Please check your internet connection and try again.
# Ibuprofen
## Overview
Ibuprofen is a nonsteroidal anti-inflammatory drug (NSAID) used for its analgesic, anti-inflammatory, and antipyretic properties.
## Primary Indications
* Pain relief (e.g., headache, dental pain, menstrual cramps, muscle aches, arthritis)
* Fever reduction
* Inflammation reduction (e.g., in rheumatoid arthritis, osteoarthritis)
## Adult Dosing
* **Pain and Fever:** 200 mg to 400 mg every 4 to 6 hours as needed. Maximum daily dose: 1200 mg.
* **Inflammation:** 400 mg to 800 mg every 6 to 8 hours. Maximum daily dose: 3200 mg (usually reserved for specific inflammatory conditions under close medical supervision).
## Pediatric Dosing
Dosing is typically based on weight.
* **Fever and Pain:** 5 mg/kg to 10 mg/kg per dose orally every 6 to 8 hours as needed.
* Maximum pediatric dose: 40 mg/kg per day or 400 mg per day, whichever is less.
* Infants younger than 6 months: Safety and efficacy not established. Consult product labeling or specific pediatric guidelines.
## Dose Adjustments
No specific dose adjustments are routinely recommended for hepatic or renal impairment, but caution is advised, especially with severe impairment, due to potential for worsening renal function. Monitor closely.
## Contraindications
* Hypersensitivity to ibuprofen, aspirin, or other NSAIDs.
* History of bronchospasm, asthma, rhinitis, or urticaria after taking aspirin or other NSAIDs.
* Perioperative pain in the setting of coronary artery bypass graft (CABG) surgery.
* Active gastrointestinal bleeding or a history of gastrointestinal bleeding/perforation with prior NSAID use.
* Severe heart failure.
* Severe renal impairment.
* Severe hepatic impairment.
* Late pregnancy (third trimester).
## Adverse Effects
Common: Nausea, vomiting, diarrhea, constipation, abdominal pain, dyspepsia, headache, dizziness, rash.
Serious: Gastrointestinal bleeding, ulceration, perforation; cardiovascular thrombotic events (MI, stroke); renal toxicity; hepatic toxicity; hypersensitivity reactions; bronchospasm; fluid retention and edema.
## Key Drug Interactions
* **Anticoagulants (e.g., warfarin):** Increased risk of bleeding.
* **Corticosteroids:** Increased risk of gastrointestinal bleeding and ulceration.
* **ACE Inhibitors and ARBs:** Reduced antihypertensive effect; increased risk of renal impairment.
* **Diuretics:** Reduced diuretic effect; increased risk of renal impairment.
* **Lithium:** Increased serum lithium levels and risk of toxicity.
* **Methotrexate:** Increased risk of methotrexate toxicity.
* **Other NSAIDs/Aspirin:** Increased risk of adverse effects, particularly gastrointestinal.
## Monitoring
* Signs and symptoms of gastrointestinal bleeding (e.g., melena, hematemesis).
* Renal function (BUN, creatinine) and electrolyte balance, especially in elderly patients or those with pre-existing renal disease.
* Liver function tests if used long-term or in patients with hepatic impairment.
* Blood pressure.
## Clinical Pearls
* Administer with food or milk to minimize gastrointestinal upset.
* Use the lowest effective dose for the shortest duration necessary to minimize risks.
* Consider gastroprotective agents (e.g., PPIs) for patients at high risk of GI complications.
* Avoid concomitant use with other NSAIDs.
* In patients with asthma, monitor for bronchospasm.
***
**Disclaimer:** This information is for educational purposes and does not substitute for professional medical advice. Always consult current prescribing information and consider individual patient factors before making any treatment decisions.
