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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, dental pain, menstrual cramps, muscle aches)
* Fever
* Inflammation (e.g., arthritis)
### Adult Dosing
* **Pain/Fever:** 200-400 mg every 4-6 hours as needed.
* Maximum daily dose: 1200 mg for over-the-counter (OTC) use.
* Maximum daily dose: 3200 mg for prescription use under medical supervision, typically for inflammatory conditions.
* **Inflammation (e.g., rheumatoid arthritis):** 400-800 mg three to four times daily.
* Maximum daily dose: 3200 mg.
### Pediatric Dosing
Dosing is weight-based. Consult a pediatrician for specific dosing.
* **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.
### Dose Adjustments
No dose adjustment is typically required for renal or hepatic impairment, but caution is advised, and the lowest effective dose should be used.
### Contraindications
* Known hypersensitivity to ibuprofen, aspirin, or other NSAIDs.
* History of bronchospasm, asthma, rhinitis, 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 adverse effects include gastrointestinal upset (nausea, dyspepsia, abdominal pain), dizziness, and headache. Serious adverse effects can include gastrointestinal bleeding, ulceration, perforation, cardiovascular thrombotic events (e.g., myocardial infarction, stroke), renal toxicity, and hypersensitivity reactions.
### Key Drug Interactions
* **Anticoagulants (e.g., warfarin):** Increased risk of bleeding.
* **Aspirin:** May reduce the cardioprotective effect of low-dose aspirin.
* **Corticosteroids:** Increased risk of gastrointestinal ulceration and bleeding.
* **Diuretics, ACE inhibitors, ARBs:** May decrease antihypertensive effects and increase risk of renal toxicity.
* **Lithium:** Increased lithium levels and potential toxicity.
* **Methotrexate:** Increased methotrexate toxicity.
### Monitoring
* Monitor for signs and symptoms of gastrointestinal bleeding or ulceration.
* Assess for signs of cardiovascular events.
* Monitor renal function, especially in patients with pre-existing renal disease or those at risk.
* Monitor blood pressure.
### Clinical Pearls
* Administer with food or milk to minimize gastrointestinal upset.
* Use the lowest effective dose for the shortest duration necessary to minimize risks.
* Advise patients to avoid concomitant use of other NSAIDs.
* Consider gastroprotection (e.g., PPI) in patients at high risk for GI complications.
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**Disclaimer:** This information is intended for healthcare professionals. Always consult the most current prescribing information and relevant clinical guidelines before making treatment decisions.
