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Overview

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This medicine contains an important and useful components, as it consists of
Hydroxypropylmethylcellulose 3mg/mlis available in the market in concentration

Name

Ibuprofen

Precaution

Ibuprofen is a widely used nonsteroidal anti-inflammatory drug (NSAID) that requires certain precautions before and during its use: - **Gastrointestinal Risks**: Ibuprofen can increase the risk of **gastric ulcers**, **gastritis**, and **upper gastrointestinal bleeding**. It should be taken with food or milk to reduce stomach irritation, especially for long-term use. Patients with a history of peptic ulcers or gastrointestinal bleeding should use ibuprofen with caution, and alternative medications should be considered. - **Renal Function**: Ibuprofen can impair kidney function, particularly in individuals with pre-existing kidney disease or those who are dehydrated. It is important to monitor renal function, especially in elderly patients or those with conditions like **hypertension** or **heart failure**. - **Cardiovascular Risks**: Prolonged use of ibuprofen has been associated with an increased risk of **heart attack**, **stroke**, and **hypertension**. Patients with a history of cardiovascular disease, such as those with **heart failure** or **hypertension**, should use ibuprofen cautiously, and alternative pain management strategies may be considered. - **Pregnancy**: Ibuprofen is **contraindicated in the third trimester** of pregnancy as it may cause premature closure of the fetal ductus arteriosus, leading to cardiovascular complications in the fetus. It is best avoided during pregnancy, especially during the second and third trimesters. The use of ibuprofen in early pregnancy should only be considered after careful evaluation of risks and benefits. - **Breastfeeding**: Ibuprofen is generally considered **safe for use during breastfeeding** in short-term doses. However, it should be used cautiously, and prolonged use or high doses should be avoided while nursing. - **Asthma**: Individuals with asthma or a history of **aspirin-induced asthma** (also known as **aspirin-exacerbated respiratory disease**) should avoid ibuprofen, as it may cause bronchospasm or exacerbate symptoms.

Indication

Ibuprofen is primarily used for its **analgesic**, **anti-inflammatory**, and **antipyretic** effects. The drug is effective in treating various conditions associated with pain, inflammation, and fever: - **Pain Relief**: Ibuprofen is commonly used for mild to moderate pain relief, including headaches, toothaches, menstrual cramps, **musculoskeletal pain**, **minor arthritis**, **back pain**, and **post-operative pain**. - **Inflammatory Conditions**: It is effective in treating inflammatory conditions such as **rheumatoid arthritis**, **osteoarthritis**, and **ankylosing spondylitis**. It can help reduce inflammation, swelling, and joint stiffness. - **Fever Reduction**: Ibuprofen is used to reduce fever in conditions such as **viral infections**, **flu**, or **common colds**. - **Off-label Uses**: While not FDA-approved for all, ibuprofen has been used off-label to alleviate pain associated with **gout** attacks, **bursitis**, and other inflammatory musculoskeletal disorders.

Contra indication

Ibuprofen should not be used in individuals with certain conditions, as its effects may exacerbate these issues: - **Hypersensitivity**: Ibuprofen is contraindicated in individuals who have a known allergy to the drug or other NSAIDs, or have experienced **asthma**, **urticaria**, or **allergic reactions** after taking aspirin or other NSAIDs. - **Active Gastrointestinal Disorders**: Ibuprofen is contraindicated in patients with active **peptic ulcers**, **gastrointestinal bleeding**, or other **GI disorders** like Crohn’s disease or ulcerative colitis, as it may worsen these conditions. - **Severe Renal Impairment**: The drug is contraindicated in patients with **severe renal impairment** or those with **kidney failure**, as NSAIDs can worsen renal function in these individuals. - **Severe Liver Disease**: Patients with **severe hepatic impairment** should not use ibuprofen due to potential liver toxicity and the drug’s metabolism in the liver. - **Pregnancy**: Ibuprofen is contraindicated in the **third trimester** of pregnancy and should be avoided during the **second trimester** unless necessary. It should also be avoided by individuals who are planning pregnancy or those with a history of preterm labor.

