IBUPROFEN

IBUPROFEN
(eye-byoo'proe-fen)
Advil, Amersol , Children's Motrin, Ibuprin, Junior Strength Motrin Caplets, Motrin, Nuprin, Pediaprofen, Pamprin-IB, Rufen, Trendar
Classifications: analgesic, nonsteroidal antiinflammatory drug (nsaid) (cox-1 and cox-2 inhibitor); antipyretic;
Therapeutic:nsaid, 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

Action

Prototype of the propionic acid NSAIDs (COX-1 and COX-2) inhibitor with nonsteroidal antiinflammatory activity and significant antipyretic and analgesic properties. It 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 Effect

Has nonsteroidal antiinflammatory, analgesic, and antipyretic effects. Inhibits platelet aggregation and prolongs bleeding time but does not affect prothrombin or whole blood clotting times.

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; perioperative pain related to CABG. Safe use in children <6 mo is not established.

Cautious Use

Hypertension, history of GI ulceration; diabetes mellitus, impaired hepatic or renal function, history of coronary artery disease, angina, MI cardiac decompensation; chronic renal failure, patients with SLE; pregnancy (category B).

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 (6 mo–12 y): PO 5–10 mg/kg q4–6h up to 40 mg/kg/d

Administration

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.
  • 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.

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% from GI tract. Onset: 1 h (antipyretic). Peak: 1–2 h. Duration: 6–8 h. Metabolism: In liver. Elimination: Primarily in urine; some biliary excretion. Half-Life: 2–4 h.

Nursing Implications

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.
  • 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 <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.

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

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© 2006-2017 medpill.info Last Updated On: 11/12/2017 (0)
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