IBUPROFEN
(eye-byoo'proe-fen)
Advil, Amersol , Children's Motrin, Ibuprin, Junior Strength Motrin Caplets, Medipren, Motrin, Nuprin, Pediaprofen, Pamprin-IB, Rufen, Trendar
Classifications: central nervous system agent; nsaid (cox-1); analgesic; antipyretic
Pregnancy Category: B

Availability

100 mg, 200 mg, 400 mg, 600 mg, 800 mg tablets; 50 mg, 100 mg chewable tablets;; 100 mg/5 mL, 100 mg/2.5 mL suspension; 40 mg/mL drops

Actions

Prototype of the propionic acid NSAIDs (cox-1) inhibitor with nonsteroidal antiinflammatory activity and significant antipyretic and analgesic properties. Blocks prostaglandin synthesis. Ibuprofen activity also includes modulation of T-cell function, inhibition of inflammatory cell chemotaxis, decreased release of superoxide radicals, or increased scavenging of these compounds at inflammatory sites.

Therapeutic Effects

Has nonsteroidal antiinflammatory, analgesic, and antipyretic effects. Inhibits platelet aggregation and prolongs bleeding time but does not affect prothrombin or whole blood clotting times. Cross-sensitivity with aspirin and other nonsteroidal antiinflammatory drugs has been reported.

Uses

Chronic, symptomatic rheumatoid arthritis and osteoarthritis; relief of mild to moderate pain; primary dysmenorrhea; reduction of fever.

Unlabeled Uses

Gout, juvenile rheumatoid arthritis, psoriatic arthritis, ankylosing spondylitis, vascular headache.

Contraindications

Patient in whom urticaria, severe rhinitis, bronchospasm, angioedema, nasal polyps are precipitated by aspirin or other NSAIDs; active peptic ulcer, bleeding abnormalities. Safe use during pregnancy (category B), lactation, or children <6 mo is not established.

Cautious Use

Hypertension, history of GI ulceration, impaired hepatic or renal function, chronic renal failure, cardiac decompensation, patients with SLE.

Route & Dosage

Inflammatory Disease
Adult: PO 400–800 mg t.i.d. or q.i.d. (max: 3200 mg/d)
Child: PO <20 kg, up to 400 mg/d in divided doses; 20–30 kg, up to 600 mg/d in divided doses; 30–40 kg, up to 800 mg/d in divided doses

Mild to Moderate Pain, Dysmenorrhea
Adult: PO 400 mg q4–6h up to 1200 mg/d

Fever
Adult: PO 200–400 mg t.i.d. or q.i.d. (max: 1200 mg/d)
Child: PO 6 mo–12 y, 5–10 mg/kg q4–6h up to 40 mg/kg/d

Administration

Oral

Adverse Effects (1%)

CNS: Headache, dizziness, light-headedness, anxiety, emotional lability, fatigue, malaise, drowsiness, anxiety, confusion, depression, aseptic meningitis. CV: Hypertension, palpitation, congestive heart failure (patient with marginal cardiac function); peripheral edema. Special Senses: Amblyopia (blurred vision, decreased visual acuity, scotomas, changes in color vision); nystagmus, visual-field defects; tinnitus, impaired hearing. GI: Dry mouth, gingival ulcerations, dyspepsia, heartburn, nausea, vomiting, anorexia, diarrhea, constipation, bloating, flatulence, epigastric or abdominal discomfort or pain, GI ulceration, occult blood loss. Hematologic: Thrombocytopenia, neutropenia, hemolytic or aplastic anemia, leukopenia; decreased Hgb, Hct; transitory rise in AST, ALT, serum alkaline phosphatase; rise in (Ivy) bleeding time. GU: Acute renal failure, polyuria, azotemia, cystitis, hematuria, nephrotoxicity, decreased creatinine clearance. Skin: Maculopapular and vesicobullous skin eruptions, erythema multiforme, pruritus, rectal itching, acne. Body as a Whole: Fluid retention with edema, Stevens-Johnson syndrome, toxic hepatitis, hypersensitivity reactions, anaphylaxis, bronchospasm, serum sickness, SLE, angioedema.

Interactions

Drug: oral anticoagulants, heparin may prolong bleeding time; may increase lithium and methotrexate toxicity. Herbal: Feverfew, garlic, ginger, ginkgo may increase bleeding potential.

Pharmacokinetics

Absorption: 80% absorbed from GI tract. Onset: 1 h antipyretic effect. Peak: 1–2 h. Duration: 6–8 h. Metabolism: Metabolized in liver. Elimination: Excreted primarily in urine; some biliary excretion. Half-Life: 2–4 h.

Nursing Implications

Assessment & Drug Effects

Patient & Family Education


Common adverse effects in italic, life-threatening effects underlined; generic names in bold; classifications in SMALL CAPS; Canadian drug name; Prototype drug