ibuprofen (Motrin, Advil, Nuprin, Rufen, NeoProfen, Caldolor)

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Introduction

Tradenames: Motrin, Advil, Nuprin, Rufen.

Indications

Contraindications

Pregnancy category: B, D in 3rd trimester

pregnancy category = b

pregnancy category = d

safety in lactation = +

Dosage

  • 200-800 mg PO TID-QID, max: 3.2 g/day
  • pediatric 5-10 mg/kg PO every 6 hours, max: 40 mg/kg/day
  • 400-800 mg IV over 30 minutes every 6 hours (pain);[18] bolus 400 mg, then 200-400 mg IV every 4-6 hours (fever)
  • prevention of acute mountain sickness[22]
    • 600 mg every 6 hours 6 hours prior to ascending
  • doses > 400 mg do not provide additional pain control[26]

Tabs: 200, 300, 400, 600, 800 mg.

Children's Motrin: (100 mg/5 mL)

NeoProfen: ibuprofen lysine, intravenous form

Calador: (intravenous, for hospital use only)[18]; 400 mg/4 mL single-dose vial & 800 mg/8 mL single-dose vial; must be diluted before infusion; dilute with normal saline, D5W, or Lactated Ringers to a final concentration of 4 mg/mL or less (25-fold dilution)

