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# Ibuprofen
## Overview
Ibuprofen is a nonsteroidal anti-inflammatory drug (NSAID) that provides analgesic, anti-inflammatory, and antipyretic effects.
## Primary Indications
* Pain (mild to moderate)
* Inflammation
* Fever
## Adult Dosing
* **Pain/Inflammation:** 200-800 mg every 6-8 hours as needed.
* **Maximum Daily Dose:** 3200 mg.
## Pediatric Dosing
Dosing is typically based on weight and indication. Consult local protocols for specific dosing.
* **Fever/Pain:** 5-10 mg/kg per dose orally every 6-8 hours.
* **Maximum Daily Dose:** 40 mg/kg per day, not to exceed adult maximum.
## Dose Adjustments
No specific dose adjustments are typically required for renal or hepatic impairment, but caution is advised, and lower doses may be considered. NSAIDs can worsen renal function.
## Contraindications
* Hypersensitivity to ibuprofen, aspirin, or other NSAIDs.
* History of bronchospasm, asthma, rhinitis, or urticaria following NSAID use.
* Perioperative pain in the context of coronary artery bypass graft (CABG) surgery.
* Active gastrointestinal (GI) bleeding or ulceration.
* Severe heart failure.
## Adverse Effects
Common:
* GI upset (dyspepsia, nausea, abdominal pain)
* Dizziness, headache
* Rash
Serious:
* GI bleeding and ulceration
* Cardiovascular thrombotic events (MI, stroke)
* Renal impairment, interstitial nephritis
* Hepatotoxicity
* Anaphylaxis
## Key Drug Interactions
* **Anticoagulants (e.g., warfarin):** Increased risk of bleeding.
* **Antiplatelets (e.g., aspirin, clopidogrel):** Increased risk of bleeding.
* **Corticosteroids:** Increased risk of GI ulceration and bleeding.
* **Diuretics:** Reduced diuretic efficacy, increased risk of renal impairment.
* **Lithium:** Increased serum lithium levels.
* **Methotrexate:** Increased risk of methotrexate toxicity.
* **Other NSAIDs:** Increased risk of adverse effects.
## Monitoring
* Renal function (serum creatinine, BUN)
* Liver function (LFTs)
* Signs and symptoms of GI bleeding (hematemesis, melena)
* Blood pressure (especially in patients with hypertension)
## Clinical Pearls
* Administer with food or milk to minimize GI upset.
* Avoid concomitant use with other NSAIDs.
* Use the lowest effective dose for the shortest duration necessary.
* Risk of cardiovascular events and GI bleeding increases with dose and duration of use.
* Caution in elderly patients, those with pre-existing renal or cardiovascular disease, and those with a history of GI issues.
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*This information is intended for healthcare professionals. Always consult the official prescribing information and relevant clinical guidelines for complete details before making therapeutic decisions. Dosing and recommendations may vary based on patient-specific factors and local protocols.*
