Ibuprofen

Non-steroidal anti-inflammatory (NSAID, non-selective), Analgesic, Antipyretic

Ibuprofen

Advil, Motrin, IBU, Caldolor (IV), NeoProfen (neonatal IV)

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Summary

Classes

Non-steroidal anti-inflammatory (NSAID, non-selective), Analgesic, Antipyretic

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

Bioavailability

~80-100% (oral)

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)

Legal status

OTC in the US at ≤200 mg per tablet / ≤1200 mg/day; Rx-only at higher strengths and indications

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.