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# Ibuprofen
## Overview
Ibuprofen is a nonsteroidal anti-inflammatory drug (NSAID) used for pain relief, fever reduction, and inflammation management.
## Primary Indications
* Pain (mild to moderate)
* Fever
* Inflammation (e.g., rheumatoid arthritis, osteoarthritis)
* Dysmenorrhea
## Adult Dosing
* **Pain/Fever:** 200-400 mg every 4-6 hours as needed. Maximum daily dose: 1200 mg.
* **Inflammation/Arthritis:** 400-800 mg twice or three times daily. Maximum daily dose: 2400 mg (under medical supervision).
* **Dysmenorrhea:** 200-400 mg every 4-6 hours as needed. Maximum daily dose: 1200 mg.
## Pediatric Dosing
Dosing is weight-based. Specific dosing varies by formulation (e.g., oral suspension, chewable tablets).
* **Fever/Pain:** 5-10 mg/kg per dose every 6-8 hours.
* For children 6 months to 12 years: Maximum single dose is typically 400 mg. Maximum daily dose is 40 mg/kg/day or 1200 mg/day, whichever is less.
* Consult product labeling for specific concentrations and dosing devices.
## Dose Adjustments
No dose adjustment is typically needed for renal or hepatic impairment, but caution is advised. If liver function abnormalities develop, discontinue ibuprofen.
## Contraindications
* Hypersensitivity to ibuprofen, aspirin, 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.
* Advanced renal disease.
* Active GI bleeding or history of ulceration.
* Pregnancy in the third trimester.
## Adverse Effects
Common: GI upset (nausea, vomiting, diarrhea, constipation, dyspepsia), dizziness, headache.
Serious: GI bleeding, ulceration, perforation, cardiovascular thrombotic events (myocardial infarction, stroke), renal failure, hepatotoxicity, hypersensitivity reactions, Stevens-Johnson syndrome, toxic epidermal necrolysis.
## Key Drug Interactions
* **Anticoagulants (e.g., warfarin) and Antiplatelets (e.g., aspirin, clopidogrel):** Increased risk of bleeding.
* **ACE inhibitors, ARBs, Diuretics:** Reduced antihypertensive effect and increased risk of renal impairment.
* **Corticosteroids:** Increased risk of GI ulceration and bleeding.
* **Lithium:** Increased serum lithium levels.
* **Methotrexate:** Increased methotrexate toxicity.
* **Selective Serotonin Reuptake Inhibitors (SSRIs):** Increased risk of GI bleeding.
## Monitoring
* Renal function (especially in elderly, dehydrated, or renally impaired patients).
* Liver function tests (especially with prolonged use or pre-existing liver disease).
* Signs and symptoms of GI bleeding.
* Blood pressure.
## Clinical Pearls
* Take with food or milk to minimize GI upset.
* Lowest effective dose for the shortest duration should be used to minimize risks.
* Risk of cardiovascular events and GI bleeding increases with dose and duration of use.
* Avoid use in patients with heart failure unless benefits outweigh risks.
* Use with caution in patients with asthma, as NSAIDs can trigger bronchospasm.
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*Disclaimer: This information is intended for clinical use and does not replace the official prescribing information or clinical judgment. Always verify the most current drug information with a reliable source before making treatment decisions.*
