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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, muscle aches, menstrual cramps, toothache)
* Fever
* Inflammation associated with conditions like arthritis
## Adult Dosing
* **Pain and Fever:** 200 mg to 400 mg orally every 4 to 6 hours as needed.
* **Inflammation:** 400 mg to 800 mg orally three times daily.
* **Maximum Daily Dose:** 3200 mg per day for chronic use under physician supervision; 1200 mg per day for over-the-counter (OTC) use. Higher doses may be used in specific rheumatologic conditions.
## Pediatric Dosing
Dosing is typically based on weight. Consult specific pediatric dosing guidelines or product labeling.
* **Fever and Pain:** 5 mg/kg to 10 mg/kg orally every 6 to 8 hours.
* **Maximum Daily Dose:** 40 mg/kg per day, not to exceed the adult maximum of 3200 mg per day.
* **Infants under 6 months:** Use is generally not recommended due to potential risks; consult a pediatrician.
## Dose Adjustments
No specific dose adjustments are typically required for renal or hepatic impairment, but caution is advised, and the lowest effective dose should be used. Patients with severe renal or hepatic impairment should be closely monitored for adverse effects.
## 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: Gastrointestinal upset (nausea, vomiting, diarrhea, constipation, abdominal pain), dizziness, headache.
Serious: Cardiovascular thrombotic events (myocardial infarction, stroke), serious gastrointestinal bleeding, ulceration, and perforation, hypertension, renal impairment, hepatic failure, hypersensitivity reactions, exacerbation of asthma.
## Key Drug Interactions
* **Anticoagulants (e.g., warfarin) and Antiplatelets (e.g., aspirin, clopidogrel):** Increased risk of bleeding.
* **Corticosteroids:** Increased risk of gastrointestinal ulceration and bleeding.
* **Selective Serotonin Reuptake Inhibitors (SSRIs) and Serotonin-Norepinephrine Reuptake Inhibitors (SNRIs):** Increased risk of bleeding.
* **Diuretics and Antihypertensives:** May decrease their efficacy and increase risk of renal toxicity.
* **Lithium and Methotrexate:** Increased serum levels and toxicity.
## Monitoring
* Signs and symptoms of gastrointestinal bleeding (e.g., melena, hematemesis).
* Blood pressure, especially in patients with hypertension.
* Renal and hepatic function, particularly with long-term use or in at-risk patients.
* Signs of cardiovascular events.
## 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, particularly cardiovascular and gastrointestinal complications.
* Patients with cardiovascular disease or risk factors should use ibuprofen with caution and at the lowest effective dose.
* Ibuprofen can mask signs of infection.
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*This information is intended for healthcare professionals and is not a substitute for current prescribing information or professional medical advice. Always consult the most recent product labeling and relevant clinical guidelines before making any treatment decisions.*
