Class: NSAID
Dosage Forms. Tablet: 200 mg, 400 mg, 600 mg, 800 mg; Suspension: 100 mg/5 mL, 50 mg/1.25 mL
Common FDA Label Indication, Dosing, and Titration.
1. Fever: Children: 6 mo-12 y of age, 5-10 mg/kg po q6-8h prn; Children 12 y and older and Adults: 200-400 mg po q4-6h prn; max 1200 mg/d for over-the-counter use
2. Pain, headache: Children: 6 mo-12 y of age, 5-10 mg/kg po q6-8h prn; Children 12 y and older and Adults: 200-400 mg po q4-6h prn; max 1200 mg/d for OTC use
3. Osteoarthritis or rheumatoid arthritis: 1200-3200 mg/d po in 3-4 divided doses
4. Juvenile rheumatoid arthritis: 30-50 mg/kg/d divided qid; max 2400 mg/d
Off-Label Uses. None
MOA. Nonselective inhibitor of cyclo-oxygenase-1 (COX-1) and cyclo-oxygenase-2 (COX-2), and reversibly alters platelet function and prolongs bleeding time.
Drug Characteristics: Ibuprofen
Medication Safety Issues: Ibuprofen
Drug Interactions: Ibuprofen
Adverse Reactions: Ibuprofen
Efficacy Monitoring Parameters. Osteoarthritis and rheumatoid arthritis: decreased pain and improved range of motion.
Toxicity Monitoring Parameters. CBC, liver function tests, SCr, fecal occult blood tests if chronic use. Seek medical attention if severe skin rash, black tarry stools, chest pains, yellowing of eyes or skin, or change in urination.
Key Patient Counseling Points. Take with food or milk to decrease GI upset.
Clinical Pearls. Elderly patients are at increased risk of GI ulceration. NSAIDs are associated with an increased risk of adverse cardiovascular thrombotic events, including fatal MI and stroke. Use lowest effective dose for shortest possible duration; after observing initial response, adjust dose and frequency to meet individual patient’s needs. Various OTC ibuprofen products are available; caution patients not to duplicate dosing with multiple ibuprofen products. Medication guide required at dispensing.