Ibuprofen Description

The active ingredient in Ibuprofen Oral Suspension USP is ibuprofen, which is a member of the propionic acid group of nonsteroidal anti-inflammatory drugs (NSAIDs). Ibuprofen is a racemic mixture of [+]S- and [-]R-enantiomers. It is a white to off-white crystalline powder, with a melting point of 74° to 77°C. It is practically insoluble in water (< 0 . 1 mg/mL), but readily soluble in organic solvents such as ethanol and acetone. Ibuprofen has a pKa of 4 . 43 ± 0 . 03 and an n-octanol/water partition coefficient of 11 . 7 at pH 7 . 4. The chemical name for ibuprofen is (±)-2 -p -Isobutylhydratropic acid. The molecular weight of ibuprofen is 206 . 28. Its molecular formula is C₁₃ H₁₈ O₂ and it has the following structural formula:

Ibuprofen Oral Suspension USP is a sucrose-sweetened, orange-colored, berry-flavored liquid suspension containing 100 mg of ibuprofen in 5 mL (20 mg/mL). Inactive ingredients include citric acid, glycerin, hydroxypropyl methylcellulose, polysorbate 80, purified water, sodium benzoate, sucrose, xanthan gum, D&C Yellow #10 and FD&C Red #40, and artificial flavors (strawberry/vanillin).

Ibuprofen Indications And Usage

In Children Ibuprofen Oral Suspension is indicated:

• For the reduction of fever in patients aged 6 months and older.
• For the relief of signs and symptoms of juvenile arthritis.

In Adults Ibuprofen Oral Suspension is indicated:

• For relief of mild to moderate pain.
• For the treatment of primary dysmenorrhea.
• For relief of the signs and symptoms of rheumatoid arthritis and osteoarthritis.

Since there have been no controlled trials to demonstrate whether there is any beneficial effect or harmful interaction with the use of ibuprofen in conjunction with aspirin, the combination cannot be recommended (see PRECAUTIONS – Drug Interactions).

Drug Interactions

Coumarin-type Anticoagulants: Several short-term controlled studies failed to show that ibuprofen significantly affected prothrombin times or a variety of other clotting factors administered to individuals on coumarin-type anticoagulants. Because bleeding has been reported when ibuprofen and other nonsteroidal anti-inflammatory agents have been administered to patients on coumarin-type anticoagulants, the physician should be cautious when administering ibuprofen to patients on anticoagulants.

Aspirin: Animal studies show that aspirin given with NSAIDs, including ibuprofen, yields a net decrease in anti-inflammatory activity with lowered blood levels of the non-aspirin drug. Single-dose bioavailability studies in normal volunteers have failed to show an effect of aspirin on ibuprofen blood levels. Correlative clinical studies have not been done.

Methotrexate: Ibuprofen, as well as other NSAIDs, has been reported to competitively inhibit methotrexate accumulation in rabbit kidney slices. This may indicate that ibuprofen could enhance the toxicity of methotrexate. Caution should be used, therefore, if ibuprofen is administered concomitantly with methotrexate.

H-2 Antagonists: In studies with human volunteers, coadministration of cimetidine or ranitidine with ibuprofen had no substantive effect on ibuprofen serum concentrations.

ACE-inhibitors: Reports suggest that NSAIDs, including ibuprofen, may diminish the antihypertensive effect of ACE-inhibitors. This interaction should be given consideration in patients taking ibuprofen concomitantly with ACE-inhibitors.

Furosemide: Clinical studies, as well as random observations, have shown that ibuprofen can reduce the natriuretic effect of furosemide and thiazides in some patients. This response has been attributed to inhibition of renal prostaglandin synthesis. During concomitant therapy with ibuprofen, the patient should be observed closely for signs of renal failure (see PRECAUTIONS, Renal Effects), as well as to assure diuretic efficacy.

Lithium: Ibuprofen produced an elevation of plasma lithium levels and a reduction in renal lithium clearance in a study of eleven normal volunteers. The mean minimum lithium concentration increased 15% and the renal clearance of lithium was decreased by 19% during this period of concomitant drug administration. This effect has been attributed to inhibition of renal prostaglandin synthesis by ibuprofen. Thus, when ibuprofen and lithium are administered concurrently, subjects should be observed carefully for signs of lithium toxicity. (Read circulars for lithium preparation before use of such concurrent therapy.)

