Drug Notebook

FDA Alerts

    Cardiovascular Risk
  • Possible increased risk of serious (sometimes fatal) cardiovascular thrombotic events (e.g., MI, stroke). Risk may increase with duration of use. Individuals with cardiovascular disease or risk factors for cardiovascular disease may be at increased risk. (See Cardiovascular Effects under Cautions.)
  • Contraindicated for the treatment of pain in the setting of CABG surgery.

    GI Risk
  • Increased risk of serious (sometimes fatal) GI events (e.g., bleeding, ulceration, perforation of the stomach or intestine). Serious GI events can occur at any time and may not be preceded by warning signs and symptoms. Geriatric individuals are at greater risk for serious GI events. (See GI Effects under Cautions.)

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ibuprofen
(eye byoo PROE fen)

What is ibuprofen?
Ibuprofen is in a group of drugs called nonsteroidal anti-inflammatory drugs (NSAIDs). Ibuprofen works by reducing hormones that cause inflammation and pain in the body. Ibuprofen is used to reduce fever and treat pain or inflammation caused by many conditions such as headache, toothache, back pain, arthritis, menstrual cramps, or minor injury. Ibuprofen may also be used for other purposes not listed in this medication guide.

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What is the price of this medication and similar alternatives?

Pricing information provided by drugstore.com.

Ibuprofen 100MG/5ML SUSP ACTAVIS MID ATLANTIC473/$24.27 or 1419/$72.8
Ibuprofen 400MG TABS INTERPHARM30/$8.99 or 90/$20.99
Ibuprofen 600MG TABS INTERPHARM90/$9.99 or 180/$19.76
Motrin 400MG TABS PFIZER U.S.30/$7.99 or 90/$23.62
Motrin 600MG TABS PFIZER U.S.30/$11.75 or 90/$35.24
Motrin 800MG TABS PFIZER U.S.30/$15.41 or 90/$46.23

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What are the possible side effects of ibuprofen?

Get emergency medical help if you have any of these signs of an allergic reaction: hives; difficulty breathing; swelling of your face, lips, tongue, or throat.

Stop taking ibuprofen and seek medical attention or call your doctor at once if you have any of these serious side effects:

  • chest pain, weakness, shortness of breath, slurred speech, problems with vision or balance;

  • black, bloody, or tarry stools;

  • coughing up blood or vomit that looks like coffee grounds;

  • swelling or rapid weight gain;

  • urinating less than usual or not at all;

  • nausea, stomach pain, low fever, loss of appetite, dark urine, clay-colored stools, jaundice (yellowing of the skin or eyes);

  • fever, sore throat, and headache with a severe blistering, peeling, and red skin rash;

  • bruising, severe tingling, numbness, pain, muscle weakness; or

  • fever, headache, neck stiffness, chills, increased sensitivity to light, purple spots on the skin, and/or seizure (convulsions).

Less serious side effects may include:

  • upset stomach, mild heartburn, diarrhea, constipation;

  • bloating, gas;

  • dizziness, headache, nervousness;

  • skin itching or rash;

  • blurred vision; or

  • ringing in your ears.

This is not a complete list of side effects and others may occur. Tell your doctor about any unusual or bothersome side effect.

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How should I take ibuprofen?
Take this medication exactly as directed on the label, or as it has been prescribed by your doctor. Do not use the medication in larger amounts, or use it for longer than recommended. Do not take more of this medication than is recommended. An overdose of ibuprofen can cause damage to your stomach or intestines. The maximum amount of ibuprofen for adults is 800 milligrams per dose or 3200 mg per day (4 maximum doses). Use only the smallest amount of ibuprofen needed to get relief from your pain, swelling, or fever.

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What is the most important information I should know about ibuprofen?
This medicine can increase your risk of life-threatening heart or circulation problems, including heart attack or stroke. This risk will increase the longer you use ibuprofen. Do not use this medicine just before or after having heart bypass surgery (also called coronary artery bypass graft, or CABG). Seek emergency medical help if you have symptoms of heart or circulation problems, such as chest pain, weakness, shortness of breath, slurred speech, or problems with vision or balance. This medicine can also increase your risk of serious effects on the stomach or intestines, including bleeding or perforation (forming of a hole). These conditions can be fatal and gastrointestinal effects can occur without warning at any time while you are taking ibuprofen. Older adults may have an even greater risk of these serious gastrointestinal side effects.

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What happens if I miss a dose?
Since ibuprofen is sometimes taken as needed, you may not be on a dosing schedule. If you are taking the medication regularly, take the missed dose as soon as you remember. If it is almost time for the next dose, skip the missed dose and wait until your next regularly scheduled dose. Do not take extra medicine to make up the missed dose.

