Medication is used in cases of pain, fever, inflammation and menstrual cramps. After taking a dose of 400 mg of ibuprofen, the analgesic effect lasts about 8 hours. In most clinical trials, the onset of significant pain relief was faster, greater, and longer-lasting with ibuprofen than with paracetamol.
Widely used in cases of pain, fever, inflammation and menstrual cramps, ibuprofen is a drug classified as a non-steroidal anti-inflammatory drug (NSAID).
Despite widespread use, some doubts are recurrent, such as those related to forms of use, presentations, price, drug interactions, among others.
What is Ibuprofen?
It is an anti-inflammatory drug that has the following indications for use:
- Psoriasis arthritis
- Reiter’s disease - reactive arthritis
- Rheumatoid arthritis
- Mild to moderate pain
- Ankylosing spondylitis
- Spondylosis
- Fever
Other indications
- Primary dysmenorrhea (also known as menstrual cramps)
- Musculoskeletal inflammatory diseases
What is ibuprofen for? When can it be used?
Ibuprofen is a non-steroidal anti-inflammatory drug (NSAID) indicated for temporary relief not only from fever, but also from mild to moderate pains such as headache, low back pain, colds and flu, toothache, muscle pain, dysmenorrhea and arthritis as described in the package insert.
For its use, therefore, the risk-benefit ratio must be taken into account before use in patients in the following conditions: history of peptic ulcer disease, gastrointestinal bleeding or perforation, renal dysfunction, cirrhosis, asthma or other allergic conditions , hypertension or heart disease worsened by water retention and edema, liver dysfunction, history of coagulation disorders or systemic lupus erythematosus, or who are also using other NSAIDs.
In addition, the use of this drug by the elderly requires caution and special attention.
Understand how it works
Ibuprofen has excellent pharmacokinetics, that is, regardless of presentation, it is well absorbed and distributed by tissues, until it reaches its target, performs its action, turns into an excretable product (metabolization) and finishes its task, leaving the body through the kidney. As for pharmacodynamics, or mechanism of action, it works by blocking the organic mechanisms that cause pain and inflammation (COX2 enzyme). The waiting time to benefit from its effects is 20 to 30 minutes, and they last from 4 to 6 hours.
Advantages and disadvantages of its use?
The first advantage is that ibuprofen is considered the most tolerated drug among NSAIDs, especially among children over 2 years old. That is why he is highly recommended by paediatricians. In addition, it is recognized as being the safest, as long as its indications, doses and contraindications are respected.
The second advantage concerns lower risks of bleeding, liver toxicity and agranulocytosis, that is, a reduction in the body’s defence system when compared to dipyrone and paracetamol.
The disadvantage is that it cannot be used by people allergic to any of its components. However, depending on the cause of its use, there.
Who should avoid ibuprofen?
Talk to your pharmacist or doctor before using ibuprofen if you have ever had an allergic reaction related to NSAIDs or acetylsalicylic acid (aspirin).
Individuals who fit into any of the conditions below should avoid the medication.
Check out:
- People who have ulcers or gastritis;
- Uncontrolled hypertension;
- Patients at high risk of cardiovascular diseases, such as heart attack;
- Individuals with liver disease;
- People with renal or heart failure;
- Preoperative patients (they should not use it 48 hours before surgery);
- Bleeding individuals present;
- People who use anticoagulants or antiplatelet agents (drugs that prevent thrombosis in patients at risk).
What are the differences between ibuprofen and paracetamol?
Presenting analgesic and antipyretic action, paracetamol does not, therefore, have the same anti-inflammatory properties as ibuprofen.
Thus, it is less effective in reducing pain associated not only with inflammation, but also with bodily injury.
However, while ibuprofen acts for 30 minutes, paracetamol has no effect for 45 to 60 minutes after taking the first dose.
Therefore, primarily, ibuprofen can act more quickly and has a longer lasting effect than paracetamol.
What can ibuprofen cause? Are there any contraindications?
Meta-analysis study (which is a statistical technique specially developed to integrate the results of several studies on the same research question, in a systematic review of the literature) evaluated the consequences of the use of non-steroidal anti-inflammatory drugs (NSAIDs) in relation to events cardiovascular diseases, such as acute myocardial infarction (AMI), stroke (stroke) and death from cardiovascular disease.
