Ibuprofen

Ibuprofen is an anti-steroidal anti-inflammatory drug, an NSAID. As an NSAID, indomethacin is an analgesic, anti-inflammatory and antipyretic. It is used in the management of mild to moderate pain and inflammation in conditions such as dysmenorrhea, migraine, postoperative pain, dental pain, musculoskeletal and joints disorders including ankylosing spondylitis, osteoarthritis and rheumatoid arthritis. Also for soft-tissue disorders such as sprains and strains. It can also reduce fever.

Generic Name 藥名	HA Code 藥物代碼	Classification藥物分類
Ibuprofen Tablet 200 mg		Part 1 Poison
Ibuprofen Tablet 400 mg		Part 1 Poison

Mechanism of Action

Non-opioid Analgesic (NSAID) Anti-inflammatory agent Nonselective COX inhibitor

Dosage

Usual oral dose for painful conditions:

Oral: 400 to 600 mg every 4 to 6 hours to a maximum of 2.4 g daily.

Intravenous infusion: 400 to 800 mg every 6 hours as necessary.

Topical: applied as a 5% cream, foam, gel or spray solution.

The recommended dose for fever reduction:

Oral: 200 to 400 mg every 4 to 6 hours to a maximum of 1.2 g daily.

Administration in children

Given according to age for the treatment of pain, inflammation of soft-tissue injuries or fever in children:

• 1 to 2 months: 5 mg/kg 3 or 4 times daily
• 3 to 5 months: 50 mg 3 times daily
• 6 to 11 months: 50 mg 3 or 4 times daily
• 1 to 3 years: 100 mg 3 times daily
• 4 to 6 years: 150 mg 3 times daily
• 7 to 9 years: 200 mg 3 times daily
• 10 to 11 years: 300 mg 3 times daily
• 12 to 17 years: initially 300 to 400 mg 3 or 4 times daily, if necessary, to a maximum of 2.4 g daily.
• For more severe symptoms in children aged between 3 months and 11 years, a dose of 30 mg/kg (maximum 2.4 g) daily in 3 or divided doses may be given.

Side Effects

NSAIDs in general

Common side effects include heartburn, nausea, dyspepsia, diarrhea, constipation, gastrointestinal ulceration/bleeding, headache, dizziness, rash, salt and fluid retention, and high blood pressure.

It increases the risk of heart attack, stroke, kidney failure and liver failure.

Ibuprofen can also worsen asthma.

Cardiovascular risk

Chronic ibuprofen use has been found correlated with risk of progression to hypertension and myocardial infarction (heart attack). Both the U.S. Food and Drug Administration (FDA) and The European Medicines Agency (EMA) issues warnings of increased heart attack and stroke risk in 2015.

Skin

Along with other NSAIDs, ibuprofen has been associated with the onset of bullous pemphigoid.

Pharmacokinetics

After oral administration, peak serum concentration is reached after 1-2 hours and up to 99% of the drug is bound to plasma proteins. The majority of ibuprofen is metabolized and eliminated within 24 hours in the urine; however, 1% of the unchanged drug is removed through biliary excretion.

Drug Management

Efficiency

Pain and inflammation control

Safety

Monitor signs of bleeding and bruising, and blood pressure.

Drug Interaction

Interactions involving NSAIDs include

• enhancement of the effects of oral anticoagulants
• increased plasma concentrations of lithium, methotrexate and cardiac glycosides
• Risk of nephrotoxicity may be increased if given with ACE inhibitors, ciclosporin, tacrolimus or diuretics
• Antihypertensive effects of ACEIs, beta blockers and diuretics may be reduced
• Use of more than one NSAID together (including aspirin) should be avoided because of the increased risk of adverse effects
• The risk of gastrointestinal bleeding and ulceration is increased when used with steroids, the SSRIs, the SNRI venlafaxaine, the antiplatelet clopidogrel, bisphosphonates or pentoxifylline
• Co-administration of ACE inhibitor can increase risk of kidney problem and increase hypotensive effect.
• Aspirin.

Caution

• Allergic reaction,
• Previous peptic ulcer
• uncontrolled hypertension,
• Impaired renal function

Contraindication

• Active peptic ulcer
• patient with severe renal impairment.

FAQ

How should I take the tablet?

Follow the doctor's prescription Take with food if ibuprofen upsets your stomach.

What should I avoid while taking?

Avoid alcohol consumption.

What happen if I overdose?

Contact your primary care doctor. If emergency situation, call 999

What happen if I miss a dose?

Take it as soon as you remember. If it is near the time of the next dose, skip the missed dose. Take your next dose at the regular time. Do not double the dose to catch up.