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Ibuprofen Dosage

Applies to the following strength(s): 100 mg/5 mL ; 800 mg ; 300 mg ; 600 mg ; 400 mg ; 200 mg ; 50 mg/1.25 mL ; 50 mg ; 100 mg ; 10 mg/mL ; 100 mg/mL

The information at Drugs.com is not a substitute for medical advice. ALWAYS consult your doctor or pharmacist.

Usual Adult Dose for:

Usual Pediatric Dose for:

Additional dosage information:

Usual Adult Dose for Dysmenorrhea

200 to 400 mg orally every 4 to 6 hours as needed
Maximum dose: 3200 mg/day (prescription strength); 1200 mg/day (over-the-counter)

Comment:
-Treatment should begin at the earliest onset of pain.

Use: For the relief of signs and symptoms of primary dysmenorrhea

Usual Adult Dose for Osteoarthritis

1200 to 3200 mg orally per day in divided doses
Maximum dose: 3200 mg/day

Comments:
-Patients with rheumatoid arthritis may require higher doses than those with osteoarthritis.
-Once response to therapy is determined, dose and frequency should be adjusted to the lowest effective dose for the shortest duration possible to suit the individual patient's treatment goals.
-Patients treated with 3200 mg orally per day should be observed for sufficient increased clinical benefits to offset potential increased risk.

Use: For the relief of signs and symptoms of rheumatoid arthritis and osteoarthritis

Usual Adult Dose for Rheumatoid Arthritis

1200 to 3200 mg orally per day in divided doses
Maximum dose: 3200 mg/day

Comments:
-Patients with rheumatoid arthritis may require higher doses than those with osteoarthritis.
-Once response to therapy is determined, dose and frequency should be adjusted to the lowest effective dose for the shortest duration possible to suit the individual patient's treatment goals.
-Patients treated with 3200 mg orally per day should be observed for sufficient increased clinical benefits to offset potential increased risk.

Use: For the relief of signs and symptoms of rheumatoid arthritis and osteoarthritis

Usual Adult Dose for Pain

IV Ibuprofen (Caldolor[R]):
400 to 800 mg IV every 6 hours as needed
Maximum dose: 3200 mg/day

Comments:
-Patients should be well hydrated prior to infusion to reduce the risk of renal adverse events.
-Doses should be infused over at least 30 minutes.

Uses: For the management of mild to moderate pain; and the management of moderate to severe pain as an adjunct to opioid analgesics

Oral:
200 to 400 mg orally every 4 to 6 hours as needed
Maximum dose: 3200 mg/day (prescription strength); 1200 mg/day (over-the-counter)

Comment:
-Oral doses greater than 400 mg have not been shown to be any more effective than the 400 mg dose.

Use: For the relief of mild to moderate pain

Usual Adult Dose for Fever

IV Ibuprofen (Caldolor[R]):
-Initial dose: 400 mg IV once
-Following initial dose, 100, 200, or 400 mg IV every 4 to 6 hours as needed
-Maximum dose: 3200 mg/day

Comments:
-Patients should be well hydrated prior to infusion to reduce the risk of renal adverse events.
-Doses should be infused over at least 30 minutes.

Oral:
Initial dose: 200 mg orally every 4 to 6 hours
-May increase to 400 mg every 4 to 6 hours if additional relief is needed
Maximum dose: 1200 mg/day

Use: For the reduction of fever

Usual Pediatric Dose for Fever

IV Ibuprofen (Caldolor[R]):
6 months to less than 12 years: 10 mg/kg IV every 4 to 6 hours as needed
-Maximum dose: Single dose: 400 mg; Daily dose: 40 mg/kg or 2400 mg/day, whichever is less

12 to 17 years: 400 mg IV every 4 to 6 hours as needed
-Maximum dose: 2400 mg/day

Comments:
-Patients should be well hydrated prior to infusion to reduce the risk of renal adverse events.
-Doses should be infused over at least 10 minutes.

Oral Suspension (Infant drops: 50 mg/1.25 mL):
6 to 11 months; 12 to 17 pounds: 50 mg (1.25 mL) every 6 to 8 hours as needed
12 to 23 months; 18 to 23 pounds: 75 mg (1.875 mL) orally every 6 to 8 hours as needed
-Maximum dose: 4 doses per day

Oral Suspension (100 mg/5 mL):
6 months to 2 years:
-Baseline temperature less than 102.5F (39.2C): 5 mg/kg orally every 6 to 8 hours
-Baseline temperature 102.5F (39.2C) or greater: 10 mg/kg orally every 6 to 8 hours
-Maximum dose: 40 mg/kg/day

2 to 11 years: 5 to 10 mg/kg orally every 6 to 8 hours as needed
-Maximum dose: 40 mg/kg/day or 4 doses per day

Oral Chewable Tablets:
2 to 11 years: 5 to 10 mg/kg every 6 to 8 hours as needed
-Maximum dose: 40 mg/kg/day or 4 doses per day

Oral Capsules and Tablets:
12 years and older:
-Initial dose: 200 mg orally every 4 to 6 hours as needed
-May increase to 400 mg every 4 to 6 hours if additional analgesia is needed
Maximum dose: 1200 mg/day

Comment:
-There are multiple over-the-counter formulations with different concentrations of the oral suspension and capsule/tablet strengths; manufacturer labeling may be consulted for weight/age based dosing charts.

