Ibuprofen

Indications
Oral
Pain and inflammation
Adult: 1.2-1.8 g/day in divided doses. Maintenance: 0.6-1.2 g daily. Max: 2.4 g per day.
Oral
Juvenile idiopathic arthritis
Child: ≥3 mth and weighing >5 kg: 30-40 mg/kg/day in 3-4 divided doses. Max: 2.4 g/day.
Oral
Fever
Adult: 200-400 mg every 4-6 hr. Max: 1.2 g/day.
Child: 1-6 mth: 5 mg/kg 3-4 times daily, 6-12 mth: 50 mg 3 times daily, 1-2 yr: 50 mg 3-4 times daily, 2-7 yr: 100 mg 3-4 times daily, >7 yr: 200 mg 3-4 times daily. Max: 40 mg/kg/day.
Intravenous
Closure of patent ductus arteriosus
Child: Given as three IV doses infused over 15 minutes at 24-hr intervals. Initially 10 mg/kg followed by two doses of 5 mg/kg. A second course may be given if ductus remains open after 48 hr. Surgery may be required if neonate is unreponsive to 2 courses of treatment. Dose should be based on birth weight.
Topical/Cutaneous
Pain and inflammation associated with musculoskeletal and joint disorders
Adult: As 5% or 10% gel: Apply onto affected area.

Special Populations: Dose reduction in renal and hepatic impairment. Patients who developed severe mucositis during the 1st course of therapy: Reduce the 2nd course dose to 25%.
Contraindications
Active peptic ulcer; hypersensitivity. Neonates with congenital heart disease, suspected necrotising enterocolitis and active bleeding (parenteral).
Warnings / Precautions
Asthma; renal or hepatic disorders; bleeding disorders; CV disease. Pregnancy, lactation.
Adverse Reactions
Oral: Dyspepsia, vomitting, abdominal pain, heart burn, nausea, diarrhoea, epigastric pain, edema, fluid retention, dizziness, rash, tinnitus. Parenteral: Intraventricular hemorrhage, skin irritation, hypocalcemia, hypoglycemia, GI disorders, anemia, apnea, respiratory infection, sepsis.
Potentially Fatal: Severe CV thrombotic events. Severe GI bleeding, ulceration and perforation.
Overdose Reactions
Symptoms: Apnoea, metabolic acidosis, coma, nystagmus, seizures, leukocytosis and renal failure. Management: Supportive and symptomatic. Multiple doses of charcoal may be required.
Drug Interactions
Reduces effects of antihypertensives. Enhanced effect with moclobemide. Increased risk of GI bleeding with warfarin.
Potentially Fatal: Reduces antiplatelet effect of aspirin. Increases risk of methotrexate and lithium toxicity.
See Below for More ibuprofen Drug Interactions
Food Interactions
Decreased peak serum levels if taken with food.
Mechanism of Actions
Ibuprofen exhibits anti-inflammatory, analgesic and antipyretic activities. Its analgesic effect is independent of anti-inflammatory activity and has both central and peripheral effects. It potently inhibits the enzyme cyclooxygenase resulting in the blockage of prostaglandin synthesis. It also prevents formation of thromboxane A2 by platelet aggregation.
Onset: Analgesic: 30-60 min. Anti-inflammatory: ≤7 days.
Duration: 4-6 hr.
Absorption: Oral: Peak plasma concentrations after 1-2 hr. Topical: Minimal.
Distribution: Protein-binding: 90-99%.
Metabolism: Hepatic via oxidation.
Excretion: Via urine (1% as free drug), some feces; 2 hr (plasma half-life).
Administration
Should be taken with food.
Storage Conditions
Intravenous: Store at room temperature of 20-25°C (68-77°F). Oral: Cap/Gelcap/Tab: Store at room temperature of 20-25°C (68-77°F). Susp/Drops: Store at room temperature of 15-30°C (59-86°F).
ATC Classification
C01EB16 - ibuprofen ; Belongs to the class of other cardiac preparations.
G02CC01 - ibuprofen ; Belongs to the class of antiinflammatory products for vaginal administration used in the treatment and prevention of inflammation.
M01AE01 - ibuprofen ; Belongs to the class of propionic acid derivatives of non-steroidal antiinflammatory and antirheumatic products.
M02AA13 - ibuprofen ; Belongs to the class of non-steroidal antiinflammatory preparations for topical use. Used in the treatment of joint and muscular pains.
Storage
Intravenous: Store at room temperature of 20-25°C (68-77°F). Oral: Cap/Gelcap/Tab: Store at room temperature of 20-25°C (68-77°F). Susp/Drops: Store at room temperature of 15-30°C (59-86°F).
Available As
  • Ibuprofen 100 mg
  • Ibuprofen IP 100 mg
  • Ibuprofen 125 mg
  • Ibuprofen 200 mg
  • Ibuprofen IP 200 mg
  • Ibuprofen 300 mg
  • Ibuprofen 325 mg
  • Ibuprofen IP 325 mg
  • Ibuprofen 400 mg
  • Ibuprofen IP 400 mg
  • Ibuprofen 425 mg
  • Ibuprofen 50 mg
  • Ibuprofen 600 mg
  • Ibuprofen 75 mg
  • Ibuprofen 800 mg
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    Drug - Drug Interactions of Ibuprofen

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