Primarily, these authors mention that all medications studied (for example, naproxen, ibuprofen, diclofenac, celecoxib, etoricoxib, lumiracoxib, rofecoxib) caused an increase in cardiovascular events.
As a result, it is yet another study that corroborates the information that all NSAIDs increase patients’ cardiovascular risk.
How long does it take for ibuprofen to take effect?
Up to 30 minutes.
Is ibuprofen available in drops and capsules? What are the differences in effect and indications of each?
Not only drops but also capsules are pharmaceutical forms used in pharmacotherapy.
For children and people who have difficulty swallowing, undeniably, the best way to administer the medication is in liquid form.
On the other hand, adults who do not have problems related to the ingestion of solid dosage forms, usually use them even due to their ease of transport.
After all, they bring more convenience if it is necessary to administer them during work hours, for example.
In capsules, ibuprofen is available in 300 mg, 400 mg and 600 mg presentations. What are the differences in effect between them?
The dose to be prescribed depends not only on age but also on the disease, severity of symptoms, the period of therapy and according to the clinical response obtained.
Does ibuprofen have contraindications?
The drug ibuprofen belongs to the group of non-steroidal anti-inflammatory drugs (NSAIDs). Therefore, according to the Food and Drug Administration (FDA), it is mainly indicated for the relief/treatment of pain, fever, headache, migraine, osteoarthritis, primary dysmenorrhea and rheumatoid arthritis.
However, despite being a Prescription-Free Medicine (IPM), its administration must be guided by a health professional, considering all the implications arising from the use of any medication.
In addition, this medication has numerous contraindications, such as, for example, asthma, hives or other allergic reaction after the administration of aspirin or other NSAIDs (severe and sometimes fatal anaphylactic reactions have been reported), in myocardial revascularization, hypersensitivity to ibuprofen or, equally, to any component of the product.
Can ibuprofen generate drug interactions?
According to the database of the package insert, a series of drug interactions can be summarized. Between them:
Graves
1. Cyclosporine
The concomitant use of cyclosporine and NSAIDs can therefore result in an increased risk of nephrotoxicity caused by cyclosporine.
2. Selective Serotonin Reuptake Inhibitors (SSRIs)
In principle, the simultaneous use of NSAIDs and with SSRIs, such as, for example, fluoxetine, fluvoxamine, paroxetine, sertraline, citalopram, escitalopram, vortioxetine, can result not only in the increased risk of gastrointestinal bleeding but also in intracranial haemorrhage.
3. Selective Serotonin and Noradrenaline Reuptake Inhibitors (ISRSN)
Using NSAIDs and ISRSN (such as venlafaxine, nefazodone, sibutramine, reboxetine, milnacipran, duloxetine, desvenlafaxine) simultaneously can consequently result in an increased risk of bleeding.
4. Low Molecular Weight Heparins (LMWH)
The simultaneous use of NSAIDs and LMWH (drug use, among others, as an anticoagulant in cases of thrombosis), such as, for example, enoxaparin, dalteparin, paranaparin, danaparoid, nadroparin, reviparin, tinzaparin, ardeparin, certainparin, can result, in short, increasing the risk of bleeding.
5. Methotrexate (systemic)
The concomitant use of ibuprofen (systemic) and systemic methotrexate (a drug used to treat cancer and autoimmune diseases) may cause, as a consequence, an increased risk of methotrexate toxicity, such as leukopenia, thrombocytopenia, anaemia, nephrotoxicity and ulceration of mucous.
6. Ginkgo biloba
The ■■■■■ use of NSAIDs and ginkgo biloba can therefore result in an increased risk of bleeding.
7. Tacrolimus
I use using NSAIDs and tacrolimus (a drug used mainly after ■■■■■ transplantation) concurrently can result, therefore, in acute kidney failure.
8. Acetylsalicylic acid - ASA (systemic)
Synchronizing the concomitant use of ibuprofen (systemic) and AAS can result, for example, in an increased risk of bleeding.
Moderate
1. Angiotensin-Converting Enzyme Inhibitors (ACEI) and Angiotensin II Receptor Blockers (BRAII)
Concomitant use of NSAIDs and ACE inhibitors / BRAII can generate not only renal dysfunction but also a decrease in antihypertensive efficacy.
