Drug Facts for Africans: Ibuprofen 

 

By: Ruth Abi, B. Pharm. Freelance Health Writer

Two ibuprofen caplets in the open cup of a hand

 

Drug name: Ibuprofen

 

Indication for use: Analgesic (pain killer), anti-inflammatory, antipyretic (fever reducer).

Use is common in the management of mild to moderate pain related to headache, migraine, dysmenorrhea (menstrual cramps), dental pain, osteoarthritis and rheumatoid arthritis (bone and joint pains), soft tissue pains.

 

Dosage forms: Suspension, tablet, injection, and suppository

[Note: Ready availability of ibuprofen injection may vary by African countries. It is not commonly available in Nigeria for example].

 

Drug class: Non-steroidal anti-inflammatory drugs  

 

If you experienced back pain, menstrual cramps or a toothache recently, it most likely crossed your mind to lay hold of some ibuprofen and get some relief. Before you pop another pill, here are some vital information about ibuprofen to be aware of.

 

What is ibuprofen?

Ibuprofen is a non-steroidal anti-inflammatory drug, meaning, it is not a steroid by nature and is used in the management of mild to moderate pain, fever and inflammation. 

Some conditions ibuprofen is used to treat are: headache, menstrual cramps, toothache, arthritis and back pain.

 

How does ibuprofen work?

Ibuprofen works by inhibiting cyclooxygenase enzymes 1 and 2 (COX-1 & COX-2). These enzymes are involved in the production of prostaglandin and thromboxane. Prostaglandin is produced when the body is in pain, while thromboxane triggers the process of blood clotting. So, when you take ibuprofen, it blocks COX-1 and COX-2, preventing the production of prostaglandin and thromboxane. These in turn block pain sensation and the ability of blood to clot in the body. [1]

 

How should I take ibuprofen?

Ibuprofen should be taken as written in the label or as directed by your physician or pharmacist. This is important because an overdose of ibuprofen can cause damage to the stomach and intestines. It is recommended to take the lowest effective dose of ibuprofen per time. Also, ibuprofen should be taken with food to prevent the occurrence of stomach upset. [1]

 

Adult Dosage

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).

 Parenteral:
 IV (Caldolor): 400 to 800 mg IV every 6 hours as needed
 Maximum dose: 3200 mg/day. [2]

 

Child Dosage

For children, the dose is dependent on their age and weight.

Oral:
 6 months to less than 24 months:
 Infant Drops (50 mg/1.25 mL):

• Weight of 5 to 7 kg: 50 mg orally every 6 to 8 hours as needed.
• Weight of 8 to 10 kg: 75 mg orally every 6 to 8 hours as needed.

Maximum: 4 doses per day.
 

1 year to less than 12 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.
 

12 years or older:

• Initial dose: 200 mg orally every 4 to 6 hours as needed.  
• May be increased to 400 mg every 4 to 6 hours if additional pain relief is needed.

Maximum dose: 1200 mg/day.

 

Parenteral (Caldolor):
6 months to less than 12 years: 10 mg/kg IV every 4 to 6 hours as needed.

•  Maximum single-dose: 400 mg.

 Maximum 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 daily dose: 2400 mg/day. [2]

 

What should I do if I miss a dose of ibuprofen?

Ibuprofen is usually taken when needed, hence, whatever dose is missed should be skipped. Do not take two doses at once to make up for a missed dose.

 

Warnings on ibuprofen

• Do not take more than the prescribed dose of ibuprofen as it can damage your intestines and stomach.

• Ibuprofen could cause stomach or intestinal bleeding when used for a long period or in high doses, especially in older adults.

• Do not use ibuprofen just before or after coronary artery bypass surgery (i.e. an operation to skip over a blockage in a blood vessel that supplies the heart) as it can increase your risk of a stroke or heart attack.

• Do not give ibuprofen to children below 6 months without a doctor’s recommendation.

• Do not use ibuprofen when pregnant, unless recommended by your doctor. Using ibuprofen during the last 5 months of pregnancy can cause complications and seriously affect the heart or kidney of your unborn child. [3]

 

What are the side effects of ibuprofen?

• Nausea, vomiting, bleeding, dizziness and headache are the common side effects of ibuprofen.

• Ibuprofen may cause an allergic reaction. 

Symptoms may include: difficulty breathing, swelling in the face, red skin, burning sensation on the skin, skin rashes with blisters or peels.

• Ibuprofen may cause a heart attack or stroke. 

Symptoms may include: chest pain that moves towards the shoulder or jaw, difficulty with speech, numbness in one side of the body, shortness of breath and swollen legs.

• Stomach bleeding.

• Kidney problems (little urine output, painful urination, swollen feet).

• Liver problems (yellow eyes and skin, dark urine, clay colored stool, upper stomach pain). [1]

 

What should I avoid when using ibuprofen?

• Avoid using other NSAIDS (e.g ketoprofen, diclofenac, naproxen) when on ibuprofen.
• Avoid alcohol as it may increase your risk of stomach bleeding.

 

What other drugs will interact with ibuprofen?

A drug interaction occurs when a drug reacts with another drug, food, beverage, or medical condition, thereby causing a change in the drug's effect on the body. Drug interactions can cause a drug to be less or more effective, or cause unexpected side effects.

For this reason, consult with a physician or pharmacist if you are taking other drugs along with ibuprofen. Not all ibuprofen drug interactions are listed here, but some include:

• Aspirin

Taking ibuprofen with aspirin reduces aspirin’s effectiveness to prevent blood clots from forming in the body. Meaning, a heart attack or stroke can occur.

• Methotrexate

Taking ibuprofen with methotrexate increases the level of methotrexate in the blood. This is because the kidney is unable to remove methotrexate from the body as fast as it normally will. A high dose of methotrexate together with ibuprofen can cause death due to blood and gastrointestinal toxicity.

• Drugs for high blood pressure (hypertension) 

Taking ibuprofen with drugs like ramipril, captopril and lisinopril can reduce their effect against high blood pressure. It can also cause the kidney to function less effectively.

• Ciprofloxacin

Taking ibuprofen with high doses of ciprofloxacin can increase the risk of having seizures.

• Clopidogrel 

Both clopidogrel and ibuprofen work against the ability of blood to clot, so there is an increased risk of bleeding.  [3]

 

What if I overdose on ibuprofen?

An overdose of ibuprofen can cause symptoms such as nausea, vomiting, dizziness, bloody stool, and fainting. Get urgent medical attention if you overdose on ibuprofen.

 

Conclusion

Being well informed about the uses, dosage, side effects and drug interactions of ibuprofen, enables you to use the drug safely and effectively. Beware though, that the information does not replace the role of your healthcare professionals. Always talk with them if you have questions or concerns about ibuprofen. 

 

References

1.   Drugbank Online. Ibuprofen. [Internet] Last updated 2024 September 24.  [Accessed: 2024 September 25]. Available from here.

2.   Drugs.com. Ibuprofen Dosage. [Internet]. Last updated 2023 September 21. [Accessed: 20 September 2024]. Available from here.  

3.  Medscape. Ibuprofen (Rx, OTC). [Internet, n.d.]. (Accessed: 21 September 2024). Available from here. (Free subscription required for access): 

 

 

Related: Drug Facts for Africans: Acetaminophen

 

 

Published: September 25, 2024

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