Ibuprofen

Pronunciation

Generic Name: ibuprofen (EYE bue PROE fen)
Brand Names: Advil, Genpril, IBU, Midol, Motrin, Nuprin

What is ibuprofen?

Ibuprofen is a nonsteroidal anti-inflammatory drug (NSAID). It works by reducing hormones that cause inflammation and pain in the body.

Ibuprofen is used to reduce fever and treat pain or inflammation caused by many conditions such as headache, toothache, back pain, arthritis, menstrual cramps, or minor injury.

Ibuprofen may also be used for purposes not listed in this medication guide.

Important information

Ibuprofen may cause life-threatening heart or circulation problems such as heart attack or stroke, especially if you use it long term. Do not use ibuprofen just before or after heart bypass surgery (coronary artery bypass graft, or CABG).

Get emergency medical help if you have chest pain, weakness, shortness of breath, slurred speech, or problems with vision or balance.

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This medicine may also cause serious effects on the stomach or intestines, including bleeding or perforation (forming of a hole). These conditions can be fatal and can occur without warning while you are taking ibuprofen, especially in older adults.

Call your doctor at once if you have symptoms of stomach bleeding such as black, bloody, or tarry stools, or coughing up blood or vomit that looks like coffee grounds.

Do not take more of this medication than is recommended. An overdose of ibuprofen can cause damage to your stomach or intestines. Use only the smallest amount of medication needed to get relief from your pain, swelling, or fever.

Before taking this medicine

Do not use ibuprofen just before or after heart bypass surgery (coronary artery bypass graft, or CABG).

This medicine may cause life-threatening heart or circulation problems such as heart attack or stroke, especially if you use it long term.

This medicine may also cause serious effects on the stomach or intestines, including bleeding or perforation (forming of a hole). These conditions can be fatal and can occur without warning while you are taking ibuprofen, especially in older adults.

You should not use this medication if you are allergic to ibuprofen, aspirin or other NSAIDs.

Ask a doctor or pharmacist if it is safe for you to take this medication if you have:

  • a history of heart attack, stroke, or blood clot;

  • heart disease, congestive heart failure, high blood pressure;

  • a history of stomach ulcers or bleeding;

  • asthma;

  • polyps in your nose;

  • liver or kidney disease;
  • systemic lupus erythematosus (SLE);

  • a bleeding or blood clotting disorder; or

  • if you smoke.

FDA pregnancy category D. Taking ibuprofen during the last 3 months of pregnancy may harm the unborn baby. Tell your doctor if you are pregnant or plan to become pregnant while using this medicine. It is not known whether ibuprofen passes into breast milk or if it could harm a nursing baby. Do not use this medication without telling your doctor if you are breast-feeding a baby. Do not give this medicine to a child without the advice of a doctor.

See also: Pregnancy and breastfeeding warnings (in more detail)

How should I take ibuprofen?

Take ibuprofen exactly as directed on the label, or as prescribed by your doctor. Do not use in larger or smaller amounts or for longer than recommended.

Do not take more of this medication than is recommended. An overdose can cause damage to your stomach or intestines. The maximum amount of ibuprofen for adults is 800 milligrams per dose or 3200 mg per day (4 maximum doses). Use only the smallest amount of medication needed to get relief from your pain, swelling, or fever. Take ibuprofen with food or milk to lessen stomach upset. Shake the oral suspension (liquid) well just before you measure a dose. To be sure you get the correct dose, measure the liquid with a marked measuring spoon or medicine cup, not with a regular table spoon. If you do not have a dose-measuring device, ask your pharmacist for one.

The ibuprofen chewable tablet must be chewed before you swallow it.

If you take this medicine for a long period of time, your doctor may want to check you on a regular basis to make sure this medication is not causing harmful effects. Do not miss any scheduled visits to your doctor.

Store ibuprofen at room temperature away from moisture and heat. Do not allow the liquid medicine to freeze.

What happens if I miss a dose?

Since ibuprofen is taken as needed, you may not be on a dosing schedule. If you are taking the medication regularly, take the missed dose as soon as you remember. Skip the missed dose if it is almost time for your next scheduled dose. Do not take extra medicine to make up the missed dose.

