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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 associated with conditions like rheumatoid arthritis and osteoarthritis. ## Adult Dosing * **Pain/Fever:** 200-400 mg every 4-6 hours as needed. Maximum daily dose: 1200 mg. * **Rheumatoid Arthritis/Osteoarthritis:** 300-800 mg every 6-8 hours. Maximum daily dose: 2400 mg (under medical supervision). ## Pediatric Dosing * **Pain/Fever:** 5-10 mg/kg/dose every 6-8 hours. * Infants 6 months to 12 years: Maximum daily dose: 40 mg/kg or 2400 mg, whichever is less. * Dosing for children under 6 months is generally not recommended without specific guidance from a pediatrician. ## Dose Adjustments No specific dose adjustments are typically required for renal or hepatic impairment, but caution is advised in patients with severe dysfunction due to potential risks of NSAID use. ## Contraindications * Known hypersensitivity to ibuprofen, aspirin, or other NSAIDs. * History of bronchospasm, asthma, rhinitis, or urticaria triggered by NSAIDs. * Perioperative pain in the context of coronary artery bypass graft (CABG) surgery. * Third trimester of pregnancy. ## Adverse Effects Common adverse effects include gastrointestinal upset (nausea, dyspepsia, abdominal pain), dizziness, and headache. Serious risks include GI bleeding, perforation, cardiovascular thrombotic events, renal impairment, and hypersensitivity reactions. ## Key Drug Interactions * **Anticoagulants (e.g., warfarin):** Increased risk of bleeding. * **Corticosteroids:** Increased risk of GI ulceration and bleeding. * **ACE inhibitors, ARBs, beta-blockers:** May reduce antihypertensive effect and increase risk of renal impairment. * **Diuretics:** May reduce diuretic efficacy and increase risk of renal impairment. * **Lithium:** Increased lithium levels and toxicity. * **Methotrexate:** Increased risk of methotrexate toxicity. ## Monitoring * Assess for signs of GI bleeding (e.g., melena, hematemesis). * Monitor blood pressure, especially when used with antihypertensives. * Evaluate renal function in patients with risk factors. * Monitor for signs of cardiovascular events. ## Clinical Pearls * Administer with food or milk to minimize GI upset. * Lowest effective dose should be used for the shortest duration necessary. * Use with caution in elderly patients, those with pre-existing renal or cardiovascular disease, or those on anticoagulation. *** **Disclaimer:** This information is for educational purposes only and does not constitute medical advice. Always consult the most current prescribing information and a qualified healthcare professional for any medical decisions or treatment.