Please check your internet connection and try again.
# Ibuprofen
## Overview
Ibuprofen is a non-steroidal anti-inflammatory drug (NSAID) that exhibits analgesic, anti-inflammatory, and antipyretic properties.
## Primary Indications
* Pain relief (mild to moderate)
* Fever reduction
* Inflammation reduction (e.g., rheumatoid arthritis, osteoarthritis)
* Patent ductus arteriosus (PDA) in premature neonates
## Adult Dosing
* **Pain/Fever:** 200-400 mg orally every 4-6 hours as needed. Maximum daily dose: 1200 mg for over-the-counter (OTC) use; up to 3200 mg/day under medical supervision for specific inflammatory conditions.
* **Inflammation:** 400-800 mg orally 3-4 times daily. Maximum daily dose: 3200 mg.
## Pediatric Dosing
* **Pain/Fever:** 5-10 mg/kg orally every 6-8 hours.
* Maximum single dose: 40 mg/kg, not to exceed 400 mg.
* Maximum daily dose: 40 mg/kg, not to exceed 2400 mg.
* Infants < 6 months: Use with caution; consult product labeling or a pediatrician.
* **Patent Ductus Arteriosus (PDA):** Typically administered intravenously in neonatal intensive care units. Dosing is complex and requires strict monitoring; consult specific neonatal protocols or drug monographs. A common regimen is a total of 3 doses:
* First dose: 10 mg/kg.
* Second and third doses: 5 mg/kg each, given at 24- and 48-hour intervals after the first dose.
## Dose Adjustments
* **Renal Impairment:** Use with caution. Dose reduction may be necessary in moderate to severe impairment. Monitor renal function.
* **Hepatic Impairment:** Use with caution. Dose reduction may be necessary in severe impairment. Monitor liver function.
## Contraindications
* Hypersensitivity to ibuprofen, aspirin, or other NSAIDs.
* History of bronchospasm, asthma, urticaria, or allergic-type reactions after taking aspirin or other NSAIDs.
* Perioperative pain in the setting of coronary artery bypass graft (CABG) surgery.
* Third trimester of pregnancy.
## Adverse Effects
* **Common:** Dyspepsia, nausea, abdominal pain, heartburn, rash, dizziness.
* **Serious:** Gastrointestinal bleeding/ulceration, cardiovascular thrombotic events (MI, stroke), renal failure, hepatic failure, hypersensitivity reactions, bronchospasm, exacerbation of heart failure.
## Key Drug Interactions
* **Anticoagulants (e.g., warfarin):** Increased risk of bleeding.
* **Aspirin (low-dose):** May reduce the cardioprotective effect of aspirin. Avoid concurrent use if possible; if necessary, administer ibuprofen at least 8 hours before or 30 minutes after aspirin.
* **Corticosteroids:** Increased risk of GI ulceration and bleeding.
* **Diuretics, ACE inhibitors, ARBs:** May reduce antihypertensive and diuretic effects; increased risk of renal impairment.
* **Lithium:** May increase lithium levels.
* **Methotrexate:** May increase methotrexate toxicity.
* **SSRIs:** Increased risk of GI bleeding.
## Monitoring
* Signs and symptoms of GI bleeding (e.g., melena, hematemesis).
* Renal function (BUN, creatinine) and electrolytes, especially in patients with pre-existing renal disease or those on prolonged therapy.
* Liver function tests (AST, ALT), especially in patients with liver disease or those on prolonged therapy.
* Blood pressure.
* For pediatric PDA treatment: urine output, bleeding, platelet count, renal function.
## 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 disease or risk factors should use ibuprofen with caution.
* Discontinue if signs of renal toxicity (edema, oliguria) or hepatic toxicity (jaundice, elevated LFTs) occur.
* For pediatric use, accurate weight-based dosing is crucial.
***
*Disclaimer: This information is intended for healthcare professionals. Always consult the most current prescribing information and institutional protocols before administering any medication.*
