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# Ibuprofen
## Overview
Ibuprofen is a nonsteroidal anti-inflammatory drug (NSAID) that reduces inflammation, pain, and fever.
## Primary Indications
* Pain relief (mild to moderate)
* Fever reduction
* Inflammation reduction (e.g., rheumatoid arthritis, osteoarthritis)
* Dysmenorrhea
## Adult Dosing
* **Analgesia/Antipyresis:** 200-400 mg every 4-6 hours as needed. Maximum: 1200 mg/day for over-the-counter use; up to 3200 mg/day under medical supervision for specific conditions.
* **Rheumatoid Arthritis/Osteoarthritis:** 400-800 mg every 6-8 hours. Maximum: 3200 mg/day.
## Pediatric Dosing
Dosing is weight-based and indication-specific. Consult product labeling or local protocols.
* **Fever/Pain:** 5-10 mg/kg/dose every 6-8 hours. Maximum: 40 mg/kg/day or 400 mg/dose, whichever is less.
* **Rheumatoid Arthritis:** 50-100 mg/kg/day divided into 3-4 doses.
## Dose Adjustments
* **Renal Impairment:** Use with caution. May require dose reduction or increased monitoring.
* **Hepatic Impairment:** Use with caution. May require dose reduction or increased monitoring.
## 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.
* Third trimester of pregnancy.
## Adverse Effects
Common: Nausea, vomiting, diarrhea, constipation, dyspepsia, abdominal pain, dizziness, headache.
Serious: Gastrointestinal bleeding, ulceration, perforation; cardiovascular thrombotic events (MI, stroke); renal toxicity; hypersensitivity reactions; hepatic toxicity.
## Key Drug Interactions
* **Anticoagulants (e.g., warfarin):** Increased risk of bleeding.
* **Aspirin (low-dose):** May decrease cardioprotective effects of aspirin.
* **Corticosteroids:** Increased risk of GI ulceration and bleeding.
* **Diuretics:** May reduce diuretic efficacy and increase nephrotoxicity.
* **Lithium:** May increase lithium levels.
* **Methotrexate:** May increase methotrexate toxicity.
* **SSRIs/SNRIs:** Increased risk of GI bleeding.
## Monitoring
* Signs and symptoms of GI bleeding or ulceration.
* Renal function (BUN, creatinine).
* Liver function (LFTs).
* Blood pressure.
* Signs of cardiovascular events.
## Clinical Pearls
* Administer with food or milk to minimize GI upset.
* Avoid concurrent use with other NSAIDs.
* Lowest effective dose for the shortest duration should be used to minimize risks.
* Consider gastroprotection (e.g., PPI) in patients at high risk for GI events.
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*This information is for educational purposes only and does not substitute for professional medical advice. Always verify the most current prescribing information with official drug references before making clinical decisions.*
