Ibuprofen: Uses, Dosage, Side Effects, and More
1. Drug Name
Generic Name: Ibuprofen
Brand Name(s):
- Pakistan: Brufen, Calprofen
- India: Combiflam, Ibugesic
- United States: Advil, Motrin
- United Kingdom: Nurofen, Fenbid
2. Pharmacological Class
Class: Nonsteroidal Anti-inflammatory Drug (NSAID)
Subclass: Propionic Acid Derivative
3. Mechanism of Action
Ibuprofen inhibits the activity of cyclooxygenase (COX) enzymes, which are responsible for the synthesis of prostaglandins involved in inflammation, pain, and fever.
4. Indications
Primary Indications: Relief of mild to moderate pain (headache, dental pain, muscle pain), fever reduction, and inflammation.
Off-label Uses: Management of menstrual cramps, rheumatoid arthritis, and as an adjunct for severe pain.
5. Dosage and Administration
Standard Dosage:
- Adults: 200-800 mg every 4-6 hours, not to exceed 3200 mg per day.
- Children: 5-10 mg/kg per dose, every 6-8 hours, not to exceed 40 mg/kg per day.
Route of Administration: Oral (tablets, capsules), topical (gel), or rectal (suppositories).
Special Populations:
- Pediatric: Dosing is weight-based and age-based.
- Geriatric: Use lower doses to avoid adverse effects, particularly gastrointestinal bleeding and renal impairment.
6. Pharmacokinetics
Absorption: Ibuprofen is rapidly absorbed from the gastrointestinal tract.
Distribution: It is widely distributed throughout the body, including crossing the placenta and being excreted in breast milk.
Metabolism: Metabolized in the liver primarily by oxidation and conjugation.
Excretion: Excreted mainly through urine, with a small portion excreted in feces.
Half-life: Approximately 2 hours in adults.
7. Contraindications
Ibuprofen is contraindicated in patients with known hypersensitivity to ibuprofen or other NSAIDs, and in patients who have experienced asthma, urticaria, or allergic-type reactions after taking aspirin or other NSAIDs.
8. Warnings and Precautions
Use caution in patients with a history of gastrointestinal bleeding or perforation, hypertension, heart failure, renal impairment, and hepatic impairment.
Long-term use may increase the risk of serious cardiovascular thrombotic events, myocardial infarction, and stroke.
9. Side Effects
Common Side Effects: Nausea, heartburn, diarrhea, and abdominal pain.
Serious Side Effects: Gastrointestinal bleeding, renal impairment, and cardiovascular thrombotic events.
10. Drug Interactions
Major Interactions: Anticoagulants (warfarin), antiplatelet drugs (aspirin), selective serotonin reuptake inhibitors (SSRIs), and angiotensin converting enzyme (ACE) inhibitors.
Moderate Interactions: Diuretics, lithium, methotrexate, and cyclosporine.
Minor Interactions: Alcohol and certain antihypertensive drugs.
11. Pregnancy and Lactation
Pregnancy Category: Ibuprofen is generally not recommended during the third trimester of pregnancy due to potential risks to the fetus. Use in the first and second trimesters should be avoided if possible.
Breastfeeding Considerations: Ibuprofen is excreted in breast milk, but at usual doses, it is unlikely to cause harm to the nursing infant.
12. Patient Counseling Information
Key Points for Patients:
- Take ibuprofen exactly as directed on the label or as prescribed by your doctor.
- Do not exceed the recommended dose or duration of treatment.
- Inform your doctor about all other medications you are taking, including over-the-counter drugs and supplements.
Administration Tips:
- Take ibuprofen with food or milk to minimize stomach upset.
- Do not crush or chew extended-release tablets. Swallow them whole.