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# Ibuprofen
## Overview
Ibuprofen is a nonsteroidal anti-inflammatory drug (NSAID) that possesses analgesic, anti-inflammatory, and antipyretic properties.
## Primary Indications
* Pain relief (mild to moderate)
* Inflammation reduction
* Fever reduction
## Adult Dosing
* **Pain/Inflammation:** 400 mg to 800 mg every 6 to 8 hours as needed.
* Maximum daily dose: 3200 mg.
* **Fever:** 200 mg to 400 mg every 4 to 6 hours as needed.
* Maximum daily dose: 1200 mg.
## Pediatric Dosing
Dosing is typically based on weight. Consult product labeling or local protocols for specific age and weight-based recommendations.
* **Fever/Pain:** 5 mg/kg/dose every 6 to 8 hours, or 10 mg/kg/dose every 6 to 8 hours for higher fever or more severe pain.
* Maximum daily dose: 40 mg/kg/day or 2400 mg/day, whichever is less.
* For children younger than 6 months, consult a pediatrician.
## Dose Adjustments
No specific dose adjustments are generally required for renal or hepatic impairment, but caution is advised. Ibuprofen should be used at the lowest effective dose for the shortest duration necessary to minimize risks.
## Contraindications
* Hypersensitivity to ibuprofen, aspirin, or other NSAIDs.
* History of bronchospasm, asthma, rhinitis, or urticaria following aspirin or NSAID use.
* Perioperative pain in the setting of coronary artery bypass graft (CABG) surgery.
* Active gastrointestinal bleeding or ulceration.
* Severe heart failure.
## Adverse Effects
* **Common:** Nausea, vomiting, dyspepsia, abdominal pain, constipation, diarrhea, rash.
* **Serious:** Gastrointestinal bleeding, ulceration, perforation; cardiovascular thrombotic events (MI, stroke); renal failure; hepatic failure; bronchospasm; hypersensitivity reactions; Stevens-Johnson syndrome.
## Key Drug Interactions
* **Anticoagulants (e.g., warfarin):** Increased risk of bleeding.
* **Corticosteroids:** Increased risk of gastrointestinal ulceration and bleeding.
* **Selective Serotonin Reuptake Inhibitors (SSRIs) / Serotonin-Norepinephrine Reuptake Inhibitors (SNRIs):** Increased risk of gastrointestinal bleeding.
* **Other NSAIDs (including aspirin):** Increased risk of adverse effects, particularly gastrointestinal bleeding and renal toxicity.
* **ACE Inhibitors / Angiotensin II Receptor Blockers (ARBs) / Diuretics:** Reduced antihypertensive effect and increased risk of renal impairment.
* **Lithium:** Increased lithium levels and toxicity.
* **Methotrexate:** Increased methotrexate toxicity.
## Monitoring
* Signs and symptoms of gastrointestinal bleeding (e.g., melena, hematemesis).
* Renal function (especially in patients with pre-existing renal disease, dehydration, or those on diuretics/ACE inhibitors).
* Liver function (especially with long-term use or in patients with liver disease).
* Blood pressure.
## 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 serious cardiovascular and gastrointestinal events.
* Avoid in patients with a history of NSAID-induced bronchospasm.
* Consider alternative analgesics in patients with active peptic ulcer disease or inflammatory bowel disease.
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*Disclaimer: This information is intended for healthcare professionals and does not replace a thorough review of the current prescribing information, clinical guidelines, or professional judgment. Always verify the most up-to-date product information before making clinical decisions.*
