Ibuprofen

General

• Type: NSAID
• Dosage Forms: Tablets: 100, 200, 400, 600, 800 mg. Suspension: 20mg/ml, 40 mg/ml
• Common Trade Names: Advil; Motrin

Adult Dosing

• 800mg PO Q8hours
  • 400mg has been shown to be as effective at pain reduction as 600mg and 800mg

Pediatric Dosing

• 10mg/kg PO Q6hours
• Max: 40mg/kg/day

Special Populations

• Pregnancy Rating: C (1st-2nd trimester), D (3rd trimester)
• Lactation risk categories: L4; enters breast milk, decreases milk supply
• Renal Dosing
  • Adult: no adjustment
  • Pediatric: no adjustment
• Hepatic Dosing
  • Adult: not defined
  • Pediatric: not defined

Contraindications

• Allergy to class/drug
• Cardiovascular
  • May cause an increased risk of serious cardiovascular thrombotic events, myocardial infarction, and stroke, which can be fatal
  • Contraindicated for treatment of perioperative pain in the setting of coronary artery bypass graft (CABG) surgery
• Gastrointestinal risk
  • Increased risk of serious gastrointestinal (GI) adverse events including bleeding, ulceration, and perforation of the stomach or intestines, which can be fatal
    • Elderly patients are at greater risk for serious GI events.

Adverse Reactions

Serious

• Anaphylaxis
• GI bleeding
• Peptic ulcer disease, gastric perforation, bowel perforation
• Thromboycytopenia
• Agranulocytosis
• Steven-Johnson Syndrome
• Nephrotoxicity

Common

• Dyspepsia
• Nausea
• Abdominal pain
• Constipation
• Headache
• Dizziness
• Rash
• Fluid retention
• Ecchymosis

Pharmacology

• Half-life: 1.8 - 2 hr
• Metabolism: liver
• Excretion: Urine
• Mechanism of Action: exact mechanism unknown; inhibits cyclooxygenase, reducing prostaglandin and thromboxane synthesis

Indications by Condition

The following table is automatically generated from disease/condition pages across WikEM.

Indication	Dose	Context	Route	Population
Acute pain management	400-800 mg PO q6-8h PRN	Step 1 - Mild pain (NSAID)	PO	Adult
Dressler's syndrome	600-800mg PO q6-8h, taper by 400-800mg/week over 3-4 weeks	NSAID, first-line alternative	PO	Adult
Gout and pseudogout	800mg TID x 3-5 days	First-line NSAID option for acute gout	PO	Adult
Pericarditis	600 mg q8hr x7-10 days, then taper over 3-4 weeks	1st line anti-inflammatory (alternative)	PO	Adult
Urolithiasis	600mg Q6hrs PRN	Analgesic if tolerating PO	PO	Adult

See Also

• NSAID
• NSAID toxicity