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NAME OF THE MEDICINAL PRODUCT

Ibuprofen 800mg

PHARMACEUTICAL FORM

Coated Tablet. White, capsule-shaped, sugar-coated tablets with no markings.

CLINICAL PARTICULARS

Therapeutic indications

Rheumatic or muscular pain, pain of non-serious arthritic conditions, backache, neuralgia, migraine, headache, dental pain, dysmenorrhoea (period pain), feverishness, symptoms of colds and influenza.

Ibuprofen Indications And Usage

In Children Ibuprofen Oral Suspension is indicated:

• For the reduction of fever in patients aged 6 months and older.
• For the relief of signs and symptoms of juvenile arthritis.

In Adults Ibuprofen Oral Suspension is indicated:

• For relief of mild to moderate pain.
• For the treatment of primary dysmenorrhea.
• For relief of the signs and symptoms of rheumatoid arthritis and osteoarthritis.

Since there have been no controlled trials to demonstrate whether there is any beneficial effect or harmful interaction with the use of ibuprofen in conjunction with aspirin, the combination cannot be recommended

Ibuprofen Contraindications

Ibuprofen should not be used in patients with previously demonstrated hypersensitivity to ibuprofen, or in individuals with a history of allergic manifestations to aspirin or other NSAIDs. Severe anaphylactic-like reactions to ibuprofen have been reported in such patients, some with fatal outcome.

Pregnancy

Teratogenic Effects

Pregnancy Category B: Reproductive studies conducted in rats and rabbits at doses somewhat less than the maximal clinical dose did not demonstrate evidence of developmental abnormalities. However, animal reproduction studies are not always predictive of human response. As there are no adequate and well-controlled studies in pregnant women, this drug should be used during pregnancy only if clearly needed. Because of the known effects of nonsteroidal anti-inflammatory drugs on the fetal cardiovascular system (closure of ductus arteriosus), use during late pregnancy should be avoided. Administration of ibuprofen is not recommended during pregnancy.

Labor and Delivery

As with other drugs known to inhibit prostaglandin synthesis, an increased incidence of dystocia and delayed parturition occurred in rats. Administration of ibuprofen is not recommended during labor and delivery.

Nursing Mothers

In limited studies, an assay capable of detecting 1 mcg/mL did not demonstrate ibuprofen in the milk of lactating mothers. Because of the limited nature of these studies, however, and the possible adverse effects of prostaglandin inhibiting drugs on neonates, ibuprofen is not recommended for use in nursing mothers.

Pediatric Use

Safety and efficacy of ibuprofen in pediatric patients below the age of 6 months has not been established. There is no evidence of age-dependent kinetics in patients 2 to 11 years old. Dosing of ibuprofen in children 6 months or older should be guided by their body weight

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NAME OF THE MEDICINAL PRODUCT

Ibuprofen 400mg

QUALITATIVE AND QUANTITATIVE COMPOSITION

Ibuprofen 400mg, per tablet.

Sucrose 190.72mg, per tablet

Lactose 80mg, per tablet

PHARMACEUTICAL FORM

Coated Tablet. White, capsule-shaped, sugar-coated tablets with no markings.

CLINICAL PARTICULARS

Therapeutic indications

Rheumatic or muscular pain, pain of non-serious arthritic conditions, backache, neuralgia, migraine, headache, dental pain, dysmenorrhoea (period pain), feverishness, symptoms of colds and influenza.

Posology and method of administration

For oral administration and short term use only:

Adults, the elderly and children over 12 years:

The minimum effective dose should be used for the shortest time necessary to relieve

symptoms. The patient should consult a doctor if symptoms persist or worsen, or if the

product is required for more than 10 days.

Swallow 400mg (1 tablet), preferably with water, up to three times a day, as required. Leave at least four hours between doses and do not take more than 1200mg (3 tablets) in any 24 hour period.

Contraindications

Hypersensitivity to ibuprofen or any of the constituents in the product. Patients who have previously shown hypersensitivity reactions (e.g. asthma, rhinitis, or urticaria) in response to aspirin or other non-steroidal anti-inflammatory drugs. Active or previous peptic ulcer. History of upper gastrointestinal bleeding or perforation, related to previous NSAIDs therapy. Use with concomitant NSAIDs including cyclo-oxygenase-2 specific inhibitors Severe hepatic failure, renal failure or heart failure Last trimester of pregnancy

Ibuprofen Information for Patients

Ibuprofen, like other drugs of its class, is not free of side effects. The side effects of these drugs can cause discomfort and, rarely there are more serious side effects, such as gastrointestinal bleeding, which may result in hospitalization and even fatal outcomes.

