Ibuprofen
Ibuprofen
Advil, Motrin, IBU, Caldolor (IV), NeoProfen (neonatal IV)
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Summary
Common uses
Mild-to-moderate pain (FDA)0, Fever (FDA, including pediatric)0, Primary dysmenorrhea (FDA)0, Osteoarthritis (FDA)0, Rheumatoid arthritis (FDA)0, Juvenile rheumatoid arthritis (FDA)0, Patent ductus arteriosus closure in preterm neonates (NeoProfen)0
Pharmacy
Starting dose
200-400 mg PO every 4-6 hours as needed. OTC max 1200 mg/day without provider direction; prescription max 3200 mg/day divided
Preparations
Tablets 200, 400, 600, 800 mg; capsules 200 mg; oral suspension 100 mg/5 mL; chewable tablets 100 mg; injection 100 mg/mL (Caldolor)
US FDA Max
3200 mg/day (Rx); 1200 mg/day (OTC, without provider direction)
Pharmacology
Routes
Oral, intravenous (Caldolor, NeoProfen)
Onset
30-60 minutes (oral)
Duration
4-6 hours
Half-life
2-4 hours[1]
Bioavailability
~80-100% (oral)[1]
Pregnancy
Avoid from 20 weeks gestation onward per FDA's 2020 expanded NSAID warning (fetal renal dysfunction, oligohydramnios); contraindicated from 30 weeks (risk of premature ductus arteriosus closure)[1]
Legal status
Purported mechanism
Non-selective inhibitor of both COX-1 and COX-2 (cyclooxygenase) isoforms, reducing prostaglandin synthesis to produce analgesic, anti-inflammatory, and antipyretic effects. Like all NSAIDs, carries the FDA Boxed Warning for cardiovascular thrombotic events and gastrointestinal bleeding, with additional acute kidney injury risk particularly in volume-depleted or elderly patients.0 Clinical pearl: when taken before low-dose aspirin, ibuprofen reversibly occupies the COX-1 site and blocks aspirin's irreversible platelet acetylation, blunting cardioprotection. The FDA-suggested workaround is to take aspirin at least 30 minutes before ibuprofen, or ≥8 hours after[1].
References
- ↑ 1.0 1.1 1.2 1.3 FDA Prescribing Information, Motrin (ibuprofen), Pfizer/various, current revision. https://www.accessdata.fda.gov/drugsatfda_docs/label/2007/017463s105lbl.pdf