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
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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
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.
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.
Chronic, symptomatic rheumatoid arthritis and osteoarthritis; relief of mild to moderate pain; primary dysmenorrhea; reduction
of fever.
Gout, juvenile rheumatoid arthritis, psoriatic arthritis, ankylosing spondylitis, vascular headache.
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.
Hypertension, history of GI ulceration, impaired hepatic or renal function, chronic renal failure, cardiac decompensation,
patients with SLE.
Inflammatory Disease Adult: PO 400800 mg t.i.d. or q.i.d. (max: 3200 mg/d) Child: PO <20 kg, up to 400 mg/d in divided doses; 2030 kg, up to 600 mg/d in divided doses; 3040 kg, up to 800 mg/d in divided doses
Mild to Moderate Pain, Dysmenorrhea Adult: PO 400 mg q46h up to 1200 mg/d
Fever Adult: PO 200400 mg t.i.d. or q.i.d. (max: 1200 mg/d) Child: PO
6 mo12 y, 510 mg/kg q46h up to 40 mg/kg/d
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Oral
- Give on an empty stomach, 1 h before or 2 h after meals. May be taken with meals or milk if GI intolerance occurs.
- Ensure that chewable tablets are chewed or crushed before being swallowed.
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Note: Tablet may be crushed if patient is unable to swallow it whole and mixed with food or liquid before swallowing.
- Store in tightly closed, light-resistant container unless otherwise directed by manufacturer.
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.
Drug:
oral anticoagulants, heparin may prolong bleeding time; may increase lithium and methotrexate toxicity. Herbal:
Feverfew,
garlic,
ginger,
ginkgo may increase bleeding potential.
Absorption: 80% absorbed from GI tract. Onset: 1 h antipyretic effect. Peak: 12 h. Duration: 68 h. Metabolism: Metabolized in liver. Elimination: Excreted primarily in urine; some biliary excretion. Half-Life: 24 h.
Assessment & Drug Effects
- Monitor for therapeutic effectiveness. Optimum response generally occurs within 2 wk (e.g., relief of pain, stiffness, or
swelling; or improved joint flexion and strength).
- Observe patients with history of cardiac decompensation closely for evidence of fluid retention and edema.
- Lab tests: Baseline and periodic evaluations of Hgb, renal and hepatic function, and auditory and ophthalmologic examinations
are recommended in patients receiving prolonged or high-dose therapy.
- Monitor for GI distress and S&S of GI bleeding.
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Note: Symptoms of acute toxicity in children include apnea, cyanosis, response only to painful stimuli, dizziness, and nystagmus.
Patient & Family Education
- Notify physician immediately of passage of dark tarry stools, "coffee ground" emesis, frankly bloody emesis, or other
GI distress, as well as blood or protein in urine, and onset of skin rash, pruritus, jaundice.
- Do not drive or engage in other potentially hazardous activities until response to the drug is known.
- Do not self-medicate with ibuprofen if taking prescribed drugs or being treated for a serious condition without consulting
physician.
- Do not give to children younger than 3 mo or for longer than 2 d without consulting physician.
- Do not take aspirin concurrently with ibuprofen.
- Avoid alcohol and NSAIDs unless otherwise advised by physician. Concurrent use may increase risk of GI ulceration and bleeding tendencies.
- Do not breast feed while taking this drug without consulting physician.