2. Beta-blockers
The concomitant use of NSAIDs and beta-blockers (indicated for cases of arrhythmia, hypertension and cardiac protection after infarction) is likely to result in a decrease in antihypertensive efficacy.
3. Potassium-sparing diuretics
The simultaneous use of NSAIDs and potassium-sparing diuretics (which act by excreting sodium) may, as a consequence, decrease the diuretic effect, hyperkalaemia and possible nephrotoxicity.
4. Amikacin (systemic)
Concomitant use of ibuprofen and amikacin (indicated for the short-term treatment of serious infections caused by sensitive strains of bacteria) may result, for example, in an increase in half-life and a decrease in clearance (clearance) of amikacin.
5. Thiazide diuretics
The use of NSAIDs and thiazide diuretics (used in cases of hypertension, for example) at the same time can consequently result in a decrease in the diuretic and hypertensive effect and an increased risk of nephrotoxicity, which is the poisonous reaction of some substances on the kidneys.
6. Loop diuretics
Concomitant use of NSAIDs and loop diuretics can result, as a consequence, in a decrease in the diuretic and hypertensive effect.
Can ibuprofen cause adverse reactions ■■■■■■?
Adverse reactions to ibuprofen by mouth include, for example:
- edema (1% to 3%);
- dizziness (3% to 9%);
- headache (1% to 3%),
- nervousness (1% to 3%);
- rash (3% to 9%),
- itching (1% to 3%);
- fluid retention (1% to 3%);
- epigastric pain (3% to 9%);
- heartburn (3% to 9%); nausea (3% to 9%);
- abdominal pain (1% to 3%);
- constipation (1% to 3%);
- decreased appetite (1% to 3%);
- diarrhea (1% to 3%);
- dyspepsia (1% to 3%),
- ■■■■■■■■■■ (1% to 3%);
- vomiting (1% to 3%); and
- tinnitus (3% to 9%).
Can ibuprofen be used in children?
The recommended dose for children from six months is 1 drop/kg of weight, in intervals of six to eight hours, therefore, three to four times a day.
In this sense, the maximum dose per dose in children over 30 kg is 20 drops (200 mg) and the maximum allowed dose per day is 80 drops (800 mg). Finally, this dose is recommended for a maximum of four times a day.
What is the best way to consume it?
The tablets should be taken with water or milk. Avoid juices, carbonated drinks and, in particular, alcoholic beverages. The suspension should be administered directly into the mouth, in drops. However, as the medicine is bitter, diluting it in a little water facilitates the process.
Is there a better time of day to use it?
No. The important thing is that it is ingested 3 times a day (every 8 hours). In cases where it is the doctor who recommends the use of ibuprofen, the frequency may be different, depending on your health condition. When you forget to take your medicine, wait until it is time for your next dose and start using the medicine.
When should use be stopped?
Sometimes, side effects can be more serious. Stop taking the medicine and seek medical help immediately if you notice the following symptoms:
- Weakness,
- vomiting with blood, dark or ■■■■■■ stools;
- Worsening of pain or pain lasting more than 10 days;
- Worsening of fever or duration for more than 3 days;
- Worsening or continuing stomach pain.
- Difficulty urinating;
- Uncontrolled blood pressure.
How do I know if I’m allergic to Ibuprofen?
Watch for the following signs of an allergic reaction: flushing (redness of the skin), facial swelling, itching, glottis closure. Get medical help immediately.
Interaction with food
Some scientific studies suggest that food interferes, even if little, in the absorption of ibuprofen, reducing its concentration in the bloodstream.
Conclusion
In conclusion, ibuprofen can be used successfully for several cases of pain, fever, inflammation, menstrual cramps and also in specific cases of some pathologies, such as arthritis. However, like any drug, it is not only subject to drug interactions but can also have contraindications.
Available in several presentations, and despite being a Prescription-Free Medication (MIP), its administration must be guided by a health professional, thus considering all the implications arising from the use of any medication.
In addition, this medication has numerous contraindications, such as, for example, asthma, hives or other allergic reaction after the administration of aspirin or other NSAIDs (severe and sometimes fatal anaphylactic reactions have been reported), in myocardial revascularization, hypersensitivity to ibuprofen or, equally, to any component of the product.
In summary, it is essential that, when symptoms persist, the doctor is consulted.