Drug Index

Ibuprofen

 
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Mechanism :

Ibuprofen possesses analgesic and antipyretic activities. Its mode of action, like that of other NSAIDs, is not completely understood, but may be related to prostaglandin synthetase inhibition.


Indication :

• Fever

• Pain

• Juvenile idiopathic arthritis (JIA)

• PDA closure in neonate


Contraindications :

Contraindicated in patients with known hypersensitivity to Ibuprofen, in patients who have experienced asthma, urticaria, or allergic-type reactions after taking aspirin or other NSAIDs, in the treatment of peri-operative pain in the setting of coronary artery bypass graft (CABG) surgery, in active peptic ulceration. Use with caution in renal, cardiac or hepatic impairment.


Dosing :

Pain/fever: Oral

6 months-12 years: 5-10 mg/kg/dose 3-4 times daily; Max: 40 mg/kg/day.

>12 years: 200-400 mg every 4-6 hourly; Max: 1200 mg/day. In severe pain: 2400 mg/day.

Juvenile idiopathic arthritis and other rheumatic disorders: Oral

30-50 mg/kg/24 hour in 3-4 divided doses; Max: 2400 mg/day.

Closure of PDA in newborn:

First dose 10 mg/kg IV, 2nd and 3rd dose 5 mg/kg IV after 24 and 48 hours. If PDA dose not close 48 hours after last dose or reopens, a 2nd course of 3 doses may be given.


Adverse Effect :

Gastrointestinal discomfort, diarrhea, nausea, heartburn, constipation, bleeding and ulceration, dizziness, headache, vertigo, tinnitus, confusion, fluid retention and hypersensitivity reactions.


Interaction :

ACE-inhibitors: NSAIDs may diminish the antihypertensive effect of ACE-inhibitors. This interaction should be given consideration in patients taking NSAIDs concomitantly with ACE-inhibitors.
Diuretics: Can reduce the natriuretic effect-of furosemide and thiazides in some patients. This response has been attributed to inhibition of renal prostaglandin synthesis.
Lithium: When ibuprofen and lithium are administered concurrently, subjects should be observed carefully for signs of lithium toxicity.
Methotrexate: Enhances the toxicity of methotrexate. Caution should be used when NSAIDs are administered concomitantly with methotrexate.
Warfarin: Effects of warfarin and NSAIDs on GI bleeding are synergistic, such that the users of both drugs together have a risk of serious GI bleeding higher than users of either drug alone.



Renal Dose :

Dose in Renal Impairment GFR (mL/min)
20-50Dose as in normal renal function, but avoid if possible
10-20Dose as in normal renal function, but avoid if possible
<10Dose as in normal renal function, but only use if on dialysis

Dose in Patients undergoing Renal Replacement Therapies
CAPDNot dialysed. Dose as in normal renal function.
HDNot dialysed. Dose as in normal renal function.
HDF/High fluxNot dialysed. Dose as in normal renal function.
CAV/VVHDNot dialysed. Dose as in GFR=10– 20 mL/min

Hepatic Dose :

Ibuprofen is metabolized in the liver, and its elimination half-life is significantly prolonged in patients with moderate to severe cirrhosis.
Mild hepatic impairment: Use with caution.
Moderate hepatic impairment: Reduce dose or initiate at the lower end of the usual dosage range.
Severe hepatic impairment: Use is contraindicated.
05/26/2020 03:52:32 Ibuprofen
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