-400 mg every 4-6 hours as needed. Maximum daily dose: 1200 mg.
* **Inflammation:** 400-800 mg every 6-8 hours. Maximum daily dose: 1200 mg. Higher doses (up to 2400 mg/day) may be used under close medical supervision for specific inflammatory conditions.
* **Dysmenorrhea:** 200-400 mg every 4-6 hours as needed. Maximum daily dose: 1200 mg.
### Pediatric Dosing
Dosing is typically weight-based. Always confirm with current pediatric dosing guidelines or protocols.
* **Fever/Pain:** 5-10 mg/kg/dose every 6-8 hours.
* Maximum single dose: 400 mg.
* Maximum daily dose: 40 mg/kg or 2400 mg, whichever is less.
* **Infants < 6 months:** Use is generally not recommended due to potential risks; consult with a pediatrician.
### Dose Adjustments
* **Renal Impairment:** Use with caution. May require dose reduction in severe impairment. Monitor renal function.
* **Hepatic Impairment:** Use with caution. May require dose reduction in severe impairment.
### Contraindications
* Hypersensitivity to ibuprofen, aspirin, or other NSAIDs.
* History of bronchospasm, asthma, rhinitis, or urticaria precipitated by aspirin or other NSAIDs.
* Peri-operative pain in the setting of coronary artery bypass graft (CABG) surgery.
* Active peptic ulceration or gastrointestinal bleeding.
* Severe heart failure.
* Third trimester of pregnancy.
### Adverse Effects
* **Common:** Gastrointestinal upset (nausea, dyspepsia, abdominal pain), dizziness, headache.
* **Serious:** Gastrointestinal bleeding/perforation, cardiovascular thrombotic events (MI, stroke), renal impairment, hypersensitivity reactions, exacerbation of asthma, fluid retention, edema, hypertension.
### Key Drug Interactions
* **Anticoagulants (e.g., warfarin, DOACs):** Increased risk of bleeding.
* **Corticosteroids:** Increased risk of GI ulceration and bleeding.
* **SSRIs/SNRIs:** Increased risk of GI bleeding.
* **ACE Inhibitors/ARBs/Diuretics:** Decreased antihypertensive effect; increased risk of renal impairment.
* **Lithium:** Increased lithium levels and toxicity.
* **Methotrexate:** Increased methotrexate toxicity.
### Monitoring
* Signs and symptoms of GI bleeding or ulceration.
* Renal function (BUN, creatinine).
* Blood pressure.
* Signs of cardiovascular events.
* Liver function tests may be considered with prolonged use or in patients with pre-existing liver disease.
### Clinical Pearls
* Administer with food or milk to minimize GI upset.
* Use the lowest effective dose for the shortest duration necessary to minimize risks.
* Caution in patients with pre-existing cardiovascular disease, hypertension, or risk factors for GI bleeding.
* Hydration is important, especially in patients with risk factors for renal impairment.
***
**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 institutional protocols before administering any medication.