NSAIDs are often essential agents in the management of arthritis, pain and fever, but they also may be commonly employed for conditions which are less serious.

Physicians may wish to discuss with their patients the potential risks and likely benefits of NSAID treatment, particularly when the drugs are used for less serious conditions where treatment without NSAIDs may represent an acceptable alternative to both the patient and physician.

Patients on ibuprofen should report to their physicians.  Signs or symptoms of gastrointestinal ulceration or bleeding, blurred vision or other eye symptoms, skin rash, weight gain, or edema.

Because serious GI tract ulceration and bleeding can occur without warning symptoms, physicians should follow chronically treated patients for the signs and symptoms of ulceration and bleeding and should inform them of the importance of this follow-up

Patients should also be instructed to seek medical emergency help in case of an occurrence of an anaphylactoid reaction

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Ibuprofen belongs to the class of medications known as nonsteroidal anti-inflammatory drugs (NSAIDs). It is used for the relief of mild to moderately severe pain accompanied by inflammation. It can be used to relieve pain and inflammation associated with rheumatoid arthritis and osteoarthritis. It can also help relieve pain from menstrual cramps, headaches, muscular aches and pain, and dental pain. Ibuprofen can also relieve fevers. In children under 12, ibuprofen is used for fever and pain due to colds, sore throat, immunization, and earache.

Doses

The recommended adult dose of ibuprofen for mild to moderate pain and inflammation or menstrual cramps is 400 mg with food or milk, repeated as required every four to six hours. The maximum daily dose is 2,400 mg

The dose of Advil ibuprofen for children is based on body weight. Ibuprofen pediatric suspension is often used for young children and for adults who have difficulty swallowing tablets. Always shake the suspension well before using. Acetaminophen should not be used at the same time as ibuprofen for relief of fevers.

It is very important that this medication be taken exactly as prescribed by your doctor. A common side effect of nonsteroidal anti-inflammatory drugs (NSAIDs) such as Advil ibuprofen is stomach upset. This can be minimized by taking the medication immediately after a meal, or with food or milk. If you miss a dose of this medication, take it as soon as you remember it. If it is almost time for your next dose, skip the missed dose and carry on with your regular schedule. Do not take a double dose to make up for a missed one.

Form(s) of Advil

Tablets/Caplets (Sugar-coated)
Each brown, sugar-coated tablet/caplet contains ibuprofen 200 mg. Nonmedicinal ingredients: acetylated monoglyceride, beeswax, carnauba wax, corn starch, croscarmellose sodium, ethoxyethanol, iron oxides, lecithin, microcrystalline cellulose, parabens, pharmaceutical glaze, pharmaceutical shellac, povidone, pregelatinized starch, silicon dioxide, simethicone, sodium benzoate, sodium lauryl sulfate, stearic acid, sucrose and titanium dioxide.

Gel Caplets
Each beige brown, gelatin-coated gel-caplet contains ibuprofen 200 mg. Nonmedicinal ingredients: corn starch, croscarmellose sodium, FD&C Red No.40, FD&C Yellow No.6, gelatin, glycerin, hypromellose, iron oxides, medium chain triglycerides, pregelatinized starch, propyl gallate, propylene glycol, silicon dioxide, sodium lauryl sulfate, stearic acid, titanium dioxide and triacetin.

Liqui-Gels
Each green, transparent, gelatin capsule contains ibuprofen 200 mg. Nonmedicinal ingredients: FD&C Green No.3, gelatin, polyethylene glycol, polyvinyl acetate phthalate, potassium hydroxide, propylene glycol, purified water, sorbitan, sorbitol and titanium dioxide.

Extra Strength Caplets
Each brown film-coated caplet contains ibuprofen 400 mg. Nonmedicinal ingredients: cornstarch, croscarmellose sodium, hydroxypropyl methylcellulose, iron oxides, lecithin, pharmaceutical shellac, polyethylene glycol, pregelatinized starch, silicon dioxide, simethicone, sodium lauryl sulfate, stearic acid, talc and titanium dioxide.

