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Pharmacy Author: Omudhome Ogbru, Pharm.D.
Medical Editor: Jay Marks, M.D.
GENERIC NAME: ibuprofen
BRAND NAME: Advil, Children's Advil/Motrin, Medipren, Motrin, Nuprin, Pediacare Fever etc.
DRUG CLASS AND MECHANISM: Ibuprofen belongs to a class of drugs called non-steroidal anti-inflammatory drugs (NSAIDs). Other members of this class include naproxen (Aleve), indomethacin (Indocin), nabumetone (Relafen) and several others. These drugs are used for the management of mild to moderate pain, fever, and inflammation. Prostaglandins are chemicals that are made by the body and are responsible for causing pain, fever and inflammation. Ibuprofen blocks the enzyme that makes prostaglandins (cyclooxygenase), resulting in lower levels of prostaglandins. As a consequence, inflammation, pain and fever are reduced. The FDA approved ibuprofen in 1974.
PRESCRIPTION: Yes and no
GENERIC AVAILABLE: Yes
PREPARATIONS: Tablets of 200, 400, 600, and 800 mg; Chewable tablets of 50 and 100 mg; Capsules of 200 mg; Suspension of 100 mg/2.5 ml and 100 mg/5 ml; Oral drops of 40 mg/ml.
STORAGE: Ibuprofen should be stored at room temperature, between 15-30°C (59-86°F).
PRESCRIBED FOR: Ibuprofen is used for the treatment of mild to moderate pain, inflammation and fever.
DOSING: For minor aches, mild to moderate pain, menstrual cramps and fever the usual adult dose is 200 or 400 mg every 4 to 6 hours. Arthritis is treated with 300 to 800 mg 3 or 4 times daily. When under the care of a physician, the maximum dose of ibuprofen is 3.2 g daily. Otherwise, the maximum dose is 1.2 g daily. Individuals should not use ibuprofen for more than 10 days for the treatment of pain or more than 3 days for the treatment of a fever unless directed by a physician.
Children 6 months to 12 years of age usually are given 5-10 mg/kg of ibuprofen every 6-8 hours for the treatment of fever and pain. The maximum dose is 40 mg/kg daily. Juvenile arthritis is treated with 20 to 40 mg/kg/day in 3-4 divided doses.
Ibuprofen should be taken with meals.
DRUG INTERACTIONS: Ibuprofen is associated with several suspected or probable interactions that can affect the action of other drugs. Ibuprofen may increase the blood levels of lithium (Eskalith) by reducing the excretion of lithium by the kidneys. Increased levels of lithium may lead to lithium toxicity. Ibuprofen may reduce the blood pressure-lowering effects of drugs that are given to reduce blood pressure. This may occur because prostaglandins play a role in the regulation of blood pressure. When ibuprofen is used in combination with aminoglycosides (e.g., gentamicin) the blood levels of the aminoglycoside may increase, presumably because the elimination of aminoglycosides from the body is reduced. This may lead to aminoglycoside-related side effects. Individuals taking oral blood thinners or anticoagulants (e.g., warfarin) should avoid ibuprofen because ibuprofen also thins the blood, and excessive blood thinning may lead to bleeding.
PREGNANCY: There are no adequate studies of ibuprofen in pregnant women. Therefore, ibuprofen is not recommended during pregnancy.
NURSING MOTHERS: Most NSAIDs are excreted in breast milk. In general, mothers who breast feed should avoid the use of NSAIDs because of possible effects on the fetus.
SIDE EFFECTS: The most common side effects from ibuprofen are rash, ringing in the ears, headaches, dizziness, drowsiness, abdominal pain, nausea, diarrhea, constipation and heartburn. Ibuprofen may cause ulceration of the stomach or intestine, and the ulcers may bleed. Sometimes, ulceration and bleeding can occur without abdominal pain, and black tarry stools, weakness, and dizziness upon standing (orthostatic hypotension) may be the only signs of a problem. NSAIDs reduce the flow of blood to the kidneys and impair function of the kidneys. The impairment is most likely to occur in patients with preexisting impairment of kidney function or congestive heart failure, and use of NSAIDs in these patients should be done cautiously. People who are allergic to other NSAIDs, including aspirin, should not use ibuprofen. Individuals with asthma are more likely to experience allergic reactions to ibuprofen and other NSAIDs.