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BackIbuprofen Data - Uses, Dosage, Drug class, Brand name, Warnings, etc
| Pharmacology | Ibuprofen is an NSAID with analgesic and antipyretic properties. It is a nonselective inhibitor of cyclo-oxygenase-1 (COX-1) and cyclo-oxygenase-2 (COX-2) and reversibly alters platelet function and prolongs bleeding time. |
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| Administration and Adult Dosage |
- PO for mild to moderate pain: 400 mg every 4–6 hr as needed - PO for primary dysmenorrhea: 400 mg every 4 hr as needed - PO for rheumatoid arthritis and osteoarthritis: 400–800 mg 3–4 times daily, to a maximum of 3.2 g/day |
| Special Populations - Pediatric Dosage |
- PO for fever (6 months–12 yr): • 5 mg/kg for fever <102.5°F or 10 mg/kg for fever >102.5°F every 6–8 hr, to a maximum of 40 mg/kg/day - PO for pain (6 months–12 yr): 10 mg/kg every 6–8 hr as needed, to a maximum of 40 mg/kg/day - PO for juvenile arthritis: 30–40 mg/kg/day in 3–4 divided doses; 20 mg/kg/day for milder disease |
| Special Populations - Geriatric Dosage | Use minimal effective dosages; elderly are more susceptible to GI bleeding and acute renal insufficiency. |
| Dosage Forms |
- Capsule: 200, 400 mg - Chewable Tablet: 50, 100 mg - Tablet: 100, 200, 400, 600, 800 mg - Drops: 40 mg/mL - Suspension: 20, 40 mg/mL |
| Patient Instructions |
- Take with food, milk, or antacid to minimize stomach upset - Report symptoms of gastrointestinal ulceration or bleeding, skin rash, weight gain, or edema - Dizziness may occur; use caution until the extent of this effect is known |
| Missed Doses |
- If taken on a regular schedule, take a missed dose as soon as remembered - If near the time for the next dose, take that dose only; do not double the dose or take extra |
| Pharmacokinetics - Serum Levels |
- Antipyretic effect: 10 mg/L (48 µmol/L) - Toxicity (acute overdose): >200 mg/L (971 µmol/L) 1 hr post-ingestion may be associated with severe toxicity (apnea, metabolic acidosis, coma) |
| Pharmacokinetics - Fate |
- Absorption: Rapidly absorbed from the GI tract; bioavailability >80% - Peak Serum Levels (children): • 5 mg/kg: 17–42 mg/L (82–204 µmol/L) in 1.1 ± 0.3 hr • 10 mg/kg: 25–53 mg/L (121–257 µmol/L) in 1.1 ± 0.3 hr - Protein Binding: >99% - Metabolism: To at least 2 inactive metabolites - Distribution: Vd = 0.15 ± 0.02 L/kg, increased in cystic fibrosis - Clearance: Cl = 0.045 ± 0.012 L/hr/kg, increased in cystic fibrosis - Excretion: <1% unchanged in urine |
| Pharmacokinetics - t¹⁄₂ | - Elimination half-life: 2 ± 0.5 hr |
| Adverse Reactions & Side Effects |
Occasional: - Gastric distress, blood loss, diarrhea, vomiting, dizziness, skin rash - GI ulceration (higher risk in elderly and with higher dosages) - Fluid retention Other: - Renal dysfunction, particularly in pre-existing renal disease, CHF, or cirrhosis Rare: - Slight rise in bleeding time, elevated liver enzymes, lymphopenia, agranulocytosis, aplastic anemia, aseptic meningitis |
| Contraindications |
- Syndrome of nasal polyps - Angioedema - Bronchospastic reactivity to aspirin or other NSAIDs |
| Precautions & Warnings |
- Avoid during pregnancy - Use with caution in patients with pre-existing renal disease, CHF, cirrhosis, history of ulcer disease or bleeding, or risk factors for peptic ulcer disease (e.g., advanced age) |
| Drug Interactions |
- May inhibit antihypertensive response to ACE inhibitors, beta-blockers, diuretics, and hydralazine - May inhibit natriuretic effect of diuretics - Possible GI bleeding and antiplatelet effect increase bleeding risk during anticoagulant therapy - May decrease renal lithium clearance - Some NSAIDs (e.g., indomethacin, ketoprofen) reduce methotrexate clearance - NSAIDs may reduce renal function |
| Parameters to Monitor | - Monitor for blood loss, weight gain, and renal function during long-term use |
| Class and Drug Brand Name |
- Class: Analgesic and Anti-Inflammatory Drugs - Brand Names: Advil, Motrin, Nuprin, Various |
| Notes |
- Misoprostol is effective in preventing NSAID-associated GI ulceration - H2-receptor antagonists prevent duodenal but not gastric ulcerations and may mask symptoms of NSAID-induced GI ulceration - Proton-pump inhibitors (e.g., omeprazole) are effective in treating NSAID-related dyspepsia and preventing NSAID-induced ulcers |
References
Hand of Clinical Drug Data