Extra Strength Liqui-Gels
Each yellow, transparent, gelatin capsule contains ibuprofen 400 mg. Nonmedicinal ingredients: gelatin, iron oxide, lecithin, medium chain triglycerides, polyethylene glycol, polyvinyl acetate phthalate, potassium hydroxide, propylene glycol, purified water, sorbitan and sorbitol.

Some medications may have other generic brands available. Always ask your doctor or pharmacist about the safety of switching between brands of the same medication.

Who should NOT take Advil?

This medication should not be used by anyone who:

• currently has or recently had an inflammatory disease of the stomach and intestines such as stomach or intestinal ulcer or ulcerative colitis
• is currently taking other NSAIDs
• is or may be allergic to ibuprofen or any of the ingredients of the medication
• has had nasal polyps, bronchospastic reactivity to ASA, or an allergic reaction to ASA or any other anti-inflammatory medications
• has systemic lupus erythematosus

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Ibuprofen is an NSAID (non-steroidal anti-inflammatory drug). Non-steroidal means they are not steroids, which often have similar effects. As analgesics, NSAIDs are generally non-narcotic (do not cause insensibility or stupor). Ibuprofen also has an antiplatelet effect (protects from blood clots), though less than aspirin.

History of ibuprofen

Ibuprofen was derived form propionic acid by researchers at the Boots Company (Boots Group Plc), UK, during the 1960s. It was discovered by Stewart Adams, with colleagues John Nicholson, Andrew RM Dunlop, Jeffery Bruce Wilson & Colin Burrows, and was patented in 1961. Dr. Adams initially tested the drug on a hangover.

In 1969 it was launched as a medication for the treatment of rheumatoid arthritis in the UK in 1969, and in the USA in 1974. The Boots Group was awarded the Queen’s Award for Technical Achievement for the development of ibuprofen in 1987.

How does ibuprofen work?

Ibuprofen blocks the production of prostaglandins, substances our body releases in response to illness and injury. Prostaglandins cause pain and swelling (inflammation); they are released in the brain and can also cause fever.

Ibuprofen’s painkilling effects kick in soon after a dose is taken. Ibuprofen’s anti-inflammatory effects can take a bit longer, sometimes a few weeks.

Most common uses of ibuprofen

• Fever
• Inflammation
• Headache
• Toothache
• Back pain
• Arthritis, including juvenile arthritis
• Menstrual main
• Minor injuries

Brand names of ibuprofen

Ibuprofen brand names include Brufen, Calprofen, Genpril, Ibu, Midol, Nuprin, Cuprofen, Nurofen, Advil Motrin and there are many others. Some medications, such as decongestants, have ibuprofen added.

Ibuprofen is available as gels, sprays, tablets or mousses.

What are the side effects of ibuprofen?

The most common side-effects include:

• Diarrhea
• Nausea
• Vomiting
• Dyspepsia (upper abdominal pain, bloating, indigestion)
• Any pain in the stomach or intestines

The following side-effects are also possible, but less common:

• Dizziness (if you experience this, don’t drive or operate heavy machinery)
• Edema (fluid retention, bloating)
• Hypertension (elevated blood pressure)
• Stomach inflammation
• Ulcers in the digestive system
• Rash, and some other allergic reactions
• Worsening of asthma symptoms

The following side effects are possible, but extremely rare:

• Bleeding in the stomach which may be presented as..

..malaena (black stools)
..hematemesis (vomiting with blood)

Some women may have reduced fertility after long-term use of ibuprofen. This problem stops soon treatment is over.

Precautions

Do not take ibuprofen if you..

• are sensitive to aspirin or any other NSAID
• have a peptic ulcer
• have had a peptic ulcer
• have severe heart failure.

The following people should use ibuprofen with caution – if you are not sure, check with your doctor or a qualified pharmacist:

people with, or who have had..

• asthma
• liver problems
• kidney problems
• mild heart failure
• hypertension (high blood pressure)
• angina, heart attacks (ischemic heart disease)
• narrowing of the arteries (peripheral arterial disease)
• a history that includes any episode of stomach bleeding
• stroke

Ibuprofen problems if taken along with other medications – interactions

Sometimes one medication can interfere with the effects of another medication – this is known as drug interaction. Below is a list of some common interactions; if you are taking medications not listed below check with your doctor or pharmacist to make sure:

• Antihypertensive medications – these are drugs taken for high blood pressure (hypertension).

