Type of Medication: Non-steroidal anti-inflammatory drug

Indications: Treatment of mild to moderate pain, particularly related to inflammation, gout

Side Effects: Nausea, diarrhoea, dyspepsia, gastritis, duodenal or gastric ulcer.Hypersensitivity reactions rash (pruritus, urticaria, purpura, angioedema, photosensitivity, epidermal necrolysis erythema multiforme), bronchoconstriction (caution in asthmatics). Nephrotoxicty, abnormal liver function, visual disturbances, optic neuritis, headaches, paraesthesias, tinnitus, fatigue, haematological disorder, oedema, depression, vertigo . Containdications – Hypersensitivity to any of the ingredients, history of, or existing peptic ulceration, history of bronchospasm, rhinitis, urticaria, particularly associated with therapy with aspirin or other NSAID.

Route of administration: Adult (Oral)

Dose:400mg tds, or 200-800mg tds. When using ibuprofen as an analgesic agent the daily dose should not exceed 2400mg. *High dose oral Ibuprofen has been shown to have some effect on reducing the decline of lung function, weight and chest radiographic scores in patients with cystic fibrosis (Konstan et al, 1995). Follow up data from this study suggests that the improvement in lung function has persisted and that the greatest benefit remains in the 5 – 12 year age group. We do not advocate the use of high dose NSAID at the present time. The major disadvantage of the NSAID relates to their narrow treatment window and high side effect profile. Close monitoring of plasma levels is mandatory to ensure both a potential therapeutic effect and to prevent toxicity. Results from an ongoing Canadian study are awaited.

Administration: After meals

Route of administration: Paediatric (Oral)

Dose:over 7 kg: 30-40 mg/kg per day in divided doses, 1-2 yr:50 mg 3-4 x/day, 3-7 yr: 100 mg 3-4 x/day, 8-12: yr 200 mg 3-4 x/day.

Examples of some Drug Interactions

Interacting drug: ACE inhibitors

Reduced anti-hypertensive effect, increased risk of renal impairment.

Interacting drug: Anticoagulants

enhanced anticoagulant effect

Interacting drug: Anti-hypertensives

reduced anti-hypertensive effect

Interacting drug: Ciprofloxacin (Quinolone antibiotics)

enhanced risk of convulsions

Interacting drug: Cyclosporin

increased risk of nephrotoxicity

Interacting drug: Digoxin

NSAIDs may exacerbate cardiac failure, reduce GFR and increase plasma digoxin levels

Interacting drug: Diuretics

NSAIDs reduce the diuretic effect. Diuretics can increase the risk of nephrotoxicity of NSAIDs

Interacting drug: Lithium

decreases elimination of lithium

Interacting drug: Methotrexate

decreased elimination of methotrexate

Interacting drug: Prednisolone

increased risk of gastric bleeding

Interacting drug: SSRIs and venlafaxine

increased risk of bleeding

Interacting drug: Tacrolimus

Increased risk of nephrotoxicity