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# Ibuprofen
## Overview
Ibuprofen is a nonsteroidal anti-inflammatory drug (NSAID) that reduces inflammation, pain, and fever.
## Primary Indications
* Pain management (e.g., headache, muscle aches, menstrual cramps, dental pain)
* Fever reduction
* Inflammation associated with conditions like arthritis
## Adult Dosing
* **Pain/Fever:** 200 mg to 400 mg orally every 4 to 6 hours as needed.
* **Inflammation:** 400 mg to 800 mg orally every 6 to 8 hours.
* **Maximum Daily Dose:** 3200 mg. Higher doses should be used cautiously and under medical supervision.
## Pediatric Dosing
Dosing is typically weight-based. Consult specific pediatric dosing guidelines or product labeling.
* **Fever/Pain:** 5 mg/kg to 10 mg/kg orally every 6 to 8 hours as needed.
* **Maximum Single Dose:** 40 mg/kg or 10 mg/kg depending on indication and formulation, not to exceed adult single doses.
* **Maximum Daily Dose:** 40 mg/kg, not to exceed 400 mg per dose or 2400 mg daily for anti-inflammatory effects.
## Dose Adjustments
No specific dose adjustment is typically required for renal or hepatic impairment, but caution is advised due to potential for exacerbation of renal dysfunction and gastrointestinal toxicity. Use the lowest effective dose for the shortest duration.
## Contraindications
* Known 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.
* Active gastrointestinal bleeding or history of gastrointestinal perforation or ulceration.
* Severe heart failure.
* Third trimester of pregnancy.
## Adverse Effects
Common adverse effects include gastrointestinal upset (nausea, dyspepsia, abdominal pain), dizziness, headache, and rash. Serious adverse effects can include:
* Gastrointestinal bleeding, ulceration, and perforation.
* Cardiovascular thrombotic events (myocardial infarction, stroke).
* Renal toxicity (acute kidney injury, interstitial nephritis).
* Hepatic toxicity.
* Hypersensitivity reactions.
* Fluid retention and edema.
## Key Drug Interactions
* **Anticoagulants (e.g., warfarin):** Increased risk of bleeding.
* **Corticosteroids:** Increased risk of gastrointestinal ulceration and bleeding.
* **SSRIs/SNRIs:** Increased risk of bleeding.
* **Diuretics and antihypertensives:** May decrease their efficacy and increase risk of renal impairment.
* **Lithium:** Increased lithium levels and toxicity.
* **Methotrexate:** Increased methotrexate levels and toxicity.
## Monitoring
* Monitor for signs and symptoms of gastrointestinal bleeding or ulceration.
* Assess for cardiovascular risk factors and monitor for signs of cardiovascular events.
* Evaluate renal and hepatic function, especially in patients with pre-existing conditions or those on long-term therapy.
* Monitor blood pressure, particularly in patients with hypertension.
## 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 adverse events.
* Avoid concurrent use with other NSAIDs or aspirin (unless directed by a physician for cardioprotection).
* Patients with asthma may be at increased risk of bronchospasm.
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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.*
