Ibuprofen for Adults

1. Introduction

Ibuprofen is a nonsteroidal anti-inflammatory drug (NSAID) used to relieve pain, reduce inflammation, and lower fever. It works by inhibiting cyclooxygenase (COX-1 and COX-2) enzymes, which decreases the production of prostaglandins responsible for pain, fever, and inflammation.

2. Indications

  • Approved Indications:
    • Mild to moderate pain (e.g., headache, toothache, menstrual pain, muscle pain).
    • Fever (pyrexia).
    • Inflammatory conditions (e.g., rheumatoid arthritis, osteoarthritis).
    • Postoperative pain.
  • Off-Label Uses:
    • Gout (acute flares).
    • Pericarditis (mild to moderate cases).

3. Dosage

  • Mild to Moderate Pain or Fever:
    • 200–400 mg every 4–6 hours as needed.
    • Maximum daily dose: 1200 mg (over-the-counter use) or 3200 mg (prescription use, under medical supervision).
  • Inflammatory Conditions (e.g., Rheumatoid Arthritis):
    • 400–800 mg three to four times daily, as prescribed by a doctor.
  • Dysmenorrhoea (Menstrual Pain):
    • 400 mg every 6–8 hours as needed.

4. Administration

  • Take orally with or after food or milk to minimise gastrointestinal irritation.
  • Swallow tablets or capsules whole with a full glass of water.
  • Do not lie down for at least 10 minutes after taking ibuprofen.

5. Forms Available

  • Tablets: 200 mg, 400 mg, 600 mg, 800 mg.
  • Capsules: 200 mg, 400 mg.
  • Liquid suspension: 100 mg/5 mL.
  • Topical gel: 5%, 10% (for localised pain).

6. Side Effects

6.1. Common Side Effects

  • Nausea.
  • Heartburn or indigestion.
  • Headache.
  • Dizziness.

6.2. Less Common Side Effects

  • Diarrhoea or constipation.
  • Flatulence or bloating.
  • Skin rash.

6.3. Rare but Serious Side Effects

  • Gastrointestinal bleeding or ulcers.
  • Cardiovascular events (e.g., heart attack, stroke, especially with long-term use).
  • Kidney dysfunction.
  • Severe allergic reactions (e.g., angioedema, anaphylaxis).

7. Warnings

  • Gastrointestinal Risks: Prolonged use may increase the risk of ulcers, bleeding, or perforation, especially in older adults.
  • Cardiovascular Risks: Long-term use or high doses may increase the risk of heart attack and stroke.
  • Renal Impairment: Use cautiously in patients with pre-existing kidney conditions or dehydration.

8. Precautions

  • Avoid use in:
    • Patients with a history of peptic ulcers or gastrointestinal bleeding.
    • Severe heart failure, renal disease, or liver disease.
    • Hypersensitivity to NSAIDs or aspirin.
  • Do not exceed the recommended dose to avoid serious side effects.

9. Interactions

  • Drug-Drug Interactions:
    • Anticoagulants (e.g., warfarin): Increased risk of bleeding.
    • ACE inhibitors/ARBs (e.g., lisinopril, losartan): May reduce antihypertensive effect and worsen kidney function.
    • Corticosteroids: Increased risk of gastrointestinal bleeding.
    • Aspirin: Ibuprofen may reduce the cardioprotective effect of low-dose aspirin.
  • Drug-Food Interactions:
    • Take with food or milk to reduce gastrointestinal side effects.

10. Monitoring Parameters

  • Pain relief and reduction of inflammation or fever.
  • Signs of gastrointestinal bleeding (e.g., black stools, vomiting blood).
  • Renal function (in long-term or high-dose use).

11. Use in Children

  • Not covered in this guide (see specific information for paediatric ibuprofen use).

12. Use in Pregnancy

  • First and Second Trimesters: Use only if necessary, and at the lowest effective dose.
  • Third Trimester: Avoid due to risks of premature closure of the ductus arteriosus and delayed labour.

13. Use in Elderly

  • Use cautiously due to increased risk of gastrointestinal bleeding, kidney dysfunction, and cardiovascular side effects. Start with the lowest effective dose and monitor closely.

14. Use in Kidney Disease

  • Use cautiously, as ibuprofen may reduce renal perfusion, especially in patients with pre-existing renal impairment. Avoid in severe kidney disease.

15. Use in Liver Disease

  • Use cautiously in patients with liver disease, as ibuprofen is metabolised in the liver. Dose adjustments may be necessary in severe cases.

16. Patient Counselling Points

  • Take ibuprofen with food or milk to reduce stomach upset.
  • Do not exceed the maximum daily dose, and do not use for more than 10 days without consulting a doctor.
  • Avoid alcohol, as it may increase the risk of stomach bleeding.
  • Report any signs of gastrointestinal bleeding (e.g., black or bloody stools) or unusual symptoms to your doctor.
  • Inform your doctor if you are taking any blood thinners, corticosteroids, or other medications.

17. Table of Brand Names, Manufacturers, and Prices

Brand NameManufacturerPrice (USD)
AdvilPfizer$5–10 (30 tablets, 200 mg)
MotrinJohnson & Johnson$5–12 (30 tablets, 200 mg)
Generic IbuprofenVarious manufacturers$3–8 (30 tablets, 200 mg)

18. FAQs (15 Questions)

  1. What is ibuprofen used for?
    It is used for pain relief, reducing inflammation, and lowering fever.
  2. How does ibuprofen work?
    It inhibits COX enzymes, reducing prostaglandin production, which alleviates pain, fever, and inflammation.
  3. How long does ibuprofen take to work?
    It starts working within 30 minutes to 1 hour, with maximum effect in 2–3 hours.
  4. Can I take ibuprofen on an empty stomach?
    It is best taken with food or milk to minimise gastrointestinal irritation.
  5. What is the maximum daily dose of ibuprofen for adults?
    For over-the-counter use, the maximum daily dose is 1200 mg. For prescription use, it may be up to 3200 mg/day under medical supervision.
  6. Can ibuprofen cause side effects?
    Yes, common side effects include nausea, heartburn, and dizziness. Rare but serious side effects include gastrointestinal bleeding and kidney problems.
  7. Is ibuprofen safe during pregnancy?
    It is not recommended during the third trimester. Consult your doctor for use in the first and second trimesters.
  8. Can I drink alcohol while taking ibuprofen?
    It is best to avoid alcohol, as it increases the risk of gastrointestinal bleeding.
  9. Can ibuprofen cause kidney problems?
    Yes, long-term or high-dose use may impair kidney function, particularly in people with pre-existing kidney issues.
  10. Is ibuprofen safe for elderly patients?
    Yes, but it should be used cautiously due to increased risks of side effects. Start with the lowest effective dose.
  11. Can I take ibuprofen with other painkillers?
    Avoid combining ibuprofen with other NSAIDs. However, it can be taken with paracetamol under medical advice.
  12. Can ibuprofen cause stomach ulcers?
    Prolonged use or high doses may increase the risk of stomach ulcers and bleeding.
  13. How long can I take ibuprofen for pain?
    It should not be taken for more than 10 days unless advised by a doctor.
  14. Does ibuprofen interact with other medications?
    Yes, it interacts with anticoagulants, corticosteroids, and certain antihypertensives.
  15. How should ibuprofen be stored?
    Store at room temperature, away from moisture and heat.