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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)
* Dysmenorrhea
## Adult Dosing
* **Pain/Fever:** 200-400 mg every 4-6 hours as needed. Maximum daily dose: 1200 mg (over-the-counter), 2400-3200 mg (prescription, under medical supervision, for specific conditions like rheumatoid arthritis).
* **Inflammation:** Typically 400-800 mg 3 times daily. Maximum daily dose: 2400-3200 mg.
## Pediatric Dosing
* **Fever/Pain:** 5-10 mg/kg/dose every 6-8 hours. Maximum daily dose: 40 mg/kg or 2400 mg, whichever is less.
* For infants < 6 months: Consult a pediatrician. Dosing is generally not recommended due to potential risks.
* **Kawasaki Disease:** Dosing varies significantly based on the phase of illness; consult specific guidelines.
## Dose Adjustments
* **Renal Impairment:** Use with caution. May require dose reduction and increased monitoring. Avoid in severe renal impairment.
* **Hepatic Impairment:** Use with caution. May require dose reduction. Avoid in severe hepatic impairment.
## Contraindications
* Hypersensitivity to ibuprofen, aspirin, or other NSAIDs.
* History of asthma, urticaria, or other 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:** Gastrointestinal upset (nausea, vomiting, diarrhea, constipation), dizziness, headache.
* **Serious:**
* Gastrointestinal bleeding, ulceration, perforation.
* Cardiovascular thrombotic events (MI, stroke).
* Renal toxicity.
* Hepatic toxicity.
* Hypersensitivity reactions.
* Exacerbation of asthma.
## Key Drug Interactions
* **Anticoagulants (e.g., warfarin):** Increased risk of bleeding.
* **Corticosteroids:** Increased risk of GI ulceration and bleeding.
* **SSRIs/SNRIs:** Increased risk of GI bleeding.
* **ACE inhibitors, ARBs, Beta-blockers:** May decrease antihypertensive effect and increase risk of renal impairment.
* **Diuretics:** May decrease diuretic effect and increase risk of renal impairment.
* **Lithium:** Increased lithium levels.
* **Methotrexate:** Increased methotrexate toxicity.
## Monitoring
* Signs and symptoms of GI bleeding (melena, hematemesis).
* Renal function (BUN, creatinine).
* Liver function (AST, ALT).
* Blood pressure.
* Signs of cardiovascular events.
## Clinical Pearls
* Administer with food or milk to minimize GI upset.
* Use the lowest effective dose for the shortest duration necessary to minimize risk.
* Caution in elderly patients and those with pre-existing cardiovascular, renal, or hepatic disease.
* Risk of cardiovascular thrombotic events and GI bleeding may increase with duration of use and higher doses.
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*Disclaimer: This information is intended for educational purposes and does not substitute professional medical advice. Always verify the most current prescribing information and consult with a healthcare provider before making any decisions related to drug therapy.*
