Ibuprofen

A to Z Drug Facts

Ibuprofen

	Action
	Indications
	Contraindications
	Route/Dosage
	Interactions
	Lab Test Interferences
	Adverse Reactions
	Precautions
Patient Care Considerations
	Administration/Storage
	Assessment/Interventions
	Patient/Family Education

(eye-BYOO-pro-fen)

Advil, Advil Liqui-Gels, Advil Migraine, Children's Advil, Children's Motrin, Genpril, Haltran, Infant's Motrin, Junior Strength Advil, Junior Strength Motrin, Menadol, Midol Maximum Strength Cramp Formula, Motrin, Motrin IB, Motrin Migraine Pain, Nuprin, PediaCare Fever, Pediatric Advil Drops, Actiprofen, Alti-Ibuprofen, Apo-Ibuprofen, Novo-Profen, Nu-Ibuprofen

Class: Analgesic/NSAID

Action Decreases inflammation, pain, and fever, probably through inhibition of cyclooxygenase activity and prostaglandin synthesis.

Indications Relief of symptoms of rheumatoid arthritis, osteoarthritis, mild-to-moderate pain, primary dysmenorrhea, reduction of fever. Unlabeled use(s): Symptomatic treatment of juvenile rheumatoid arthritis, sunburn, resistant acne vulgaris.

Contraindications Hypersensitivity to aspirin, iodides, or any other NSAID.

Route/Dosage

Rheumatoid Arthritis and Osteoarthritis

Adults: PO 300 to 800 mg tid to qid, not to exceed 3.2 g/day.

Mild-to-Moderate Pain

ADULTS: PO 400 mg q 4 to 6 hr prn.

Primary Dysmenorrhea

ADULTS: PO 400 mg q 4 hr prn.

Juvenile Arthritis

CHILDREN: PO 30 to 40 mg/kg/day in 3 to 4 divided doses.

Fever Reduction

CHILDREN 1 to 12 yr: £ 39.2° C (102.5° F) recommended dose PO 5 mg/kg; > 39.2° C (102.5° F) recommended dose PO 10 mg/kg; maximum daily dose 40 mg/kg.

OTC Use (Minor Aches/Pains, Dysmenorrhea, Fever Reduction)

PO 200 mg q 4 to 6 hr. Do not exceed 1.2 g in 24 hr or take for pain for > 10 days or for fever for > 3 days, unless directed by physician. Use smallest effective dose.

Interactions

Beta-blockers: Antihypertensive effect may be decreased. Digoxin: Ibuprofen may increase digoxin serum levels. Lithium: May increase lithium levels. Loop diuretics: Diuretic effects may be decreased. Methotrexate: May increase methotrexate levels. Warfarin: May increase risk of gastric erosion and bleeding.

Lab Test Interferences None well documented.

Adverse Reactions

CV: Peripheral edema; water retention; worsening or precipitation of CHF. CNS: Dizziness; lightheadedness; drowsiness; vertigo; headaches; aseptic meningitis. EENT: Visual disturbances; photophobia; tinnitus. GI: Gastric distress; occult blood loss; diarrhea; vomiting; nausea; heartburn; dyspepsia; anorexia; constipation; abdominal distress/cramps/pain; flatulence; indigestion; GI tract fullness. GU: Menometrorrhagia; hematuria; cystitis; acute renal insufficiency; interstitial nephritis; hyperkalemia; hyponatremia; renal papillary necrosis. DERM: Rash; pruritus; erythema. OTHER: Muscle cramps.

Precautions

Pregnancy: Pregnancy category undetermined. Lactation: Undetermined. Children: Safety and efficacy not established. Elderly: Increased risk of adverse reactions. GI effects: Serious GI toxicity (eg, bleeding, ulceration, perforation) can occur at any time, with or without warning symptoms. Renal effects: Increased risk of dysfunction in patients with preexisting renal disease.

PATIENT CARE CONSIDERATIONS

Administration/Storage

Give medication soon after meals or with food, milk, or antacids to minimize GI irritation.

Assessment/Interventions

Obtain complete patient history, including drug history and any known allergies.
Notify physician if visual changes or indications of GI distress or liver or renal impairment occur.
Monitor patient's cardiac status: BP, pulse (quality and rhythm), edema, tachycardia, palpitations.
Assess renal function before and during therapy. Serum creatinine, creatinine clearance, and BUN should be monitored in patients with renal impairment.
Document any changes in liver function (AST, ALT), eye examinations and Hgb and Hct in patients on long-term therapy.
Notify physician if indigestion, epigastric pain, unusual bleeding or bruising, or dark tarry stools occur.

OVERDOSAGE: SIGNS & SYMPTOMS
	Drowsiness, lethargy, GI irritation/bleeding, nausea, vomiting, tinnitus, sweating, acute renal failure, epigastric pain, metabolic acidosis

Patient/Family Education

Tell patient to take medication soon after meals or with food, milk, or antacids.
Tell patient to avoid alcohol and medications containing aspirin, such as cold remedies.
Advise patient to discontinue drug and notify physician if any of the following occur: Persistent GI upset or headache, skin rash, itching, visual disturbances, black stools, weight gain or edema, changes in urine pattern, joint pain, fever, blood in urine.
Instruct patient not to take otc preparation for > 3 days for fever and > 10 days for pain and to notify physician if condition does not improve.
Advise patient that drug may cause drowsiness and to use caution while driving or performing other tasks requiring mental alertness.