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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 management (mild to moderate) * Fever reduction * Inflammatory conditions (e.g., rheumatoid arthritis, osteoarthritis) ## Adult Dosing * **Pain and Fever:** 200 mg to 400 mg orally every 4 to 6 hours as needed. * Maximum daily dose: 1200 mg (over-the-counter). Prescription doses can go up to 2400 mg to 3200 mg daily in divided doses for inflammatory conditions, under strict medical supervision. * **Inflammatory Conditions:** 400 mg to 800 mg orally 3 to 4 times daily. * Maximum daily dose: 3200 mg (prescription). ## Pediatric Dosing * **Pain and Fever:** 5 mg/kg to 10 mg/kg orally every 6 to 8 hours as needed. * Maximum single dose: 400 mg. * Maximum daily dose: 40 mg/kg or 2400 mg, whichever is less. * Infants: Generally recommended for infants > 6 months of age. ## Dose Adjustments No dose adjustment is typically required for renal or hepatic impairment, but caution is advised. Monitor for signs of toxicity. ## 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. ## Adverse Effects * **Common:** Nausea, vomiting, dyspepsia, abdominal pain, diarrhea, constipation, dizziness, headache. * **Serious:** Gastrointestinal bleeding and ulceration, renal toxicity, cardiovascular thrombotic events (myocardial infarction, stroke), hypersensitivity reactions, hepatotoxicity. ## Key Drug Interactions * **Anticoagulants (e.g., warfarin):** Increased risk of bleeding. * **Aspirin (low-dose):** May reduce the cardioprotective effects of aspirin. * **Corticosteroids:** Increased risk of GI ulceration and bleeding. * **Diuretics:** Reduced efficacy, increased risk of renal toxicity. * **Lithium:** Increased lithium levels. * **Methotrexate:** Increased methotrexate toxicity. * **Other NSAIDs:** Additive toxicity. * **SSRIs/SNRIs:** Increased risk of GI bleeding. ## Monitoring * Renal function (BUN, creatinine) * Liver function (ALT, AST) * Signs of GI bleeding (occult blood in stool, melena, hematemesis) * Blood pressure ## Clinical Pearls * Administer with food or milk to minimize gastrointestinal upset. * Lowest effective dose for the shortest duration should be used. * Patients with cardiovascular disease or risk factors should use with caution. * Discontinue if signs of serious adverse events occur. --- *Please verify current prescribing information for the most up-to-date dosing, indications, and contraindications.*