What happens if I overdose?

Seek emergency medical attention or call the Poison Help line at 1-800-222-1222. Overdose symptoms may include nausea, vomiting, stomach pain, drowsiness, black or bloody stools, coughing up blood, shallow breathing, fainting, or coma.

What should I avoid?

Avoid taking ibuprofen if you are taking aspirin to prevent stroke or heart attack. Ibuprofen can make aspirin less effective in protecting your heart and blood vessels. If you must use both medications, take the ibuprofen at least 8 hours before or 30 minutes after you take the aspirin (non-enteric coated form).

Ask a doctor or pharmacist before using any other cold, allergy, or pain medicine. Ibuprofen and other NSAIDs are contained in many combination medicines. Taking certain products together can cause you to get too much ibuprofen. Check the label to see if a medicine contains ibuprofen or similar NSAIDs (aspirin, naproxen, ketoprofen). Avoid drinking alcohol. It may increase your risk of stomach bleeding.

Ibuprofen side effects

Get emergency medical help if you have any of these signs of an allergic reaction to ibuprofen: hives; difficulty breathing; swelling of your face, lips, tongue, or throat.

Stop taking this medicine and seek medical attention or call your doctor at once if you have any of these serious side effects:

  • chest pain, weakness, shortness of breath, slurred speech, problems with vision or balance;

  • black, bloody, or tarry stools, coughing up blood or vomit that looks like coffee grounds;

  • swelling or rapid weight gain;

  • urinating less than usual or not at all;

  • nausea, upper stomach pain, itching, loss of appetite, dark urine, clay-colored stools, jaundice (yellowing of the skin or eyes);

  • fever, sore throat, and headache with a severe blistering, peeling, and red skin rash;

  • bruising, severe tingling, numbness, pain, muscle weakness; or

  • severe headache, neck stiffness, chills, increased sensitivity to light, and/or seizure (convulsions).

Less serious ibuprofen side effects may include:

  • upset stomach, mild heartburn, diarrhea, constipation;

  • bloating, gas;

  • dizziness, headache, nervousness;

  • skin itching or rash;

  • blurred vision; or

  • ringing in your ears.

This is not a complete list of side effects and others may occur. Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.

See also: Side effects (in more detail)

Ibuprofen dosing information

Usual Adult Dose for Dysmenorrhea:

200 to 400 mg orally every 4 to 6 hours as needed.

Usual Adult Dose for Osteoarthritis:

Initial dose: 400 to 800 mg orally every 6 to 8 hours.
Maintenance dose: May be increased to a maximum daily dose of 3200 mg based on patient response and tolerance.

Usual Adult Dose for Rheumatoid Arthritis:

Initial dose: 400 to 800 mg orally every 6 to 8 hours.
Maintenance dose: May be increased to a maximum daily dose of 3200 mg based on patient response and tolerance.

Usual Adult Ibuprofen Dose for Headache:

Study (n=34) - Prevention of Electroconvulsive therapy (ECT)-induced headache:
600 mg orally 90 minutes prior to the initial ECT session

Usual Adult Ibuprofen Dose for Pain:

Oral: Mild to moderate pain:
200 to 400 mg orally every 4 to 6 hours as needed. Doses greater than 400 mg have not been proven to provide greater efficacy.

IV: (Patients should be well hydrated before IV ibuprofen administration):
Pain: 400 to 800 mg intravenously over 30 minutes every 6 hours as needed.

Usual Adult Dose for Fever:

Oral:
200 to 400 mg orally every 4 to 6 hours as needed.

IV: (Patients should be well hydrated before IV ibuprofen administration):
Fever: Initial: 400 mg intravenously over 30 minutes
Maintenance: 400 mg every 4 to 6 hours or 100 to 200 mg every 4 hours as needed.

Usual Pediatric Ibuprofen Dose for Fever:

greater than 2 months to 11 years:
5 mg/kg for temperature less than 102.5 degrees F (39.2 degrees C) orally every 6 to 8 hours as needed.
10 mg/kg for temperature greater than 102.5 degrees F (39.2 degrees C) orally every 6 to 8 hours as needed.

