Ibuprofen is an anti-inflammatory, non-steroidal (NSAIDs) drug and like all NSAIDs it acts by inhibiting the production of prostaglandins, molecules involved in inflammatory processes. In particular, the ibuprofen blocks the activity of the enzymes cyclooxygenase Cox-1 and Cox-2.
What is Ibuprofen?
Given its anti-inflammatory and pain relieving properties, ibuprofen is used to relieve headaches, neuralgia, menstrual cramps, musculoskeletal pain (e.g. torticollis), pain resulting from trauma (associated with, for example, bruises, sprains, muscle strain), as well as post-partum and post-operative pain. It can also be prescribed in cases of osteoarthritis, rheumatoid arthritis, ankylosing spondylitis, frozen shoulder, extra-articular rheumatism, myositis, back pain, sciatica, radiculoneuritis, fibrositis, tenosynovitis and Still's disease.
Moreover, in children ibuprofen may also be used as an antipyretic.
How should Ibuprofen be taken?
Ibuprofen can be taken in the form of tablets or effervescent granules, always on a full stomach. The dosage varies depending on the age of the patient and the desired therapeutic effect. Thereofre, it is essential to follow the instructions provided by the physician at the time of prescription or, if taken as an over-the-counter medication, one must follow the instructions on the package insert.
In addition to the formulations for oral administration there are also ointments for topical use, solutions or powders for douches, suppositories for rectal use, and solutions for intramuscular injections.
Side effects associated with Ibuprofen
Taken in combination with acetylsalicylic acid, ibuprofen reduces the cardioprotective action. Otherwise when remaining below the maximum of 1200 mg daily dose, the drug can be considered safe in terms of cardiovascular risk.
However, the recognized side effects include gastrointestinal problems such as:
- Nausea
- Vomiting
- Dyspepsia
- Melena
- Hematemesis
- Epigastric pain
- Diarrhea
- Constipation
- Abdominal cramps
- Ulcerative stomatitis
- Exacerbation of colitis and Crohn's disease
- Gastritis
- Epigastric pain
- Heartburn
- Enteropathy
- Gastrointestinal bleeding
- Peptic ulcers
There has been other disorders resulting from side effects, such as:
- Dizziness
- Headache
- Irritability
- Tinnitus and other hearing disorders
- Drowsiness
- Edema
- Hypertension
- Heart failure
- Rash and other skin rashes
- Mucositis
- Erythema
- Pigmentation of nails
- Itching
- Angioedema
- Agranulocytosis
- Thrombocytopenia
- Aplastic anemia
- Hepatic impairment
- Increases in total bilirubin
- Vision problems
- Bronchospasm
- Dyspnea
- Apnea
- Aggravation of asthma
- Dehydration and changes in salivation
In rare cases, taking ibuprofen may be associated with:
- Aggravation of psoriasis
- Alopecia
- Abnormal renal function tests
- Changes in menstrual cycle
- Amenorrhea
- Hemolytic anemia
- Cystitis
- Collagenous colitis
- Convulsions
- Depression
- Dermatitis
- Difficulty concentrating
- Duodenitis
- Hematuria
- Acute enteritis
- Eosinophilia
- Hepatitis
- Multiform bullous erythema
- Esophagitis
- Glomerulonephritis
- Periorbital swelling and invasive streptococcal disease
- Insomnia
- Congestive heart failure
- Liver failure
- Acute kidney failure
- Hypotension
- Jaundice
- Aseptic drug-induced meningitis
- Hepatic necrosis
- Papillary necrosis
- Tubular necrosis
- Neutropenia
- Palpitations
- Pancytopenia
- Pancreatitis
- Thrombocytopenia
- Polyuria
- Proctitis
- Decrease in appetite
- Hemoglobin and hematocrit decrease
- Rhinitis
- Mood swings
- Dry eyes and dry mouth
- Hepatorenal syndrome
- Gum ulcers
One study also suggested that NSAIDs might also increase the risk of non-Hodgkin's lymphoma.
Contraindications and warnings associated with the use of Ibuprofen
Ibuprofen is contraindicated in case of kidney failure, liver disease and gastrointestinal disorders (such as gastritis, ulcers and hemorrhoids with bleeding), respiratory diseases, allergic asthma and pregnancy (especially during the third trimester).
It is also possible for ibuprofen to interact with certain drugs, in particular with:
- ACE inhibitors and Angiotensin II antagonists (in case of impaired renal function)
- Acetylsalicylic acid and NSAIDs in general
- Some antidiabetics
- Antibacterials
- Coumarin anticoagulants
- Antihypertensive drugs
- Antivirals
- Cefuroxime and phenobarbital
- Cetirizine
- Cyclosporine
- Oral corticosteroids
- Diuretics
- Ginko biloba and kava kava
- Lithium, digoxin and phenytoin
- Methotrexate
- Raloxifene
- SSRIs
- Tacrolimus
- Uricosuric drugs
