Indication : Rheumatoid arthritis, Osteoarthritis, Pain, Fever, Pericarditis, Dysmenorrhea, Patent ductus arteriosus, Inflammation, Musculoskeletal and joint disorders

Administration : Should be taken with food.

Adult Dose : Pain/Fever/Dysmenorrhea 200-400 mg PO q4-6hr; not to exceed 1.2 g unless directed by physician Inflammatory Disease 400-800 mg PO q6-8hr; not to exceed 3.2 g/day Osteoarthritis, Rheumatoid Arthritis 300 mg, 400 mg, 600 mg, or 800 mg PO q6-8hr; not to exceed 3.2 g/day Severe hepatic impairment: Avoid use

Child Dose : Fever 6 months to 12 years 5-10 mg/kg/dose PO q6-8hr; not to exceed 40 mg/kg/day Pain 4-10 mg/kg/dose PO q6-8hr; not to exceed 40 mg/kg/day Juvenile Idiopathic Arthritis 30-50 mg/kg/24hr PO divided q8hr; not to exceed 2.4 g/day

Renal Dose : Significantly impaired renal function: Monitor closely; consider reduced dosage if warranted

Contraindication : Active peptic ulcer; hypersensitivity. Neonates with congenital heart disease, suspected necrotising enterocolitis and active bleeding (parenteral).

Mode of Action : Ibuprofen inhibits synthesis of prostaglandins in body tissues by inhibiting cyclooxygenase-1 and 2. It has anti-inflammatory, analgesic and antipyretic properties.

Precaution : Asthma; renal or hepatic disorders; bleeding disorders; CV disease. Pregnancy, lactation. Lactation: Drug excreted into breast milk; use not recommended (American Academy of Pediatrics committee states that drug is compatible with nursing)

Side Effect : 1-10% Dizziness (3-9%),Epigastric pain (3-9%),Heartburn (3-9%),Constipation (1-3%),Nausea (3-9%),Rash (3-9%),Tinnitus (3-9%),Edema (1-3%),Fluid retention (1-3%),Headache (1-3%),Vomiting (1-3%) <1% Acute renal failure (sometimes with acute tubular necrosis or hyperkalemia, polyuria, azotemia, cystitis, hematuria, decreased creatinine clearance, elevations in blood urea nitrogen (BUN) or creatinine without other manifestations of renal failure) Agranulocytosis,Aplastic anemia,Erythema multiforme,Erythematous macular rashes,Exfoliative dermatitis,Hemolytic anemia (with or without positive direct antiglobulin test results),Neutropenia,Thrombocytopenia (with or without purpura),Toxic epidermal necrolysis (Lyell syndrome) and photosensitivity reactions Potentially Fatal: Severe CV thrombotic events. Severe GI bleeding, ulceration and perforation.

Pregnancy Category Note : Pregnancy category: C; D in 3rd trimester or near delivery. At >30 weeks' gestation; may cause premature closure of ductus arteriosus

Interaction : Increased risk of GI bleeding w/ warfarin, corticosteroids, SSRIs and aspirin. May reduce the natriuretic effects of diuretics. Reduced antihypertensive effect of ACE inhibitors and angiotensin II receptor antagonists. May increase toxicity of lithium and methotrexate. Increased nephrotoxicity w/ ciclosporin and tacrolimus.