What is Ibuprofen?
Ibuprofen is a drug used as antipyretic, analgesic and anti-inflammatory. The product ingredients are: Ibuprofen aluminum, Ibuprofen lysine, Ibuprofen potassium, Ibuprofen sodium.
The brand names of Ibuprofen in the United States are: Advil, Motrin, IBU, Motrin IB.
Ibuprofen Mechanism of Action (MOA)
Inhibition of prostaglandin synthesis at the peripheral level.
Therapeutic Indications, uses and benefits of Ibuprofen
– Oral route: rheumatoid arthritis (including juvenile rheumatoid arthritis), ankylosing spondylitis, osteoarthritis and other acute or chronic rheumatic processes.
Musculoskeletal and traumatic alterations with pain and inflammation.
Symptomatic treatment of mild or moderate pain (dental pain, post-surgical pain, headache, migraine).
Primary dysmenorrhoea.
Febrile pictures.
– Intravenous: short-term symptomatic treatment of moderate pain and fever, when intravenous administration is clinically justified and other routes of administration are not possible.
Dosage of Ibuprofen
Oral
Adults:
– Painful processes of mild-moderate intensity and febrile episodes: 200-400 mg/4-6 h or 400 mg/6-8 h; max. 1200 mg/day or 600 mg/6-8 h; max. 2400 mg/day.
– Rheumatoid arthritis: 1200-1800 mg/day; maintenance: 800-1200 mg/day; max. 2400 mg/day.
– Dysmenorrhoea 1 aria : 400 mg until pain relief; max. 1200 mg/day.
Retard “600” tablets: 600 mg/12 h; ads. max. 2400 mg/day. Adolescents 12-18 years: 1600 mg/day.
Tablets Extended release “800”: adults and children from 12 years: 1600 mg/day (single dose). In serious or acute situations: 2400 mg/day (800 mg/morning and 1600 mg/late).
Children:
– Symptomatic relief of occasional mild or moderate pain and febrile episodes: 3 months-12 years: 20-30 mg/kg/day in 3-4 doses, the interval between doses will depend on the evolution of symptoms, but will never be less than 4 hours.
– Juvenile rheumatoid arthritis: max. 40 mg/kg/day.
Mild-moderate renal insufficiency and/or mild-moderate hepatic insufficiency, reduce dose.
Intravenous
Adults:
– Treatment of moderate pain and fever: recommended daily dose: 1200-1600 mg in multiple doses. 400-600 mg/6-8 h as necessary, not to exceed the maximum daily dose of 2400 mg in multiple doses. Use the lowest effective dose and for the shortest possible time according to the needs of each patient.
Method of administration for Ibuprofen
Oral use: Administer with food or milk especially if digestive discomfort is noted.
Intravenous: Administer as an intravenous perfusion for 30 min.
Contraindications of Ibuprofen
Hypersensitivity to ibuprofen or other NSAIDs.
History of bronchospasm, asthma, rhinitis, angioedema, or urticaria associated with consumption of NSAIDs or other NSAIDs.
History of gastrointestinal bleeding or perforation related to prior treatment with NSAIDs, active or recurrent peptic ulcer/gastrointestinal bleeding (2 or more different episodes of proven ulceration or bleeding), or history of recurrent peptic ulcer/hemorrhage.
Active inflammatory bowel disease.
Severe renal failure.
Grave liver failure.
Severe heart failure.
Hemorrhagic diathesis or other coagulation disorders.
Third trimester of gestation.
Cerebrovascular or other active bleeding, coronary disorders; severe dehydration (caused by vomiting, diarrhea, or insufficient fluid intake).
Also intravenous: perioperative pain from coronary artery bypass graft adjustment surgery.
Warnings and precautions with Ibuprofen
Mild-moderate liver failure (reduce initial dose), mild-moderate kidney failure (reduce initial dose), elderly, children with severe dehydration.
History of: ulcerative colitis, Crohn’s disease, High blood pressure (BPH) and/or heart failure, bronchial asthma, allergic reactions, hematopoietic disorders, systemic lupus erythematosus, mixed connective tissue disease.
Risk of gastrointestinal bleeding, ulcer or perforation is greatest when increasing doses of NSAIDs are used, with a history of ulcers and the elderly.
Concomitant with oral dicumarinic anticoagulants, platelet antiaggregants of type AAS, oral corticoids and SSRIs as they could increase the risk of ulcer or gastrointestinal bleeding.
Assess risk/benefit in: BPH, CHF, established coronary artery disease, peripheral artery disease and/or cerebrovascular disease, acute intermittent porphyria.
