Please check your internet connection and try again.
# Ibuprofen
## Overview
Ibuprofen is a non-steroidal anti-inflammatory drug (NSAID) that reduces inflammation, pain, and fever.
## Primary Indications
* Pain (mild to moderate)
* Fever
* Inflammation (e.g., 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. Do not exceed 3200 mg/day.
## Pediatric Dosing
Dosing is typically weight-based. Consult current pediatric dosing guidelines or a pediatrician for specific recommendations.
* **Fever/Pain:** Generally dosed at 5 mg/kg to 10 mg/kg orally every 6 to 8 hours for children aged 6 months and older.
* Maximum daily dose: 40 mg/kg or 2400 mg, whichever is less.
* **Kawasaki Disease:** Specific dosing regimens exist and should be guided by specialist recommendations.
## Dose Adjustments
No specific dose adjustments are typically required for hepatic or renal impairment, but caution is advised. NSAIDs can worsen renal function. Monitor renal function closely in patients with pre-existing renal disease.
## Contraindications
* Hypersensitivity to ibuprofen, aspirin, or other NSAIDs.
* History of bronchospasm, asthma, urticaria, or allergic-type reactions after taking NSAIDs.
* Perioperative pain in the setting of coronary artery bypass graft (CABG) surgery.
* Advanced renal disease.
* Severe hepatic impairment.
* Severe heart failure.
## Adverse Effects
Common: Nausea, vomiting, diarrhea, constipation, dyspepsia, abdominal pain, dizziness, headache.
Serious:
* Gastrointestinal (GI) bleeding, ulceration, and perforation.
* Cardiovascular thrombotic events (myocardial infarction, stroke).
* Renal toxicity, interstitial nephritis, papillary necrosis.
* Hepatic dysfunction.
* Anaphylactic reactions.
* Exacerbation of asthma.
## Key Drug Interactions
* **Anticoagulants (e.g., warfarin):** Increased risk of bleeding.
* **Aspirin (low-dose):** May reduce the cardioprotective antiplatelet effect of aspirin.
* **Corticosteroids:** Increased risk of GI bleeding.
* **Diuretics:** May decrease diuretic effect and increase risk of nephrotoxicity.
* **Lithium:** Increased serum lithium levels.
* **Methotrexate:** Increased methotrexate toxicity.
* **Other NSAIDs/Salicylates:** Increased risk of adverse effects.
* **SSRIs/SNRIs:** Increased risk of GI bleeding.
## Monitoring
* Signs and symptoms of GI bleeding (melena, hematemesis).
* Renal function (BUN, creatinine).
* Liver function tests (LFTs).
* Blood pressure.
* Signs of cardiovascular events.
## Clinical Pearls
* Administer with food or milk to minimize GI upset.
* Use the lowest effective dose for the shortest duration necessary to minimize risks.
* Consider GI protection (e.g., PPI) for patients at high risk of GI complications.
* Avoid in patients with dehydration, heart failure, or pre-existing renal disease unless closely monitored.
* For fever in children, alternating ibuprofen and acetaminophen may be considered, but always follow specific hospital or pediatrician protocols.
***
Please verify the current prescribing information for the most up-to-date and complete drug information. This information is for educational purposes and does not substitute professional medical advice.
