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 Name | Manufacturer | Price (USD) |
---|---|---|
Advil | Pfizer | $5–10 (30 tablets, 200 mg) |
Motrin | Johnson & Johnson | $5–12 (30 tablets, 200 mg) |
Generic Ibuprofen | Various manufacturers | $3–8 (30 tablets, 200 mg) |
18. FAQs (15 Questions)
- What is ibuprofen used for?
It is used for pain relief, reducing inflammation, and lowering fever. - How does ibuprofen work?
It inhibits COX enzymes, reducing prostaglandin production, which alleviates pain, fever, and inflammation. - How long does ibuprofen take to work?
It starts working within 30 minutes to 1 hour, with maximum effect in 2–3 hours. - Can I take ibuprofen on an empty stomach?
It is best taken with food or milk to minimise gastrointestinal irritation. - 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. - 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. - Is ibuprofen safe during pregnancy?
It is not recommended during the third trimester. Consult your doctor for use in the first and second trimesters. - Can I drink alcohol while taking ibuprofen?
It is best to avoid alcohol, as it increases the risk of gastrointestinal bleeding. - Can ibuprofen cause kidney problems?
Yes, long-term or high-dose use may impair kidney function, particularly in people with pre-existing kidney issues. - 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. - Can I take ibuprofen with other painkillers?
Avoid combining ibuprofen with other NSAIDs. However, it can be taken with paracetamol under medical advice. - Can ibuprofen cause stomach ulcers?
Prolonged use or high doses may increase the risk of stomach ulcers and bleeding. - How long can I take ibuprofen for pain?
It should not be taken for more than 10 days unless advised by a doctor. - Does ibuprofen interact with other medications?
Yes, it interacts with anticoagulants, corticosteroids, and certain antihypertensives. - How should ibuprofen be stored?
Store at room temperature, away from moisture and heat.