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Ibuprofen Contraindications, Pregnancy Category

Ibuprofen Contraindications is a nonsteroidal anti-inflammatory agent with analgesic properties used in the therapy of rheumatism and arthritis. Ibuprofen is a propionic acid derivate and nonsteroidal anti-inflammatory drug (NSAID) with anti-inflammatory, analgesic, and antipyretic effects. Ibuprofen inhibits the activity of cyclo-oxygenase I and II, resulting in a decreased formation of precursors of prostaglandins and thromboxanes. This leads to decreased prostaglandin synthesis, by prostaglandin synthase, the main physiologic effect of ibuprofen. Ibuprofen also causes a decrease in the formation of thromboxane A2 synthesis, by thromboxane synthase, thereby inhibiting platelet aggregation. (NCI05)

Ibuprofen is a commonly used nonsteroidal anti-inflammatory (NSAID) drug which is available both by prescription and over-the-counter. Ibuprofen is considered to be among the safest NSAIDs and is generally well tolerated but can, nevertheless, rarely cause clinically apparent and serious acute liver injury.

Ibuprofen Indications

IbuprofenTablet is used for the treatment, control, prevention, & improvement of the following diseases, conditions, and symptoms

For symptomatic treatment of rheumatoid arthritis, juvenile rheumatoid arthritis, and osteoarthritis. May be used to treat mild to moderate pain and for the management of dysmenorrhea. May be used to reduce fever. Has been used with some success for treating ankylosing spondylitis, gout, and psoriatic arthritis. May reduce pain, fever, and inflammation of pericarditis. May be used IV with opiates to relieve moderate to severe pain. Ibuprofen lysine may be used IV to treat patent ductus arteriosus (PDA) in premature neonates.
Treatment of a hemodynamically significant patent ductus arteriosus in preterm newborn infants less than 34 weeks of gestational age
Prevention of patent ductus arteriosus in premature neonates of less than 34 weeks of gestational age
Polyarthralgia
Muscles stiffness in nerve diseases
Morning stiffness
Multiple joint pain
Steroid induce arthritis
Osteoarthritis
Rheumatoid arthritis
Ankylosing spondylitis
Gouty arthritis
Pain due to especially musculoskeletal system
Muscles stiffness in spinal
Muscles stiffness in muscle diseases
Muscles stiffness in the joint diseases
Lumbago
Low back pain
Pain caused by nonaticular rheumatism
Periarthritis of scapulohumeral
Ischiadynia
Treatment of patent ductus arteriosus
Temporarily reduces fever

Temporarily relieves minor aches and pains due to

Therapeutic Indications of Ibuprofen

Analgesics, Non-Narcotic; Anti-Inflammatory Agents, Non-Steroidal; Cyclooxygenase Inhibitors
Ibuprofen is used for relief of the pain and inflammation of acute gouty arthritis and acute calcium pyrophosphate deposition disease (pseudogout; chondrocalcinosis articularis; synovitis, crystal-induced). Only immediate-release dosage forms are recommended for relief of acute attacks because of their more rapid onset of action relative to delayed-release or extended-release dosage forms.
Ibuprofen is indicated for the relief of mild to moderate pain, especially when anti-inflammatory actions may also be desired, e.g., following dental, obstetric, or orthopedic surgery, and for the relief of musculoskeletal pain due to soft tissue athletic injuries (strains or sprains). Only immediate-release dosage forms are recommended for relief of acute pain because of their more rapid onset of action relative to delayed-release or extended-release dosage forms.
Ibuprofen is used in the treatment of psoriatic arthritis.
Ibuprofen is indicated for the relief of acute or chronic juvenile arthritis.
Ibuprofen is indicated for the relief of acute or chronic ankylosing spondylitis.
Ibuprofen is indicated for the relief of acute or chronic osteoarthritis.
Ibuprofen is indicated for the treatment of acute or chronic rheumatoid arthritis.
A non-steroidal anti-inflammatory agent that possesses analgesic & antipyretic activity indicated for the relief of symptoms of rheumatoid arthritis & osteoarthritis.
For the relief of primary dysmenorrhea, ibuprofen therapy should be started with the earliest onset of pain.
For the management of juvenile rheumatoid arthritis in the symptomatic treatment of acute and chronic rheumatoid arthritis and osteoarthritis.

