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# Ibuprofen
## Overview
Ibuprofen is a nonsteroidal anti-inflammatory drug (NSAID) that possesses analgesic, anti-inflammatory, and antipyretic properties.
## Primary Indications
* Mild to moderate pain (e.g., headache, dental pain, menstrual cramps)
* Inflammation (e.g., arthritis)
* Fever reduction
## Adult Dosing
* **Pain and Fever:** 200 mg to 400 mg every 4 to 6 hours as needed.
* **Inflammation:** Doses may range from 400 mg to 800 mg three times daily.
* **Maximum Daily Dose:** 3200 mg for chronic use, though typically lower doses (e.g., 1200 mg to 2400 mg) are used for symptomatic relief. Higher doses require medical supervision.
## Pediatric Dosing
Dosing is typically based on weight. Always use the provided dosing device.
* **Fever and Pain:** 5 mg/kg/dose every 6 to 8 hours for children 6 months and older. Maximum dose is 40 mg/kg/day.
* **Alternatively:** For fever and pain, an initial dose of 10 mg/kg/dose may be given, followed by 5 mg/kg/dose every 6 to 8 hours as needed. Maximum dose is 40 mg/kg/day.
* **Infants under 6 months:** Consult with a pediatrician. Safety and efficacy are not established.
## Dose Adjustments
* **Renal Impairment:** Use with caution. May require dose reduction, especially in severe impairment. Monitor renal function.
* **Hepatic Impairment:** Use with caution. May require dose reduction. Monitor liver function.
* **Elderly:** Increased risk of adverse effects. Consider a lower starting dose and monitor closely.
## Contraindications
* Known hypersensitivity to ibuprofen or other NSAIDs.
* History of asthma, urticaria, or 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 ulceration.
* Severe heart failure.
* Third trimester of pregnancy.
## Adverse Effects
Common: Nausea, vomiting, diarrhea, constipation, abdominal pain, dyspepsia, rash, dizziness, headache.
Serious: Gastrointestinal bleeding, ulceration, perforation, myocardial infarction, stroke, renal failure, hepatic failure, anaphylaxis, Stevens-Johnson syndrome.
## Key Drug Interactions
* **Anticoagulants (e.g., warfarin):** Increased risk of bleeding.
* **Corticosteroids:** Increased risk of gastrointestinal bleeding and ulceration.
* **SSRIs/SNRIs:** Increased risk of bleeding.
* **Diuretics and Antihypertensives:** May decrease their efficacy and increase risk of renal toxicity.
* **Lithium, Methotrexate:** Increased serum levels and toxicity.
## Monitoring
* Signs and symptoms of gastrointestinal bleeding (e.g., melena, hematemesis).
* Renal function (BUN, creatinine) especially in patients with pre-existing renal disease or those on concomitant nephrotoxic agents.
* Liver function tests in patients with hepatic impairment or those on long-term therapy.
* Blood pressure, especially in patients with hypertension.
## Clinical Pearls
* Administer with food or milk to minimize gastrointestinal upset.
* Lowest effective dose should be used for the shortest duration necessary.
* Ibuprofen can mask signs of infection.
* Use caution in patients with a history of cardiovascular disease, hypertension, heart failure, or risk factors for these conditions.
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*This information is for educational purposes only and does not substitute for professional medical advice. Always consult the most current prescribing information or a healthcare professional for complete and up-to-date drug details.*