Pharmacokinetics

elimination via liver

1/2life = 2-4 hours

protein binding = >99 %

elimination by hemodialysis = -

elimination by peritoneal dialysis = -

Monitor

Adverse effects

Drug interactions

Laboratory

Mechanism of action

More general terms

Additional terms

Component of

References

  1. ↑ The Pharmacological Basis of Therapeutics, 9th ed. Gilman et al, eds. Permagon Press/McGraw Hill, 1996
  2. ↑ Saunders Manual of Medical Practice, Rakel (ed), WB Saunders, Philadelphia, 1996, pg 792
  3. ↑ Drug Information & Medication Formulary, Veterans Affairs, Central California Health Care System, 1st ed., Ravnan et al eds, 1998
  4. ↑ Medical Knowledge Self Assessment Program (MKSAP) 11, American College of Physicians, Philadelphia 1998
  5. ↑ Kaiser Permanente Northern California Regional Drug Formulary, 1998
  6. ↑ Clinical Guide to Laboratory Tests, NW Tietz (ed) 3rd ed, WB Saunders, Philadelpha 1995
  7. ↑ Prescriber's Letter 13(3): 2006 Cytochrome P450 drug interactions Detail-Document#: http://prescribersletter.com/(5bhgn1a4ni4cyp2tvybwfh55)/pl/ArticleDD.aspx?li=1&st=1&cs=&s=PRL&pt=3&fpt=25&dd=220233&pb=PRL (subscription needed) http://www.prescribersletter.com
  8. ↑ Journal Watch 21(18):143-44, 2001
  9. ↑ Sepulveda VA
  10. ↑ 10.0 10.1 Prescriber's Letter 9(2):1 2002
  11. ↑ 11.0 11.1 Journal Watch 22(2):11, 2002 Catella-Lawson et al, N Engl J Med 345:1809, 2001
  12. ↑ 12.0 12.1 Prescriber's Letter 10(3):15 2003
  13. ↑ 13.0 13.1 Weggen S et al, Evidence that nonsteroidal anti-inflammatory drugs decrease amyloid beta 42 production by direct modulation of gamma-secretase activity. J Biol Chem. 2003 Aug 22;278(34):31831-7. Epub 2003 Jun 12. PMID: https://www.ncbi.nlm.nih.gov/pubmed/12805356
  14. ↑ 14.0 14.1 Eriksen JL et al, NSAIDs and enantiomers of flurbiprofen target gamma-secretase and lower Abeta 42 in vivo. J Clin Invest. 2003 Aug;112(3):440-9. PMID: https://www.ncbi.nlm.nih.gov/pubmed/12897211
  15. ↑ Geriatric Dosage Handbook, 6th edition, Selma et al eds, Lexi-Comp, Cleveland, 2001
  16. ↑ 16.0 16.1 Prescriber's Letter 12(4): 2005 Ibuprofen and the Risk of Stevens-Johnson Syndrome Detail-Document#: http://prescribersletter.com/(5bhgn1a4ni4cyp2tvybwfh55)/pl/ArticleDD.aspx?li=1&st=1&cs=&s=PRL&pt=3&fpt=25&dd=210408&pb=PRL (subscription needed) http://www.prescribersletter.com
  17. ↑ Prescriber's Letter 14(2): 2007 New drugs approved by the FDA in 2006 Detail-Document#: http://prescribersletter.com/(5bhgn1a4ni4cyp2tvybwfh55)/pl/ArticleDD.aspx?li=1&st=1&cs=&s=PRL&pt=3&fpt=25&dd=2302213&pb=PRL (subscription needed) http://www.prescribersletter.com
  18. ↑ 18.0 18.1 18.2 FDA NEWS RELEASE: FDA Approves Injectable Form of Ibuprofen http://www.fda.gov/NewsEvents/Newsroom/PressAnnouncements/ucm165971.htm
  19. ↑ Prescriber's Letter 16(11): 2009 New Drug: Caldolor (Ibuprofen) Injection Detail-Document#: http://prescribersletter.com/(5bhgn1a4ni4cyp2tvybwfh55)/pl/ArticleDD.aspx?li=1&st=1&cs=&s=PRL&pt=3&fpt=25&dd=251111&pb=PRL (subscription needed) http://www.prescribersletter.com
  20. ↑ Gonzalez ELM et al Variability among nonsteroidal antiinflammatory drugs in risk of upper gastrointestinal bleeding. Arthritis Rheum 2010 Jun; 62:1592 http://dx.doi.org/10.1002/art.27412
  21. ↑ 21.0 21.1 Prescriber's Letter 17(7): 2010 Recommended Lab Monitoring for Common Medications Liver Function Test Scheduling Detail-Document#: http://prescribersletter.com/(5bhgn1a4ni4cyp2tvybwfh55)/pl/ArticleDD.aspx?li=1&st=1&cs=&s=PRL&pt=3&fpt=25&dd=260704&pb=PRL (subscription needed) http://www.prescribersletter.com
  22. ↑ 22.0 22.1 22.2 Lipman GS et al. Ibuprofen prevents altitude illness: A randomized controlled trial for prevention of altitude illness with nonsteroidal anti-inflammatories. Ann Emerg Med 2012 Jun; 59:484. PMID: https://www.ncbi.nlm.nih.gov/pubmed/22440488
  23. ↑ Deprecated Reference
  24. ↑ 24.0 24.1 Husten L. Fairchild DG and Sofai A editors. European Regulators Investigate Cardiovascular Safety of Ibuprofen. Physician's First Watch, June 17 2014 David G. Fairchild, MD, MPH, Editor-in-Chief Massachusetts Medical Society http://www.jwatch.org
  25. ↑ 25.0 25.1 25.2 25.3 Kristensen DM, Desdoits-Lethimonier C, Mackey AL et al Ibuprofen alters human testicular physiology to produce a state of compensated hypogonadism. Proc Natl Acad Sci U S A. 2018 Jan 8. <PubMed> PMID: https://www.ncbi.nlm.nih.gov/pubmed/29311296 <Internet> http://www.pnas.org/content/early/2018/01/03/1715035115.full
  26. ↑ 26.0 26.1 Motov S, Masoudi A, Drapkin J et al. Comparison of oral ibuprofen at three single dose regimens for treating acute pain in the emergency department: A randomized controlled trial. Ann Emerg Med 2019 Aug 2; PMID: https://www.ncbi.nlm.nih.gov/pubmed/31383385

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