Please check your internet connection and try again.
# Ibuprofen
## Overview
Ibuprofen is a nonsteroidal anti-inflammatory drug (NSAID) that possesses analgesic, anti-inflammatory, and antipyretic properties. It works by inhibiting cyclooxygenase (COX) enzymes, which reduces the synthesis of prostaglandins.
## Primary Indications
* Pain relief (mild to moderate)
* Fever reduction
* Inflammation reduction (e.g., rheumatoid arthritis, osteoarthritis)
## Adult Dosing
* **Analgesia/Antipyresis:** 200-400 mg every 4-6 hours as needed. Maximum daily dose: 1200 mg for over-the-counter (OTC) use; up to 3200 mg per day under medical supervision for specific inflammatory conditions.
* **Inflammation:** 400-800 mg three to four times daily. Maximum daily dose: 3200 mg.
## Pediatric Dosing
* **Analgesia/Antipyresis:** Dosing is typically based on weight.
* **10 mg/kg/dose orally every 6-8 hours as needed.**
* **Maximum daily dose: 40 mg/kg or 4000 mg, whichever is less.**
* For infants under 6 months, consult product labeling or a pediatrician.
## Dose Adjustments
* No dose adjustment is typically required for hepatic or renal impairment unless severe. However, caution is advised, and the lowest effective dose should be used, especially in patients with pre-existing renal disease.
## Contraindications
* Hypersensitivity to ibuprofen 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 (GI) bleeding or history of GI ulceration/bleeding.
* Severe hepatic or renal impairment.
* Severe heart failure.
## Adverse Effects
Common: GI upset, nausea, vomiting, diarrhea, constipation, headache, dizziness.
Serious: GI bleeding/perforation, cardiovascular thrombotic events (MI, stroke), renal failure, hepatic failure, hypersensitivity reactions, Stevens-Johnson syndrome, toxic epidermal necrolysis.
## Key Drug Interactions
* **Anticoagulants (e.g., warfarin):** Increased risk of bleeding.
* **Corticosteroids:** Increased risk of GI ulceration/bleeding.
* **Other NSAIDs/Aspirin:** Increased risk of GI adverse effects and reduced cardioprotective effect of low-dose aspirin.
* **ACE inhibitors/ARBs/Diuretics:** May reduce antihypertensive effect and increase risk of renal impairment.
* **Lithium:** Increased lithium levels.
* **Methotrexate:** Increased methotrexate toxicity.
## Monitoring
* Monitor for signs and symptoms of GI bleeding (e.g., melena, hematemesis).
* Monitor renal function (BUN, creatinine), especially in patients with pre-existing renal disease or those taking concomitant nephrotoxic agents.
* Monitor liver function tests (LFTs) if used long-term or in patients with pre-existing liver disease.
* Monitor blood pressure.
* Assess pain and fever.
## Clinical Pearls
* Administer with food or milk to minimize GI upset.
* Use the lowest effective dose for the shortest duration necessary to minimize risks.
* Patients with cardiovascular risk factors should use ibuprofen with caution and at the lowest effective dose.
* Consider gastroprotection (e.g., proton pump inhibitor) in patients with increased risk of GI bleeding.
---
*This information is intended for clinical use and is not a substitute for professional medical advice. Always verify current prescribing information with official drug monographs or local protocols.*
