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