In long-term (mainly if high doses are required) with known cardiovascular risk factors (BPH, hyperlipidemia, diabetes mellitus, smokers), with severe cardiac pathology such as cardiac insufficiency (New York Heart Association-NYHA classification II-IV), established ischemic heart disease, peripheral arterial disease or stroke, avoid doses of 2400 mg/day or higher; as they are associated with an increased risk of arterial thrombosis.
May mask symptoms of infections (avoid in case of chickenpox). Control to submitted to major surgery. Renal, hepatic and hematological control.
Risk of serious skin reactions at the onset of treatment.
Use minimum effective doses for the shortest possible time to minimize adverse reactions. May alter female fertility affecting ovulation.
Via IV also: control at the beginning of perfusion, for possible anaphylactic reactions / hypersensitivity.
Children, safety not established.
Liver failure
Contraindicated in severe liver failure. Caution in mild-moderate liver failure, reduce initial dose.
Renal insufficiency
Contraindicated in severe renal failure. Caution in mild-moderate renal insufficiency, reduce initial dose.
Interactions with Ibuprofen
- Increased risk of gastrointestinal ulcer and bleeding with: NSAIDs, dicumarinic-type oral anticoagulants, AAS-type platelet antiaggregants, oral corticosteroids and SSRIs.
- Reduces efficacy of: furosemide, thiazide diuretics.
- Reduces hypotensive effect of: ß-blockers, ACEi, angiotensin II antagonists.
- Risk of hyperkalemia with: potassium-sparing diuretics.
- Reduces effect of: mifepristone.
- Increases plasma levels of: digoxin, phenytoin and lithium.
- Increases toxicity of: methotrexate, hydantoins, sulfonamides, baclofen.
- Potential gastrointestinal lesions with: salicylates, phenylbutazone, indomethacin and other NSAIDs.
- Increases effect of: oral hypoglycemic and insulin.
- Additive effect on platelet inhibition with: ticlopidine.
- Increases risk of hematotoxicity of: zidovudine.
- Bleeding time potency of: anticoagulants.
- Increases risk of nephrotoxicity with: tacrolimus, cyclosporine.
- Increased risk of hemorrhage and gastrointestinal ulcer with: corticosteroids, bisphosphonates or oxypentiphiline, selective cyclooxygenase-2 inhibitors.
- Risk of bleeding with: ginkgo biloba, thrombolytics.
- Plasma concentrations increased by: probenecid and sulfinpirazone.
- Effect decreased by: ion exchange resins (cholestyramine).
- Toxicity potency of: tacrine.
- Potency of the nephrotoxic effect of: aminoglycosides.
Pregnancy and Ibuprofen
Not recommended in the first and second trimester of pregnancy unless absolutely necessary.
Contraindicated third trimester of pregnancy, due to premature closure of the ductus arteriosus, increased risk of maternal-fetal haemorrhage and possible decrease in uterine contractility.
Breastfeeding
Ibuprofen and its metabolites pass in low concentrations into breast milk.
To date there are no known harmful effects in children, so it is generally not necessary to stop breastfeeding for a short course of treatment with the recommended dose for pain and fever.
Effects on driving ability
Patients who experience dizziness, lightheadedness, visual disturbances, or other disorders of the central nervous system while taking ibuprofen should refrain from driving or operating machinery.
If a single dose of ibuprofen is administered or for a short period of time, no precautions are necessary.
Adverse reactions and side effects of Ibuprofen
Peptic ulcer, perforation and gastrointestinal bleeding, nausea, vomiting, diarrhea, flatulence, constipation, dyspepsia, abdominal pain, mane, hematemesis, ulcerative stomatitis, exacerbation of ulcerative colitis and Crohn’s disease.
Fatigue or drowsiness, headache, dizziness; vertigo; rash; pain and burning sensation at the injection site.
⭐⭐⭐⭐⭐ VIDEO OF IBUPROFEN/ADVIL (DRUG)
Source: The content of this active ingredient has been written taking into account the clinical and molecular information of all medicines authorised and marketed in the United States under the Unique Ingredient Identifier (UNII) by the Substance Registration System (SRS) of the Food and Drug Administration (FDA) and the United States Pharmacopeia (USP).
In order to know in detail the information authorized by the FDA for each drug, you should consult the corresponding medication guide authorized by the FDA.
Resources:
UNII: WK2XYI10QM
ChemIDplus
DrugPortal
PubChem CID: 3672
NCI Thesaurus: C561