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ibuprofen
ACT-3‡, Actiprofen‡, AdvilOTC, Apo-Ibuprofen†, Bayer Select Pain Relief Formula, Brufen‡, Children's Advil, Children's MotrinOTC, Excedrin IB TabletsOTC, Excedrin IB CapletsOTC, IbuprinOTC, Junifen Sugar Free§, Midol IB, Motrin, Motrin-IB CapletsOTC, Motrin-IB TabletsOTC, Novo-Profen†, NuprinOTC, Nuprin CapletsOTC, Nurofen‡, Nurofen Junior‡, Pamprin-IB

Pregnancy Risk Category NR

How supplied
Tablets:
100 mg, 200 mgOTC, 300 mg, 400 mg, 600 mg, 800 mg
Tablets (chewable):
50 mg, 100 mg
Oral suspension:
100 mg/5 ml
Oral drops:
40 mg/ml

Action
Unknown. Produces anti-inflammatory, analgesic, and antipyretic effects, possibly by inhibiting prostaglandin synthesis.

Indications & dosage
Rheumatoid arthritis, osteoarthritis, arthritis
--
Adults:
300 to 800 mg P.O. t.i.d. or q.i.d. not to exceed 3.2 g daily.
Mild to moderate pain, dysmenorrhea
--
Adults:
400 mg P.O. q 4 to 6 hours, p.r.n.
Fever
--
Adults:
200 to 400 mg P.O. q 4 to 6 hours. Don't exceed 1.2 g daily or give longer than 3 days.
Children ages 6 months to 12 years:
if fever is below 102.5° F (39.2° C), the recommended dose is 5 mg/kg P.O. q 6 to 8 hours. Treat higher fevers with 10 mg/kg q 6 to 8 hours. Don't exceed 40 mg/kg daily.
Juvenile arthritis--

Children:
30 to 70 mg/kg/day P.O. in three or four divided doses.

Adverse reactions
CNS:
headache, dizziness, nervousness, aseptic meningitis.
CV:
peripheral edema, fluid retention, edema.
EENT:
tinnitus.
GI:
epigastric distress, nausea, occult blood loss, peptic ulceration, diarrhea, constipation, dyspepsia, flatulence, heartburn, decreased appetite.
GU:
acute renal failure, azotemia, cystitis, hematuria, increased BUN and creatinine.
Hematologic:
prolonged bleeding time, anemia, neutropenia, pancytopenia, thrombocytopenia, aplastic anemia, leukopenia, agranulocytosis.
Hepatic:
elevated liver enzyme levels.
Metabolic:
hypoglycemia, hyperkalemia.
Respiratory:
bronchospasm.
Skin:
pruritus, rash, urticaria, Stevens-Johnson syndrome.
Other:
decreased serum uric acid levels.

Interactions
Drug-drug.
Antihypertensives, furosemide, thiazide diuretics: ibuprofen may decrease the effectiveness of diuretics or antihypertensives. Monitor patient closely.
Aspirin:
may decrease serum levels of ibuprofen. Avoid concomitant use.
Aspirin, corticosteroids:
increased risk of adverse GI reactions. Avoid concomitant use.
Cyclosporine:
nephrotoxicity of both drugs may be increased. Avoid concomitant use.
Digoxin, lithium, oral anticoagulants:
ibuprofen may increase plasma levels or effects of these drugs. Monitor for toxicity.
Methotrexate:
decreased methotrexate clearance and increased toxicity. Use together cautiously.
Drug-lifestyle.
Alcohol use: increased risk of adverse GI reactions. Avoid concomitant use.
Sun exposure:
may cause photosensitivity reactions. Take precautions.

Effects on diagnostic tests
None reported.

Contraindications
Contraindicated in patients with hypersensitivity to drug and in those with angioedema, syndrome of nasal polyps, or bronchospastic reaction to aspirin or other NSAIDs.

Nursing considerations

Patient teaching

*Liquid contains alcohol. **May contain tartrazine.  †Canada  ‡Australia  §U.K.  OTCOver the counter
Reactions may be common, uncommon, life-threatening, or COMMON AND LIFE-THREATENING

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