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What other drugs will affect ibuprofen?
Before taking ibuprofen, tell your doctor if you are taking any of the following drugs: aspirin or other NSAIDs (non-steroidal anti-inflammatory drugs) such as diclofenac (Voltaren), etodolac (Lodine), flurbiprofen (Ansaid), indomethacin (Indocin), ketoprofen (Orudis), ketorolac (Toradol), mefenamic acid (Ponstel), meloxicam (Mobic), nabumetone (Relafen), naproxen (Aleve, Naprosyn), piroxicam (Feldene), and others; an ACE inhibitor such as benazepril (Lotensin), captopril (Capoten), fosinopril (Monopril), enalapril (Vasotec), lisinopril (Prinivil, Zestril), moexipril (Univasc), perindopril (Aceon), quinapril (Accupril), ramipril (Altace), or trandolapril (Mavik);

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Can I take this if I am pregnant or trying to get pregnant or if I am breastfeeding?

Ibuprofen has been assigned to pregnancy category B by the FDA. Animal studies failed to reveal evidence of fetal harm. There are no controlled data in human pregnancy. While there are no literature reports linking the use of ibuprofen in pregnancy with birth defects, use late in pregnancy may cause premature closure of the ductus arteriosus and prolong labor and delivery. Ibuprofen should only be given during pregnancy when benefit outweighs risk. Ibuprofen should be avoided near term.

One manufacturer of ibuprofen has reported on 50 in utero exposures to ibuprofen. Seven cases were reported retrospectively and included one-third trimester fetal death of unknown cause, one spontaneous abortion without evidence of abnormalities, anencephaly (N=1), petit mal seizures progressing to grand mal seizures (N=1), cerebral palsy (N=1), microphthalmia, nasal cleft, and mildly rotated palate (N=1), and tooth staining (N=1). Of the 43 prospective cases, 23 were followed to a normal delivery. Of the remaining cases, one ended in a stillbirth without abnormalities, one ended in a spontaneous abortion without abnormalities, and the remaining were lost to follow-up.

Ibuprofen has not been detected in human milk. Ibuprofen is considered compatible with breast-feeding by the American Academy of Pediatrics.

In one woman treated with ibuprofen 400 mg twice a day for two weeks, ibuprofen concentrations in milk were below the level of detection (< 0.5 mcg/mL) at all times tested. The hydroxy and carboxy metabolites were also undetectable. In another study, ibuprofen concentrations in milk were below the level of detection (nine below 1.0 mcg/mL) in all samples taken from 12 postpartum women receiving ibuprofen 400 mg every six hours for 24 hours. The authors conclude that a breast-feeding infant would ingest less than 1 mg ibuprofen per day.

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Who should NOT use this medication?

  • Known hypersensitivity to ibuprofen or any ingredient in the formulation.
  • History of asthma, urticaria, or other sensitivity reaction precipitated by aspirin or other NSAIAs.
  • Treatment of perioperative pain in the setting of CABG surgery.
  • When used for PDA, known or suspected untreated infection; bleeding, especially active intracranial hemorrhage or GI bleeding; thrombocytopenia; coagulation defects; known or suspected necrotizing enterocolitis; substantial renal impairment; congenital heart disease if patency of the ductus arteriosus is necessary for pulmonary or systemic blood flow (e.g., pulmonary atresia, severe tetralogy of Fallot, or severe coarctation of the aorta).

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What happens if I overdose?
Seek emergency medical attention if you think you have used too much of this medicine. Overdose symptoms may include nausea, vomiting, stomach pain, drowsiness, black or bloody stools, coughing up blood, shallow breathing, fainting, or coma.

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What should I discuss with my healthcare provider before taking ibuprofen?
Taking an NSAID can increase your risk of life-threatening heart or circulation problems, including heart attack or stroke. This risk will increase the longer you use an NSAID. Do not use this medicine just before or after having heart bypass surgery (also called coronary artery bypass graft, or CABG). NSAIDs can also increase your risk of serious effects on the stomach or intestines, including bleeding or perforation (forming of a hole). These conditions can be fatal and gastrointestinal effects can occur without warning at any time while you are taking an NSAID. Older adults may have an even greater risk of these serious gastrointestinal side effects.

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Can I stop taking the medication if I feel better?
If you are taking an analgesic for pain and you are no longer experiencing the pain you may stop using the medication. In general, pain medications are to be used on an as needed basis.

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I am on so many medications; do I have to take them all?
This is called polypharmacy—many different medications being used at the same time by one person. Sometimes, being on multiple medications is acceptable and appropriate but at other times it may be problematic. If you are receiving your medications from multiple physicians you need to ensure that they all know what medications you are taking. The best way to do this is to make a list of all the medications you are currently using, including all nutritional supplements, homeopathic remedies, vitamins and over-the-counter drugs (if possible, also include all the diseases you have been diagnosed with). Give a copy to every doctor who takes care of you so they have it on file, this way they can avoid duplicating medications and perhaps even try to consolidate some. After every doctor's visit remember to update the list accordingly. Also, as much as you possibly can, try to use the same pharmacy to fill all your prescriptions, this way any potential drug interactions can be caught and averted.

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Where can I get more information?
More Information

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