• Anti-inflammatory painkillers – if you are taking diclofenac (Voltarol), indometacin, or naproxen you should not take ibuprofen because of the increased risk of stomach bleeding.

• Aspirin – ibuprofen taken in combination with aspirin significantly raises the risk of stomach bleeding.

• Digoxin – often used for the treatment of atrial fibrillation. Ibuprofen taken in combination with digoxin can raise blood levels.

• Lithium – A medication sometimes prescribed for certain mental disorder and illnesses. Ibuprofen can make it harder for the body to eliminate lithium, resulting in high and potentially dangerous levels of lithium in the body.

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The function of the liver is to clear drugs from the entire body. But the excessive doses of this medication can badly damage your liver. High doses of this drug can prevent your liver from getting rid of this drug. In some cases the liver metabolism is slowed down. The liver is inflamed and no longer works properly, and ultimately is damaged by the Ibuprofen doses. In severe cases the liver failure results.

Effect of Ibuprofen on the Liver

Ibuprofen is one of the nonsteroidal anti-inflammatory drugs (NSAIDs). Ibuprofen relieves pain and inflammation. The liver eliminates the drug out of the body. The process may be slow in some people, or the function of the liver may be altered by high doses of this drugs. If the liver is not able to eliminate Ibuprofen properly then it may be damaged or inflamed. Liver inflammation due to the medication is called drug-induced hepatitis.

Symptoms of Liver Damage

Hepatitis caused by ibuprofen is marked by abdominal pain and tenderness on the upper right side, dark-colored urine, diarrhea, headache, nausea and vomiting, loss of appetite, fatigue, jaundice and white or clay-colored stool (NIH). The diagnosed is confirmed with a blood test, which will show elevated liver enzymes.

Treatment for Liver Damage

The treatment for Ibuprofen-induced liver damage is simply discontinuing use of the drug. No other treatment is necessary. Symptoms usually fade within a few days after Ibuprofen is stopped but may linger for a few weeks.

Prevention

Ibuprofen can be used safely without risking damage to the liver. Never exceed the maximum recommended dose. People who are heavy drinkers of alcohols should avoid using Ibuprofen. The effects of ibuprofen on the liver are worse for people who already have liver damage or hepatitis.

Other Side Effects

Other side effects of Ibuprofen are upset stomach, heartburn, diarrhea, constipation, bloating or gas, dizziness, headache, nervousness, rash, blurred vision or ringing in the ears. High blood pressure is a direct result of hepatitis or liver damage caused by Ibuprofen. A damaged liver can not work properly.

Ibuprofen Liver is a post from: Ibuprofen 800mg

Ibuprofen is in a group of drugs called nonsteroidal anti-inflammatory drugs (NSAIDs), which can cause tears in the stomach lining if taken on an empty tummy. Add alcohol to the mix, and the potential danger is heightened.

Stomach

If you take ibuprofen when drinking more than the recommended amount for men and women (about two to three drinks), you increase your risk of stomach irritation and bleeding. This is especially true for people who are prone to ulcers. Ibuprofen can also cause stomach bleeding if you take it with alcohol.

Liver

According to research institutes, Ibuprofen can lead to liver damage if you take it in large doses like 4,000 milligrams, for more than a couple of days.  While in some cases it has been reported that it has result in a permanent liver damage.

One of the functions of the liver is to eliminate ibuprofen as well as alcohol from the body. The process may work too slowly in some people, or liver function may be altered by high doses of drugs, such as ibuprofen and alcohol (National Institutes of Health [NIH]). If the liver is unable to eliminate the drugs and alcohol properly, the liver may become damaged or inflamed. Liver inflammation resulting from medication is called drug-induced hepatitis.

Therefore it is obvious that heavy drinkers who take Ibuprofen and don’t eat enough can overtax their livers. However, the risks associated with taking Ibuprofen after recreational drinking is somewhat blurry.

Conclusion

Basically Ibuprofen and alcohol in combination overwhelm the liver’s ability to remove toxins from your bloodstream. It’s not clear from the medical literature what happens if you take Ibuprofen after a one-time bender (as opposed to chronic alcohol abuse). But don’t substitute some other painkiller — aspirin and acetaminophen can have side effects too. Better to be suffering than dead.

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Ibuprofen is in a group of drugs called nonsteroidal anti-inflammatory drugs (NSAIDs). It works by reducing hormones that cause inflammation and pain in the body.

