Classification
Analgesic
Antipyretic
Nonsteroidal anti-inflammatory
Indications
Mild to moderate pain (PO only)
PCP: Mild to moderate pain
PCP: Severe pain in a multimodal approach
Symptomatic pyrexia
Contraindications
- Hypersensitivity to ibuprofen or other nonsteroidal anti-inflammatory drugs
- Active GI hemorrhage or ulcers
- Pregnancy (first, second, or third trimesters)
Adult dosages
EMR: Analgesia
- 300-400 mg PO; may repeat every 4-6 hours; maximum daily dose 1,200 mg/day
PCP: Analgesia and antipyresis(Consider in symptomatic fever greater than 38°C (myalgias, chills, rigors))
- 300-400 mg PO; may repeat every 4-6 hours; maximum daily dose 1,200 mg/day
Pediatric Considerations And Dosing
Follow weight-based dosing
PCP: Analgesia and antipyresis (Consider in symptomatic fever greater than 38°C (fussiness, irritability, inability to soothe, etc))
- 10 mg/kg PO; may repeat once after 6 hours; maximum daily dose 40 mg/kg/day
Mechanism Of Action
Inhibits prostaglandin synthesis, reducing pain, inflammation, and pyrexia.
Pharmacokinetics
Oral:
- Analgesic effects:
- Onset: 30-60 minutes
- Peak: 1-2 hours
- Duration: 4-6 hours
- Antipyretic effects:
- Onset: 30 minutes to 2.5 hours
- Peak: 2-4 hours
- Duration: 6-8 hours
Adverse Effects
- The most common adverse reactions involve gastrointestinal upset, ranging from abdominal discomfort to gastric ulceration, bleeding, and perforation
- These events are unlikely following a single, out-of-hospital dose of ibuprofen, but care should be exercised in patients with a recent history of NSAID use
Overdose
The most common symptoms of NSAID overdose are gastrointestinal irritation and CNS depression. Care is primarily supportive.
Warning And Precautions
Alternative treatment options should be considered in patients with a history of gastrointestinal, renal, or significant cardiovascular disease: ibuprofen, and all NSAIDs, have the potential to cause significant adverse reactions. The risk appears to increase with dose, duration of therapy, and underlying risk factors.
Drug Interactions
As a class of medications, NSAIDs may raise blood pressure, limiting the effectiveness of antihypertensives.