Use: For the relief of fever

Usual Pediatric Dose for Pain

IV Ibuprofen (Caldolor[R]):
6 months to less than 12 years: 10 mg/kg IV every 4 to 6 hours as needed
-Maximum dose: Single dose: 400 mg; Daily dose: 40 mg/kg or 2400 mg/day, whichever is less

12 to 17 years: 400 mg IV every 4 to 6 hours as needed
-Maximum dose: 2400 mg/day

Comments:
-Patients should be well hydrated prior to infusion to reduce the risk of renal adverse events.
-Doses should be infused over at least 10 minutes.

Uses: For the management of mild to moderate pain; and the management of moderate to severe pain as an adjunct to opioid analgesics

Oral Suspension (Infant drops: 50 mg/1.25 mL):
6 to 11 months; 12 to 17 pounds: 50 mg (1.25 mL) every 6 to 8 hours as needed
12 to 23 months; 18 to 23 pounds: 75 mg (1.875 mL) orally every 6 to 8 hours as needed
-Maximum dose: 4 doses per day

Oral Suspension (100 mg/5 mL):
6 months to 2 years: 10 mg/kg orally every 6 to 8 hours
-Maximum dose: 40 mg/kg/day

2 to 11 years: 5 to 10 mg/kg orally every 6 to 8 hours
-Maximum dose: 40 mg/kg/day or 4 doses per day

Oral Chewable Tablets:
2 to 11 years: 5 to 10 mg/kg every 6 to 8 hours as needed
-Maximum dose: 40 mg/kg/day or 4 doses per day

Oral Capsules and Tablets:
12 years or older:
Initial dose: 200 mg orally every 4 to 6 hours as needed
-May increase to 400 mg every 4 to 6 hours if additional analgesia is needed
Maximum dose: 1200 mg/day

Comment:
-There are multiple over-the-counter formulations with different concentrations of the oral suspension and capsule/tablet strengths; manufacturer labeling may be consulted for weight/age based dosing charts.

Use: For the relief of mild to moderate pain

Usual Pediatric Dose for Juvenile Rheumatoid Arthritis

Oral Suspension (100 mg/5 mL):
6 months or older: 30 to 40 mg/kg/day orally in 3 to 4 divided doses; milder disease may use 20 mg/kg/day
-Maximum dose: 40 mg/kg/day

Comments:
-Doses greater than 40 mg/kg/day may increase risk of serious adverse effects; doses greater than 50 mg/kg/day have not been studied and are not recommended.
-With doses above 30 mg/kg/day or in patients with a history of abnormal liver function tests with previous NSAID therapy, closely monitor for signs/symptoms of early liver dysfunction.
-Therapeutic response may not be achieved for a few days or several weeks; the dosage should be lowered to the lowest effective dose once clinical effect is achieved.

Use: For the relief of signs and symptoms of juvenile rheumatoid arthritis

Usual Pediatric Dose for Patent Ductus Arteriosus

Ibuprofen lysine (NeoProfen[R]):
Gestational age 32 weeks or less and weight between 500 and 1500 g:
-Initial dose: 10 mg/kg IV
-Following initial dose, two doses of 5 mg/kg each, after 24 and 48 hours
-If anuria or marked oliguria (urinary output less than 0.6 mL/kg/hr) is evident at time of the second or third dose, hold drug until laboratory studies indicate renal function has returned to normal.

Comments:
-A course of therapy is defined as 3 doses; if ductus arteriosus closes or has significantly reduced in size after completion of the first course, no further doses are needed.
-If during continued medical management the ductus arteriosus fails to close or reopens, then a second course, alternative pharmacological therapy, or surgery may be needed.

Use: For the closure of a clinically significant patent ductus arteriosus (PDA) in premature infants weighing between 500 and 1500 g, who are no more than 32 weeks gestational age when usual medical management is ineffective (e.g., fluid restriction, diuretics, respiratory support, etc.). The clinical trial was conducted in infants with asymptomatic PDA; however, the consequences beyond 8 weeks after treatment have not been evaluated; therefore, treatment should be reserved for infants with clear evidence of a clinically significant PDA.

Renal Dose Adjustments

-Advanced Renal Disease: Not recommended; if treatment is necessary, close monitoring of renal function is advised.

-Neonates: If anuria or marked oliguria (urinary output less than 0.6 mL/kg/hr) occurs after a dose of IV therapy, no additional doses should be given until renal function returns to normal.

