Ibuprofen

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Ibuprofen is a drug that is given for mild to moderate pain, fever and inflammation. It was approved for human use in 1969 in the United Kingdom. The drug was initially sold as a treatment for rheumatoid arthritis and shares many attributes with aspirin. Generic versions of ibuprofen has been manufactured since 1985.

Contents

Chemistry

Ibuprofen is classified as a Non-Steroidal Anti-Inflammatory Drug (NSAIDs). It blocks the production of the enzyme cyclo-oxygenase which produces prostaglandins. When prostaglandins are produced by the body, they become responsible for inflammation, pain, and fever.

Discovered in the 1960's by Andrew Dunlop and Stewart Adams with other colleagues, ibuprofen’s empiric chemical formula is C13H18O2 with a systemic name of 2-(4-(2-methylpropyl)phenyl)propanoic acid. It was patented in 1961. Its generic name came from the outdated nomenclature Iso-butyl-propanoic-phenolic acid and is listed as one of the core medicines in the World Health Organization's Essential Drug List.

Uses

For adults

When under the care of a physician, the maximum adult daily dose is 3.2 grams. If it is taken as an over-the-counter medication, it must not exceed 1.2 grams a day.

  • Rheumatoid and osteoarthritis - 300 to 800 mg a 3 to 4 times daily
  • Mild to moderate pain - 200 to 400 mg orally every 4 to 6 hours when needed
  • Fever - 200 to 400 mg given 4 to 6 hours as needed

For children

Despite the similarities with aspirin, ibuprofen can be given to children 6 months to 12 years of age at 5 to 10 milligrams per kilo body weight. The maximum dose per day is 40 milligrams per kilogram body weight.

  • Fever - For patients aged 2 months to 11 years old, 5 mg/kg for fevers less than 39.2 degrees Centigrade. For higher grade fever, 10 mg/Kg is given.
  • Pain – Patients are given 10 mg/Kg orally every 4 to 6 hours as needed.
  • Juvenile arthritis - Treated with 20 to 40 mg/Kg per day in 3 to 4 divided doses.
  • Cystic fibrosis. Children aged 4 years and above are given ibuprofen twice daily for long-term use. This must maintain serum concentrations of 50 - 100 micrograms per milliliters to sow down disease progression.

Side effects

Most of ibuprofen's side effects are similar to that of aspirin’s. Common side effects include:

Meanwhile, these serious side effects must immediately be reported to the doctor:

  • Chest pain, shortness of breath
  • Black, bloody, clay-colored stools
  • Vomit that looks like coffee grounds
  • Slurred speech, vision and balance disturbance, convulsions
  • Dark or absence of urine

Interactions

Ibuprofen shares many of the drug interactions that aspirin may have.

With lithium, ibuprofen might cause lithium poisoning. This is because ibuprofen limits the excretion of lithium in the urine.

Aspirin must be discontinued when taking ibuprofen. If necessary, take ibuprofen at least 8 hours before or 30 minutes after taking aspirin.

Tacrolimus is given to patients who have organ transplants. Using this with ibuprofen might cause kidney damage.

Selective serotonin reuptake inhibitors (SSRI antidepressants) such as fluoxetine, sertaline, and citalopram may increase the risk for bleeding.

Ibuprofen must also be avoided in pregnancy. It is generally safe to use for breastfeeding women as ibuprofen is not excreted in breast milk.

The risk of heart or circulation problems increases the longer ibuprofen is used. This must be avoided before or after heart bypass surgery.

Availability

Ibuprofen in the Philippines is commonly given non-prescription. Common brands include Advil ®, Dolan ®, Alaxan ®, Medicol ®, and Midol ® . It is often found in combination with paracetamol. Whether alone or in combination, ibuprofen comes as a tablet (ordinary, film coated, or sustained release), caplet, and soft-gel capsules for adult patients. Pediatric suspension and drops are available for children.

References