IBUPROFEN

(eye-byoo'proe-fen)
Advil, Amersol  , Children's Motrin, Haltran, 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

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

Actions
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.

Therapeutic Effects
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.

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. Safe
use during pregnancy (category B), lactation, or children <6 mo is not established.

Cautious Use
Hypertension, history of GI ulceration, impaired hepatic or renal function, chronic renal
failure, cardiac decompensation, patients with SLE.

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: PO 6 mo–12 y, 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% absorbed from GI tract. Onset: 1 h antipyretic effect. Peak: 1–2 h.
Duration: 6–8 h. Metabolism: Metabolized in liver. Elimination: Excreted 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 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.

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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