Liver Dose Adjustments

-Patients who have an abnormal liver test or who develop signs or symptoms of liver dysfunction should be evaluated for hepatic dysfunction.
-If liver disease develops or if systemic manifestations such as eosinophilia or rash occur, this drug should be discontinued.

-Pediatric: With doses above 30 mg/kg/day or in patients with a history of abnormal liver function tests with previous NSAID therapy, closely monitor for signs/symptoms of early liver dysfunction.

Precautions

US BOXED WARNINGS: RISK OF SERIOUS CARDIOVASCULAR AND GASTROINTESTINAL EVENTS:
-Nonsteroidal anti-inflammatory drugs (NSAIDs) may cause an increased risk of serious cardiovascular (CV) thrombotic events, myocardial infarction, and stroke, which can be fatal. This risk may increase with duration of use. Patients with CV disease or risk factors for CV disease may be at greater risk.
-This drug is contraindicated for the treatment of perioperative pain in the setting of coronary artery bypass graft (CABG) surgery.
-NSAIDs cause an increased risk of serious gastrointestinal (GI) adverse events including bleeding, ulceration, and perforation of the stomach or intestines, which can be fatal. These events can occur at any time during use and without warning symptoms. Elderly patients are at a greater risk for serious GI events.

IV Ibuprofen (Caldolor[R]) and Oral Suspension:
Safety and efficacy have not been established in patients younger than 6 months.

Over the Counter Capsules and Tablets:
Safety and efficacy have not been established in patients younger than 12 years.

Over the Counter Chewable Tablets and Suspension:
Safety and efficacy have not been established in patients younger than 6 months.

Oral Prescription Tablets:
Safety and efficacy have not been established in patients younger than 18 years.

Ibuprofen Lysine (NeoProfen[R]): Safety and efficacy have not been established in patients younger than 32 weeks gestational age.

Consult WARNINGS section for additional precautions.

Dialysis

Data not available

Other Comments

Administration advice:
-Oral Tablets and Capsules: Take with food and fluid.
-Oral Suspensions: Shake well before use. Multiple concentrations are available; consult manufacturer product labeling for dosing reference tables. Use with dosing device provided; do not use any other device.
-Ibuprofen Lysine (NeoProfen[R]): For IV use only; must be diluted prior to use.
-IV Ibuprofen (Caldolor[R]): For IV use only; must be diluted prior to use to a concentration of 4 mg/mL or less.
-Administer IV formulations carefully to avoid extravasation.

Storage requirements:
-IV Injection (Caldolor[R]): Diluted solution stable up to 24 hours at ambient temperature (20C to 25C) and room lighting.
-Ibuprofen Lysine (NeoProfen[R]): Protect from light; store vials in carton until contents are used.

Reconstitution/preparation techniques:
-Consult the appropriate manufacturer product information.

IV Compatibility:
-Ibuprofen Lysine (NeoProfen[R]): Compatible with dextrose or saline. Do not administer simultaneously in the same IV line with TPN; if necessary, TPN should be interrupted for 15 minutes prior to and after drug administration; line patency should be maintained using dextrose or saline.
-IV Ibuprofen (Caldolor[R]): Compatible with 0.9% Sodium Chloride Injection (normal saline), 5% Dextrose Injection USP (D5W), or Lactated Ringers Solution.

General:
-Consult manufacturer product labeling for weight/age based dosing charts.
-Prior to initiating treatment, the potential benefits and risks of this drug should be weighed against other treatment options.
-The lowest effective dose for the shortest duration consistent with individual patient treatment goals should be used.
-There is an increased risk of heart attack, heart failure, and stroke when taking nonsteroidal anti-inflammatory drugs (NSAIDs); these events may occur at any time during treatment and risk increases with long term use, a history of cardiovascular (CV) disease or risk factors for CV disease, and higher doses.

Monitoring:
-Neonates: Monitor renal function and urinary output during therapy.
-Cardiovascular: Monitor blood pressure closely during initiation and throughout course of therapy.
-Gastrointestinal: Monitor for signs/symptoms of gastrointestinal bleeding.
-Renal function: Monitor renal status, especially in patients with conditions where renal prostaglandins have a supportive role in the maintenance of renal perfusion.
-Monitor blood counts, renal, and hepatic function periodically for patients receiving long-term therapy.

Patient advice:
-Patients should seek medical advice for signs and symptoms of gastrointestinal events, adverse skin reactions, allergic reactions, hepatotoxicity, or unexplained weight gain or edema.
-Patients should seek medical attention immediately if signs/symptoms of cardiovascular events occur including, shortness of breath, slurred speech, chest pain, or weakness on one side of the body.
-Patients should talk to their health care provider if they are pregnant, planning to become pregnant, or breastfeeding; this drug should not be used during pregnancy at 30 weeks gestation or later.
-Patients should contact a healthcare provider if symptoms persist for more than 3 days in pediatric patients and more than 10 days in adult patients.

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