Pharmacy Author: Omudhome Ogbru, PharmD
Medical and Pharmacy Editor: Jay W. Marks, MD
GENERIC NAME: ibuprofen
BRAND NAME: Advil, Children's Advil/Motrin, Medipren,
Motrin, Nuprin, PediaCare Fever etc.
DRUG CLASS AND MECHANISM: Ibuprofen belongs
to a class of drugs called non-steroidal anti-inflammatory drugs (NSAIDs). Other
members of this class include aspirin, naproxen (Aleve), indomethacin (Indocin),
nabumetone (Relafen) and several others. These drugs are used for the management
of mild to moderate pain, fever, and inflammation. Pain, fever, and inflammation
are promoted by the release in the body of chemicals called prostaglandins.
Ibuprofen blocks the enzyme that makes prostaglandins
(cyclooxygenase), resulting in lower levels of prostaglandins. As a consequence,
inflammation, pain and fever are reduced. The FDA approved ibuprofen in 1974.
PRESCRIPTION: Yes
GENERIC AVAILABLE: Yes
PREPARATIONS: Tablets of 200, 400, 600, and 800 mg; Chewable tablets of 50
and 100 mg; Capsules of 200 mg; Suspension of 100 mg/2.5 ml and 100 mg/5 ml;
Oral drops of 40 mg/ml.
STORAGE: Ibuprofen should be stored at room temperature, between 15-30°C
(59-86°F).
PRESCRIBED FOR: Ibuprofen is used for the treatment of mild to
moderate pain, inflammation and fever caused by many and diverse diseases.
DOSING: For minor aches, mild to moderate pain, menstrual cramps, and fever,
the usual adult dose is 200 or 400 mg every 4 to 6 hours.
Arthritis is treated
with 300 to 800 mg 3 or 4 times daily.
When under the care of a physician, the
maximum dose of ibuprofen is 3.2 g daily. Otherwise, the maximum dose is 1.2 g
daily. Individuals should not use ibuprofen for more than 10 days for the
treatment of pain or more than 3 days for the treatment of a fever unless
directed by a physician.
Children 6 months to 12 years of age usually are given
5-10 mg/kg of ibuprofen every 6-8 hours for the treatment of fever and pain. The
maximum dose is 40 mg/kg daily.
Juvenile arthritis is treated with 20 to 40
mg/kg/day in 3-4 divided doses.
Ibuprofen should be taken with meals to prevent
stomach upset.
DRUG INTERACTIONS: Ibuprofen is associated with several suspected or probable
interactions that can affect the action of other drugs. Ibuprofen may increase
the blood levels of lithium (Eskalith) by reducing the excretion of lithium by
the kidneys. Increased levels of lithium may lead to lithium toxicity. Ibuprofen
may reduce the blood pressure-lowering effects of drugs that are given to reduce
blood pressure. This may occur because prostaglandins play a role in the
regulation of blood pressure. When ibuprofen is used in combination with
aminoglycosides [for example, gentamicin
(Garamycin)] the blood levels of the aminoglycoside may
increase, presumably because the elimination of aminoglycosides from the body is
reduced. This may lead to aminoglycoside-related side effects. Individuals
taking oral blood thinners or anticoagulants [for example, warfarin
(Coumadin)] should
avoid ibuprofen because ibuprofen also thins the blood, and excessive blood
thinning may lead to bleeding.
PREGNANCY: There are no adequate studies of ibuprofen in
pregnant women.
Therefore, ibuprofen is not recommended during pregnancy. Ibuprofen should be
avoided in late pregnancy due to the risk of premature closure of the ductus
arteriosus in the fetal heart..
NURSING MOTHERS: Ibuprofen is not excreted in breast milk. Use of ibuprofen
while breastfeeding, poses little risk to the infant.
SIDE EFFECTS: The most common side effects from ibuprofen are rash,
ringing
in the ears, headaches, dizziness, drowsiness, abdominal pain,
nausea, diarrhea,
constipation and
heartburn. NSAIDs reduce the ability of blood to clot and
therefore increase bleeding after an injury. Ibuprofen may cause ulceration of
the stomach or intestine, and the ulcers may bleed. Sometimes, ulceration can
occur without abdominal pain, and black, tarry stools, weakness, and dizziness
upon standing (orthostatic hypotension) due to bleeding may be the only signs of
an ulcer. NSAIDs reduce the flow of blood to the kidneys and impair function of
the kidneys. The impairment is most likely to occur in patients who already have
impaired function of the kidney or congestive heart failure, and use of NSAIDs
in these patients should be cautious. People who are allergic to other NSAIDs,
including aspirin, should not use ibuprofen. Individuals with asthma are more
likely to experience allergic reactions to ibuprofen and other NSAIDs. Fluid
retention (edema), blood clots,
heart attacks,
hypertension and heart failure
have also been associated with the use of NSAIDs.
Last Editorial Review: 8/28/2007
Report Problems to the Food and Drug Administration
You are encouraged to report negative side effects of prescription drugs to the FDA. Visit the FDA MedWatch website or call 1-800-FDA-1088.
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