Way of usage

Take this medicine by mouth with a glass of water. Follow the directions on the prescription label. Take this medicine with food if your stomach gets upset. Try to not lie down for at least 10 minutes after you take the medicine. Take your medicine at regular intervals. Do not take your medicine more often than directed.

Why is this medication prescribed?

Prescription ibuprofen is used to relieve pain, tenderness, swelling, and stiffness caused by osteoarthritis and rheumatoid arthritis. It is also used to relieve mild to moderate pain, including menstrual pain. Nonprescription ibuprofen is used to reduce fever and to relieve mild pain from headaches, muscle aches, arthritis, menstrual periods, the common cold, toothaches, and backaches.

Other uses for this medicine

Ibuprofen is also sometimes used to treat ankylosing spondylitis, gouty arthritis and psoriatic arthritis.

Mechanism of action

Non-steroidal anti-inflammatory drugs such as ibuprofen work by inhibiting the enzyme cyclooxygenase (COX), which converts arachidonic acid to prostaglandin H2 (PGH2). PGH2, in turn, is converted by other enzymes to several other prostaglandins (which are mediators of pain, inflammation, and fever) and to thromboxane A2 (which stimulates platelet aggregation, leading to the formation of blood clots).

Chemistry

Ibuprofen is only very slightly soluble in water, less than 1 mg of ibuprofen dissolves in 1 ml water (< 1 mg/mL).

Typical administration

Low doses of ibuprofen (200 mg, and sometimes 400 mg) are available over the counter (OTC) in most countries. Ibuprofen has a dose-dependent duration of action of approximately 4–8 hours, which is longer than suggested by its short half-life. The recommended dose varies with body mass and indication. Generally, the oral dose is 200–400 mg (5–10 mg/kg in children) every 4–6 hours, adding up to a usual daily dose of 800–1200 mg. 1200 mg is considered the maximum daily dose for over-the-counter use, though under medical direction, a maximum daily dose of 3200 mg may sometimes be used in increments of 600–800 mg.

In case of emergency/overdose

In case of overdose, call your local poison control center. If the victim has collapsed or is not breathing, call local emergency services.
Symptoms of overdosage may include:
• dizziness
• fast eye movements that you cannot control
• slow breathing or short periods of time without breathing
• blue color around the lips, mouth, and nose

Ibuprofen side effects

Get emergency medical help if you have any of these signs of an allergic reaction: hives; difficulty breathing; swelling of your face, lips, tongue, or throat. Stop taking ibuprofen 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, stomach pain, low fever, 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
• fever, headache, neck stiffness, chills, increased sensitivity to light, purple spots on the skin, and/or seizure (convulsions).

What should I tell my health care provider before I take this medicine?

• asthma
• cigarette smoker
• drink more than 3 alcohol containing drinks a day
• heart disease or circulation problems such as heart failure or leg edema (fluid retention)
• high blood pressure
• kidney disease
• liver disease
• stomach bleeding or ulcers
• an unusual or allergic reaction to ibuprofen, aspirin, other NSAIDS, other medicines, foods, dyes, or preservatives
• pregnant or trying to get pregnant
• breast-feeding

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Side effects:

Ibuprofen is nonsteroidal anti-inflammatory drug (NSAID). It relieves pain and inflammation. It is used for treating headaches, muscle aches, backaches, dental pain, menstrual cramps, arthritis, athletic injuries, to reduce fever and to relieve minor aches and pain due to the common cold or flu. This works by reducing hormones that cause inflammation and pain in the body.

The most common side effects caused by Ibuprofen are rash, itching, swelling, severe dizziness, trouble breathing, upset stomach, nausea, vomiting, heartburn, headache, diarrhea, constipation, and drowsiness. If any of these symptoms occurs then stop taking ibuprofen and seek medical attention or call your doctor at once. Many people using this medicine do not have any serious side effects. If serious side effects like stomach pain, swelling of the hands or feet, sudden or unexplained weight gain, ringing in the ears (tinnitus), vision changes, rapid or pounding heartbeat, easy bruising or bleeding, difficult/painful swallowing, change in amount of urine, severe headache, very stiff neck, mental/mood changes, persistent sore throat or fever occur then seek medical attention.