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Contra-Indications of Ibuprofen

Active peptic ulcer
Acute rhinitis
Allergic to thiocolchicoside
Asthma
Pregnant
Concurrent peptic ulcer, or history of ulcer disease
Allergy to indomethacin, aspirin, or other NSAIDs
Patients with nasal polyps reacting with angioedema to other NSAIDs
Children under 2 years of age (with the exception of neonates with patent ductus arteriosus)
Severe pre-existing renal and liver damage
Caution: pre-existing bone marrow damage (frequent blood cell counts are indicated)
Caution: bleeding tendencies of unknown origin ( inhibits platelet aggregation)
Caution: Parkinson’s disease, epilepsy, psychotic disorders ( may worsen these conditions)
Concurrent with potassium-sparing diuretics
Patients who have a patent ductus arteriosus dependent heart defect (such as transposition of the great vessels)
Significant hypertension (high blood pressure)
Concomitant administration of lithium salts (such as lithium carbonate)

Dosage of Ibuprofen

Strengths:50 mg; 100 mg; 200 mg; 300 mg; 400 mg; 800 mg; 200 mg;100 mg/5 mL;

Dysmenorrhea

200 to 400 mg orally every 4 to 6 hours as needed.

Osteoarthritis

Initial dose: 400 to 800 mg orally every 6 to 8 hours.
Maintenance dose: May be increased to a maximum daily dose of 3200 mg based on patient response and tolerance.

Rheumatoid Arthritis

Initial dose: 400 to 800 mg orally every 6 to 8 hours.
Maintenance dose: May be increased to a maximum daily dose of 3200 mg based on patient response and tolerance.

Headache

600 mg orally 90 minutes prior to the initial ECT session

Pain

200 to 400 mg orally every 4 to 6 hours as needed. Doses greater than 400 mg have not been proven to provide greater efficacy.
IV: (Patients should be well hydrated before IV ibuprofen administration):
Pain: 400 to 800 mg intravenously over 30 minutes every 6 hours as needed.

Fever

200 to 400 mg orally every 4 to 6 hours as needed.
IV: (Patients should be well hydrated before IV ibuprofen administration):
Fever: Initial: 400 mg intravenously over 30 minutes
Maintenance: 400 mg every 4 to 6 hours or 100 to 200 mg every 4 hours as needed.

Pediatric Dose for Fever

Greater than 6 months to 12 years

5 mg/kg/dose for a temperature less than 102.5 degrees F (39.2 degrees C) orally every 6 to 8 hours as needed.
10 mg/kg/dose for temperature greater than or equal to 102.5 degrees F (39.2 degrees C) orally every 6 to 8 hours as needed.
The recommended maximum daily dose is 40 mg/kg.
OTC pediatric labeling (analgesic, antipyretic): 6 months to 11 years: 7.5 mg/kg/dose every 6 to 8 hours; Maximum daily dose: 30 mg/kg

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Pediatric Dose for Pain

Infants and Children: 4 to 10 mg/kg orally every 6 to 8 hours as needed.
The recommended maximum daily dose is 40 mg/kg.
OTC pediatric labeling (analgesic, antipyretic): 6 months to 11 years: 7.5 mg/kg/dose every 6 to 8 hours; Maximum daily dose: 30 mg/kg

Pediatric Dose for Rheumatoid Arthritis

6 months to 12 years

Usual: 30 to 40 mg/kg/day in 3 to 4 divided doses; start at lower end of dosing range and titrate; patients with milder disease may be treated with 20 mg/kg/day; doses greater than 40 mg/kg/day may increase risk of serious adverse effects; doses greater than 50 mg/kg/day have not been studied and are not recommended.
Maximum dose: 2.4 g/day