Side Effect

While ibuprofen is widely used, it can cause side effects, which can range from mild to severe: - **Common Side Effects**: - **Gastrointestinal issues**: These include **dyspepsia (indigestion)**, **nausea**, **abdominal pain**, and **gastritis**. Long-term use may increase the risk of peptic ulcers and gastrointestinal bleeding. - **Headache** and **dizziness** are also common. - **Less Common Side Effects**: - **Rash**, **urticaria (hives)**, and **pruritus (itching)** can occur in some individuals. - **Fluid retention**, leading to **edema** and **swelling**, especially with long-term use. - **Serious Side Effects**: - **Gastrointestinal bleeding**: This is a rare but serious complication, which can present as blood in the stool or vomit. - **Kidney problems**: Prolonged use of ibuprofen may lead to **acute kidney injury** or **chronic renal insufficiency** in predisposed individuals. - **Cardiovascular events**: Long-term use of ibuprofen, especially at high doses, increases the risk of heart attacks, **stroke**, and **hypertension**. - **Liver toxicity**: Rare, but significant liver damage can occur, including **hepatitis** and **jaundice**. - **Severe Allergic Reactions**: Signs of an allergic reaction, such as **swelling of the face, lips, or throat**, **rash**, **itching**, or difficulty breathing, require immediate medical attention.

Pregnancy Category ID

3

Mode of Action

Ibuprofen works by inhibiting the action of **cyclooxygenase (COX)** enzymes, which are involved in the production of **prostaglandins**. Prostaglandins are chemicals that play a key role in inflammation, pain, and fever. - **Pharmacodynamics**: Ibuprofen primarily inhibits **COX-1** and **COX-2** enzymes. COX-1 is involved in producing prostaglandins that protect the stomach lining, while COX-2 is involved in inflammatory processes. By inhibiting these enzymes, ibuprofen reduces pain, swelling, and fever. - **Pharmacokinetics**: Ibuprofen is rapidly absorbed in the gastrointestinal tract, with peak plasma concentrations occurring about **1–2 hours** after oral administration. It is metabolized in the liver and excreted in the urine. The half-life of ibuprofen is approximately **2 hours**.

Interaction

Ibuprofen can interact with various drugs and substances, which may alter its effectiveness or lead to harmful effects: - **Anticoagulants**: Ibuprofen can enhance the effects of **anticoagulants** like **warfarin**, increasing the risk of bleeding. Careful monitoring of INR (International Normalized Ratio) is recommended for patients taking both medications. - **Other NSAIDs**: Concomitant use of ibuprofen with other NSAIDs, including **aspirin**, should be avoided due to an increased risk of gastrointestinal ulcers and bleeding. - **Antihypertensive Drugs**: Ibuprofen can reduce the effectiveness of **ACE inhibitors**, **angiotensin II receptor blockers (ARBs)**, and **diuretics**, as it may cause fluid retention and sodium retention, leading to increased blood pressure. - **Lithium**: Ibuprofen can increase **serum lithium levels**, leading to potential toxicity. Patients using both drugs should have their lithium levels closely monitored. - **Methotrexate**: Co-administration of ibuprofen with **methotrexate** can increase the levels of methotrexate in the blood, raising the risk of **methotrexate toxicity**. Dose adjustments may be needed. - **Alcohol**: Consuming alcohol while taking ibuprofen increases the risk of **gastric bleeding** and **liver damage**. Patients should avoid excessive alcohol consumption during ibuprofen therapy.

Pregnancy Category Note

Pregnancy category: C; D in 3rd trimester or near delivery. At >30 weeks' gestation; may cause premature closure of ductus arteriosus

Adult Dose

The standard adult dose of ibuprofen for various indications is: - **Pain relief**: The typical dose for mild to moderate pain is **200–400 mg every 4–6 hours** as needed. The maximum daily dose should not exceed **3200 mg** in divided doses. - **Inflammation (e.g., rheumatoid arthritis)**: Higher doses may be required, typically **400–800 mg every 6–8 hours**, with a maximum daily dose of **3200 mg**. - **Fever**: The typical dose for reducing fever is **200–400 mg every 4–6 hours**. - Ibuprofen should be taken with food or milk to minimize gastrointestinal irritation.

Child Dose

Ibuprofen is commonly used for pain and fever relief in children: - **For infants and children 6 months to 11 years**: The typical dose is **5–10 mg/kg every 6–8 hours**, not to exceed **40 mg/kg per day**. - **For children under 6 months**: Ibuprofen is generally not recommended unless prescribed by a healthcare provider. - It is important to adjust the dose based on the child's weight and to use the appropriate pediatric formulation.

Renal Dose

In patients with renal impairment, the dose of ibuprofen should be adjusted based on the degree of renal dysfunction: - For patients with **mild to moderate renal impairment**, the standard dose may be used, but caution should be exercised, and renal function should be monitored. - In patients with **severe renal impairment**, ibuprofen should be avoided or used with extreme caution. Alternative pain relief strategies that do not exacerbate renal issues may be considered.

Administration

Information not available