The recommended maximum daily dose is 40 mg/kg.

Usual Pediatric Dose for Pain:

6 months to 11 years: 10 mg/kg orally every 6 to 8 hours as needed.
The recommended maximum daily dose is 40 mg/kg.

Usual Pediatric Dose for Rheumatoid Arthritis:

30 to 50 mg/kg/day divided into 3 to 4 doses. Milder disease may be adequately treated with 20 mg/kg/day.
Doses greater than 50 mg/kg/day are not recommended. Doses greater than 2400 mg/day are not recommended.

Usual Pediatric Ibuprofen Dose for Cystic Fibrosis:

Oral: Chronic (greater than 4 years) twice daily dosing adjusted to maintain serum concentration of 50 to 100 mcg/mL has been associated with slowing of disease progression in pediatric patients with mild lung disease.

Usual Pediatric Dose for Patent Ductus Arteriosus:

Ibuprofen lysine:
Gestational age - less than 33 weeks; greater than or equal to 0.5 kg less than 1.5 Kg: 10 mg/kg IV initial dose, followed by two doses of 5 mg/kg each, after 24 hours and 48 hours. All doses should be based on birth weight.

Investigational Studies - Gestational age - less than 33 weeks: 10 mg/kg initial dose, IV or through feeding tube, followed by two doses of 5 mg/kg, administered at 24-hour intervals, starting on the third day of life.

What other drugs will affect ibuprofen?

Ask your doctor before using an antidepressant such as citalopram (Celexa), escitalopram (Lexapro), fluoxetine (Prozac, Sarafem, Symbyax), fluvoxamine (Luvox), paroxetine (Paxil), or sertraline (Zoloft). Taking any of these medicines with an NSAID may cause you to bruise or bleed easily.

Tell your doctor about all other medicines you use, especially:

  • aspirin or other NSAIDs such as naproxen (Aleve, Naprosyn, Naprelan, Treximet), celecoxib (Celebrex), diclofenac (Arthrotec, Cambia, Cataflam, Voltaren, Flector Patch, Pennsaid, Solareze), indomethacin (Indocin), meloxicam (Mobic), and others;

  • heart or blood pressure medicine such as benazepril (Lotensin), enalapril (Vasotec), lisinopril (Prinivil, Zestril), quinapril (Accupril), ramipril (Altace), and others;

  • lithium (Eskalith, Lithobid);

  • diuretics (water pills) such as furosemide (Lasix);

  • methotrexate (Rheumatrex, Trexall);

  • steroids (prednisone and others); or

  • a blood thinner such as warfarin (Coumadin, Jantoven).

This list is not complete and other drugs may interact with ibuprofen. Tell your doctor about all medications you use. This includes prescription, over-the-counter, vitamin, and herbal products. Do not start a new medication without telling your doctor.

Where can I get more information?

  • Your pharmacist can provide more information about ibuprofen.
  • Remember, keep this and all other medicines out of the reach of children, never share your medicines with others, and use this medication only for the indication prescribed.
  • Disclaimer: Every effort has been made to ensure that the information provided by Cerner Multum, Inc. ('Multum') is accurate, up-to-date, and complete, but no guarantee is made to that effect. Drug information contained herein may be time sensitive. Multum information has been compiled for use by healthcare practitioners and consumers in the United States and therefore Multum does not warrant that uses outside of the United States are appropriate, unless specifically indicated otherwise. Multum's drug information does not endorse drugs, diagnose patients or recommend therapy. Multum's drug information is an informational resource designed to assist licensed healthcare practitioners in caring for their patients and/or to serve consumers viewing this service as a supplement to, and not a substitute for, the expertise, skill, knowledge and judgment of healthcare practitioners. The absence of a warning for a given drug or drug combination in no way should be construed to indicate that the drug or drug combination is safe, effective or appropriate for any given patient. Multum does not assume any responsibility for any aspect of healthcare administered with the aid of information Multum provides. The information contained herein is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects. If you have questions about the drugs you are taking, check with your doctor, nurse or pharmacist.

Copyright 1996-2014 Cerner Multum, Inc. Version: 16.01. Revision Date: 3/28/2011 9:56:19 AM.

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