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# Ibuprofen
## Overview
Ibuprofen is a nonsteroidal anti-inflammatory drug (NSAID) used for pain relief, fever reduction, and reducing inflammation.
## Primary Indications
* Pain (mild to moderate)
* Fever
* Inflammation associated with conditions like arthritis
## Adult Dosing
* **Pain and Fever:** 200-400 mg orally every 4-6 hours as needed. Maximum daily dose is 1200 mg.
* **Inflammation (e.g., arthritis):** 400-800 mg orally every 6-8 hours. Maximum daily dose is 3200 mg, but typically lower doses are used for chronic conditions.
## Pediatric Dosing
Dosing is based on weight. Available in liquid and chewable formulations.
* **Fever and Pain:** 5-10 mg/kg orally every 6-8 hours.
* **Maximum pediatric dose:** Do not exceed adult maximums.
* **Infants < 6 months:** Generally not recommended without physician guidance due to potential risks. Consult specific pediatric guidelines.
## Dose Adjustments
* **Renal Impairment:** Use with caution; consider dose reduction in severe impairment.
* **Hepatic Impairment:** Use with caution; consider dose reduction in severe impairment.
## 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.
* Peri-operative pain in the setting of coronary artery bypass graft (CABG) surgery.
* Third trimester of pregnancy.
## Adverse Effects
Common: GI upset, heartburn, nausea, rash.
Serious: GI bleeding, ulceration, perforation, renal toxicity, cardiovascular thrombotic events, hypertension, fluid retention, hypersensitivity reactions.
## Key Drug Interactions
* **Anticoagulants (e.g., warfarin, DOACs):** Increased risk of bleeding.
* **Aspirin (low-dose):** May diminish cardioprotective effects of aspirin.
* **Corticosteroids:** Increased risk of GI adverse effects.
* **Diuretics and antihypertensives:** May reduce efficacy and increase risk of renal toxicity.
* **Lithium:** Increased lithium levels.
* **Methotrexate:** Increased methotrexate toxicity.
## Monitoring
* Signs and symptoms of GI bleeding (e.g., melena, hematemesis).
* Renal function (BUN, creatinine) especially in patients with risk factors.
* Blood pressure.
* Signs of hypersensitivity reactions.
## Clinical Pearls
* Administer with food or milk to minimize GI upset.
* Lowest effective dose for the shortest duration should be used to minimize risk of serious adverse events.
* Higher doses are associated with increased risk of cardiovascular and renal events.
**Disclaimer:** This information is a summary and does not substitute for professional medical advice. Always refer to the most current prescribing information and consult with a qualified healthcare provider for any medical decisions.