Side Effects of Ibuprofen

The most common

More common

Abdominal or stomach pain,
Chills or fever
Headache,
Joint or back pain
Muscle aching or cramping
Muscle pains or stiffness
Chest pressure or squeezing pain in chest
Excessive sweating
feeling of heaviness, pain, warmth and/or swelling in a leg or in the pelvis
sudden tingling or coldness in an arm or leg
Constipation
Diarrhoea
Loss of muscle coordination
Sleepiness or unusual drowsiness
Clumsiness or unsteadiness
Drowsiness

Rare

Anxiety
change in vision
seizures
abnormal or fast heart rate
tremors
weight loss
chest pain or tightness
confusion
cough
Agitation
arm, back, or jaw pain
blurred vision
chest pain or discomfort
convulsions
extra heartbeats
fainting
hallucinations
headache
irritability
lightheadedness
mood or mental changes
muscle pain or cramps
muscle spasm or jerking of all extremities
muscle pains or stiffness
chest pressure or squeezing pain in chest
discomfort in arms, shoulders, neck or upper back

Drug Interactions of Ibuprofen

Ibuprofen may interact with following drugs, supplements & may change the efficacy of drugs

aminoglycoside antibiotics (e.g., amikacin, gentamicin, tobramycin)
angiotensin-converting enzyme inhibitors (ACEIs; e.g., captopril, enalapril, ramipril)
angiotensin receptor blockers (ARBs; e.g., candesartan, irbesartan, losartan)
beta-adrenergic blockers (e.g., metoprolol, atenolol)
calcium channel blockers (e.g., amlodipine, diltiazem, nifedipine, verapamil)
celecoxib
cilostazol
clopidogrel
corticosteroids (e.g., dexamethasone, hydrocortisone, prednisone)
cyclosporine
diuretics (water pills; e.g., furosemide, hydrochlorothiazide,)
5-ASA medications (e.g. sulfasalazine)
glucosamine
haloperidol
heparin
methotrexate
multivitamins
other non-steroidal anti-inflammatory medications (NSAIDs; e.g., diclofenac, ibuprofen, ketorolac, naproxen)
Omega-3 fatty acids
pentoxifylline
quinolone antibiotics (e.g., ciprofloxacin, ofloxacin)
selective serotonin reuptake inhibitors (SSRIs; e.g., citalopram, duloxetine,fluoxetine,paroxetine, sertraline)
serotonin/norepinephrine reuptake inhibitors (SNRIs; duloxetine, )
tricyclic antidepressants (e.g., amitriptyline, clomipramine, desipramine, trimipramine)
warfarin

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Pregnancy Category of Ibuprofen

FDA pregnancy category: C

Pregnancy

Animal studies have revealed evidence of increased risk of miscarriage, cardiac malformation, and gastroschisis following use of prostaglandin synthesis inhibitors in early pregnancy. Administration of nonsteroidal anti-inflammatory drugs (NSAIDs) during the third trimester of pregnancy may cause significant adverse effects, including premature closure of the fetal ductus arteriosus, oligohydramnios, fetal renal impairment, pulmonary hypertension, and prolongation of bleeding time. There are no controlled data in human pregnancy.

Lactation

Not recommended during lthe ast trimester of pregnancy. Prior to 30 weeks gestation: Use only if the potential benefit justifies the potential risk to the fetus. Avoid use during tthe hird trimester as it may cause premature closure of the ductus arteriosus.

Tips

Take with food or milk if stomach disturbances (such as indigestion) occur with use. See a doctor if these persist.
Always use the lowest effective dose for the shortest duration consistent with the condition being treated.
If you are taking ibuprofen and find it is not working very well for you, you may like to try a different NSAID.
Response to different NSAIDs can vary so switching types (for example, from ibuprofen to naproxen) may improve response.
See a doctor immediately if you experience any difficulty with breathing, unexplained sickness or fatigue, loss of appetite, vision changes, fluid retention or abnormal bleeding.
NSAIDs should not be used in the last 3 months of pregnancy; ask your doctor before using any medication during pregnancy.
Avoid ibuprofen if you have a history of asthma or hives due to aspirin use or other NSAIDs, like naproxen.
Do not use this medicine if you have just had heart bypass surgery (also called coronary artery bypass graft, or CABG).