This drug may rarely cause serious (possibly fatal) liver disease. If you notice any of the following highly unlikely but very serious side effects, stop taking ibuprofen and consult your doctor or pharmacist immediately: yellowing eyes and skin, dark urine, unusual/extreme tiredness.

This medicine rarely causes fatal liver disease. If you notice any of this side effects like yellowing eyes and skin, dark urine, unusual/extreme tiredness then consult your doctor immediately.

This list is not complete for possible side effects of Ibuprofen. And if you notice any side effect not listed above then consult your doctor or pharmacist.

Precautions:

Before taking Ibuprofen tell your doctor or pharmacist if you have any allergies to it or to any other NSAIDs. If you have specific medical conditions then you should not take it. Before taking this drugs consult a doctor or pharmacist if you have severe kidney disease, aspirin-sensitive asthma, or recent heart bypass surgery (CABG). Before using Ibuprofen you should tell your medical history to your doctor or pharmacist especially of kidney disease, liver disease, poorly controlled diabetes, stomach/intestine/esophagus problems, heart disease, high blood pressure, stroke, swelling, dehydration, blood disorders, bleeding or clotting problems, asthma, growths in the nose, history of an allergic reaction with symptoms of lip/tongue/throat swelling), any allergies in addition to those listed above.

This medicine may make you feel dizzy or drowsy; be alert and try to be engaged in activities such as driving or using machinery and limit alcoholic beverages. Ibuprofen can also cause stomach bleeding if you take it with alcohol and bleeding. You can consult a doctor or pharmacist for more information.

This medicine can also make you sensitive to sun so avoid prolonged sun exposure, tanning booths or sunlamps. Precautions should be taken when using this drug in elderly people because they can be more sensitive to it, and they can also suffer stomach bleeding and kidney effects as the side effects.

Ibuprofen can be used only when needed during the first 6 months of pregnancy. It is not advised for use during last 3 months of pregnancy; it can harm the unborn baby and can interfere with normal labor/delivery. So just try to know risks and benefits from your doctor.

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Ibuprofen is one of the non- steroidal anti-inflammatory drugs (NSAID). It is used to relieve pain and inflammation. It is widely marketed under the trademarks like Herron Blue, Act-3, Advil, Brufen, Motrin, Nuprin, and Nurofen, etc.

Clinical use

In most of the countries low doses of Ibuprofen is available over the counter. It have a dose-dependent of action is approximately 4-8 hours, up to a usual maximum daily dose of 800–1200 mg, which is longer than it’s suggested short half-life. The dose varies with body mass and indication. Under medical direction, 3200mg may be the maximum daily dose sometimes.

Mechanism of action

Ibuprofen is believed to work through the inhibition of cyclooxygenase (COX), thus inhibiting prostaglandin synthesis. At least there are two variations of cyclooxygenase COX-1 and COX-2, Ibuprofen inhibits both. It’s analgesic, antipyretic, and anti-inflammatory activities are achieved principally through COX-2 inhibition; whereas COX-1 inhibition is responsible for its unwanted effects on platelet aggregation and the GI mucosa.

Adverse effects

Ibuprofen has the lowest incidence of gastrointestinal adverse drug reactions. However it is only true for the lower doses of 1,200mg maximum daily dose.

Reported adverse drug reactions

In daily doses of up to 1,200 mg the incidence of side effects is low. However patients treated with more than 1,200mg daily on long term bases discontinuation rates are as high as 10 to 15%.

The adverse effects commonly occur includes nausea, dyspepsia, gastrointestinal ulceration/bleeding, raised liver enzymes, diarrhoea, headache, dizziness, salt and fluid retention, and hypertension. And the infrequent adverse effects are oesophageal ulceration, heart failure, hyperkalaemia, renal impairment, confusion, bronchospasm, and rash.

Photosensitivity

Ibuprofen is reported as a photosensitizing agent. However it rarely occurs. Ibuprofen is considered to be a very weak photosensitizing agent when compared with other members of the 2-arylpropionic acids. Ibuprofen molecules contain only a single phenyl moiety and have no bond conjugation, resulting in a very weak chromophore system and a very weak absorption spectrum that does not reach into the solar spectrum.

Availability

Since, the good tolerability along with extensive experience in the community has resulted in the rescheduling of small packs of ibuprofen to allow availability over-the-counter in pharmacies worldwide. Indeed there has been an increasing trend towards rescheduling ibuprofen such that it is now available in supermarkets and other general retailers.

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