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ibuprofen

Pronunciation

Generic Name: ibuprofen (EYE bue PROE fen)
Brand Name: Advil, Genpril, IBU, Midol IB, Motrin IB, Proprinal, Smart Sense Children's Ibuprofen

What is ibuprofen?

Ibuprofen is a nonsteroidal anti-inflammatory drug (NSAID). Ibuprofen 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. This medicine is used in adults and children who are at least 6 months old.

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

What is the most important information I should know about ibuprofen?

Ibuprofen can increase your risk of fatal heart attack or stroke, especially if you use it long term or take high doses, or if you have heart disease. Do not use this medicine just before or after heart bypass surgery (coronary artery bypass graft, or CABG).

Ibuprofen may also cause stomach or intestinal bleeding, which can be fatal. These conditions can occur without warning while you are using ibuprofen, especially in older adults.

What should I discuss with my healthcare provider before taking ibuprofen?

Ibuprofen can increase your risk of fatal heart attack or stroke, especially if you use it long term or take high doses, or if you have heart disease. Even people without heart disease or risk factors could have a stroke or heart attack while taking this medicine.

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

Ibuprofen may also cause stomach or intestinal bleeding, which can be fatal. These conditions can occur without warning while you are using ibuprofen, especially in older adults.

You should not use ibuprofen if you are allergic to it, or if you have ever had an asthma attack or severe allergic reaction after taking aspirin or an NSAID.

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

  • heart disease, high blood pressure, high cholesterol, diabetes, or if you smoke;

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

  • a history of stomach ulcers or bleeding;

  • asthma;

  • liver or kidney disease;

  • fluid retention; or

  • a connective tissue disease such as Marfan syndrome, Sjogren's syndrome, or lupus.

Taking ibuprofen during the last 3 months of pregnancy may harm the unborn baby. Do not use this medicine without a doctor's advice if you are pregnant.

It is not known whether ibuprofen passes into breast milk or if it could harm a nursing baby. Do not use this medicine without a doctor's advice if you are breast-feeding a baby.

Do not give ibuprofen to a child younger than 2 years old without the advice of a doctor.

How should I take ibuprofen?

Use exactly as directed on the label, or as prescribed by your doctor. Do not use in larger amounts or for longer than recommended. Use the lowest dose that is effective in treating your condition.

Do not take more than your recommended dose. An ibuprofen overdose can damage 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 ibuprofen needed to get relief from your pain, swelling, or fever.

A child's dose of ibuprofen is based on the age and weight of the child. Carefully follow the dosing instructions provided with children's ibuprofen for the age and weight of your child. Ask a doctor or pharmacist if you have questions.

Take ibuprofen with food or milk to lessen stomach upset.

Shake the oral suspension (liquid) well just before you measure a dose. Measure liquid medicine with the dosing syringe provided, or with a special dose-measuring spoon or medicine cup. 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 use this medicine long-term, you may need frequent medical tests.

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

Read all patient information, medication guides, and instruction sheets provided to you. Ask your doctor or pharmacist if you have any questions.

What happens if I miss a dose?

Since ibuprofen is used when needed, you may not be on a dosing schedule. If you are on a schedule, use the missed dose as soon as you remember. Skip the missed dose if it is almost time for your next scheduled dose. Do not use 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 while taking ibuprofen?

Avoid drinking alcohol. It may increase your risk of stomach bleeding.

Avoid taking aspirin while you are taking ibuprofen.

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 cold, allergy, or pain medicine. Many medicines available over the counter contain aspirin or other medicines similar to ibuprofen. Taking certain products together can cause you to get too much of this type of medication. Check the label to see if a medicine contains aspirin, ibuprofen, ketoprofen, or naproxen.

Ibuprofen side effects

Get emergency medical help if you have signs of an allergic reaction: sneezing, runny or stuffy nose; wheezing or trouble breathing; hives; swelling of your face, lips, tongue, or throat.

Get emergency medical help if you have signs of a heart attack or stroke: chest pain spreading to your jaw or shoulder, sudden numbness or weakness on one side of the body, slurred speech, feeling short of breath.

Stop using ibuprofen and call your doctor at once if you have:

  • changes in your vision;

  • shortness of breath (even with mild exertion);

  • swelling or rapid weight gain;

  • the first sign of any skin rash, no matter how mild;

  • signs of stomach bleeding--bloody or tarry stools, coughing up blood or vomit that looks like coffee grounds;

  • liver problems--nausea, upper stomach pain, itching, tired feeling, flu-like symptoms, loss of appetite, dark urine, clay-colored stools, jaundice (yellowing of the skin or eyes);

  • kidney problems--little or no urinating, painful or difficult urination, swelling in your feet or ankles, feeling tired or short of breath;

  • low red blood cells (anemia)--pale skin, feeling light-headed or short of breath, rapid heart rate, trouble concentrating; or

  • severe skin reaction--fever, sore throat, swelling in your face or tongue, burning in your eyes, skin pain followed by a red or purple skin rash that spreads (especially in the face or upper body) and causes blistering and peeling.

Common side effects may include:

  • upset stomach, mild heartburn, nausea, vomiting;

  • bloating, gas, diarrhea, constipation;

  • dizziness, headache, nervousness;

  • mild itching or rash; 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
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.

Usual Pediatric Dose for Dysmenorrhea:

12 years or older:
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)

What other drugs will affect ibuprofen?

Ask your doctor before using ibuprofen if you take an antidepressant such as citalopram, escitalopram, fluoxetine (Prozac), fluvoxamine, paroxetine, sertraline (Zoloft), trazodone, or vilazodone. Taking any of these medicines with an NSAID may cause you to bruise or bleed easily.

Ask a doctor or pharmacist if it is safe for you to use ibuprofen if you are also using any of the following drugs:

  • lithium;

  • methotrexate;

  • a blood thinner (warfarin, Coumadin, Jantoven);

  • heart or blood pressure medication, including a diuretic or "water pill"; or

  • steroid medicine (such as prednisone).

This list is not complete. Other drugs may interact with ibuprofen, including prescription and over-the-counter medicines, vitamins, and herbal products. Not all possible interactions are listed in this medication guide.

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 1996-2012 Cerner Multum, Inc. Version: 17.03. Revision Date: 2015-09-23, 7:32:36 AM.

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