Ibuprofen is a nonsteroidal anti-inflammatory drug (NSAID). Ibuprofen works by reducing hormones that cause inflammation and pain in the body. Ibuprofen is used to reduce fever and treat pain or inflammation caused by many conditions such as headache, toothache, back pain, arthritis, menstrual cramps, or minor injury. It typically begins working within an hour.
It is available under a number of trade names, including Nurofen, Advil and Motrin.
Drug Fact
Class : NSAID
Category : Over The Counter (OTC) drug
Uses : reduce fever and treat pain or inflammation caused by many conditions such as headache, toothache, back pain, arthritis, menstrual cramps, or minor injury
Consumed by : Ibuprofen is used in adults and children who are at least 6 months old.
Pregnancy category : C and D
Category C: Either studies in animals have revealed adverse effects on the fetus (teratogenic or embryocide or other) and there are no controlled studies in women or studies in women and animals are not available. Drugs should be given only if the potential benefit justifies the potential risk to the fetus.
In pregnancy (3rd trimester) is Category D
Category D: There is positive evidence of human fetal risk, but the benefits from use in pregnant women may be acceptable despite the risk (e.g., if the drug is needed in a life-threatening situation or for a serious disease for which safer drugs cannot be used or are ineffective).
Dosage form : tablet, suspension and injection
Administration
Should be taken with food.
Contraindications
Hypersensitivity (including asthma) to ibuprofen or other NSAIDs. History of gastrointestinal bleeding, perforation, or ulceration related to NSAID therapy. Gastrointestinal ulceration, perforation or haemorrhage. Severe cardiac failure or patients undergoing coronary artery bypass graft surgery. Severe renal or hepatic impairment. Pregnancy (3rd trimester).
Special Precautions
Patient with CV disease or risk factors of (e.g. CHF, ischaemic heart disease, CVA, hypertension, hyperlipidaemia, diabetes mellitus), bleeding disorders, SLE, mixed connective tissue disorders, porphyria. Surgery. Hepatic and renal impairment. Elderly, children (especially premature neonates with risk factors for infection and infants with increased bilirubin levels). Pregnancy (1st-2nd trimester) and lactation. Concomitant use of other NSAIDs, antiplatelets, anticoagulants. Not for prolonged usage.
Adverse Reactions
Significant: Anaphylactoid reactions, risk of hyperkalaemia, oedema, HTN, liver function abnormalities, anaemia, blurred vision, scotomata, changes in colour vision. Rarely, severe blood dyscrasias (e.g. agranulocytosis, thrombocytopenia, aplastic anaemia).
Ear and labyrinth disorders: Tinnitus.
Gastrointestinal disorders: Nausea, vomiting, diarrhoea, flatulence, constipation, dyspepsia, heartburn, abdominal pain; enterocolitis (IV).
General disorders and administration site conditions: Fluid retention.
Infections and infestations: Sepsis (IV).
Injury, poisoning and procedural complications: Injection site reactions.
Investigations: Increased BUN (IV).
Metabolism and nutrition disorders: Decreased appetite; hypoalbuminemia, hypoglycaemia, hypocalcaemia, hypokalaemia, hypernatraemia, adrenal insufficiency (IV).
Nervous system disorders: Headache, dizziness; intraventricular haemorrhage (IV).
Psychiatric disorders: Nervousness.
Renal and urinary disorders: Haematuria, UTI.
Respiratory, thoracic and mediastinal disorders: Apnoea, cough, respiratory infection.
Skin and subcutaneous tissue disorders: Rashes, pruritus; skin irritation (IV).
Potentially Fatal: CV thrombotic events (e.g. MI, stroke), gastrointestinal ulceration, perforation or haemorrhage; rarely, hepatotoxicity (e.g. fulminant hepatitis, hepatic necrosis or failure), Stevens-Johnson syndrome, exfoliative dermatitis, toxic epidermal necrolysis.
Patient Counseling Information
This drug may cause dizziness, drowsiness or blurred vision, if affected, do not drive or operate machinery.
Monitoring Parameters
Monitor CBC, occult blood loss, K levels, LFTs and renal function; signs and symptoms of ophthalmic-related reactions.
Over dosage
Symptoms: Headache, drowsiness, CNS depression, seizures, tinnitus, nausea, vomiting, abdominal pain, hypotension, bradycardia, tachycardia, atrial fibrillation, apnoea, respiratory failure, hyperkalaemia, acute renal failure, lethargy, metabolic acidosis, coma. Management: Supportive and symptomatic treatment. Induce emesis with syrup of ipecac or perform gastric lavage. Administer activated charcoal to reduce absorption and reabsorption. Forced alkaline diuresis might be beneficial. Management of hypotension, gastrointestinal bleeding and acidosis may also be necessary.
Drug Interactions
Increased risk of gastrointestinal ulceration, perforation or haemorrhage with other NSAIDs (e.g. aspirin), antiplatelets, anticoagulants (e.g. warfarin), corticosteroids, SSRIs. Increased risk of hyperkalaemia and renal toxicity with ciclosporin, tacrolimus. Increased levels and risk of toxicity with lithium, methotrexate. May decrease antihypertensive effect of ACE inhibitors, angiotensin II receptor antagonist; natriuretic effect of diuretics.
Food Interaction
Food intake decreases absorption rate. Avoid alcohol.
Action
Description: Ibuprofen, an NSAID, has analgesic, anti-inflammatory and antipyretic properties. It inhibits cyclooxygenase-1 and 2 thereby, also inhibiting prostaglandin synthesis.
Onset: Analgesic: 30-60 minutes. Anti-inflammatory: ≤7 days (oral).
Duration: 4-6 hours (oral).
Pharmacokinetics:
Absorption: Absorbed from the gastrointestinal tract, partially into the skin, and almost completely absorbed after rectal administration. Food intake decreases absorption rate. Time to peak plasma concentration: 1-2 hours (oral); 0.75 hours (rectal).
Distribution: Enters breast milk. Plasma protein binding: 90-99%.
Metabolism: Metabolised in the liver via oxidation.
Excretion: Mainly via urine (45-80% as metabolites, approx 1% as unchanged drug); faeces. Elimination half-life: Approx 2 hours.
Chemical Structure
Storage
Store between 20-25°C. Protect from light.
ATC Classification
R02AX02 - ibuprofen ; Belongs to the class of other throat preparations.
M01AE01 - ibuprofen ; Belongs to the class of propionic acid derivatives of non-steroidal antiinflammatory and antirheumatic products.
C01EB16 - ibuprofen ; Belongs to the class of other cardiac preparations.
M02AA13 - ibuprofen ; Belongs to the class of non-steroidal antiinflammatory preparations for topical use. Used in the treatment of joint and muscular pains.
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