1 tablet

1 cent

1 tablet

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Ibuprofen, Brufen, I-Profen, Nurofen, Panafen, ACT-3, Fenpaed

PO:
Tablets:
Apo-ibuprofen 200mg (yellow), Brufen 400mg (white), I-Profen 200mg, Ibuprofen 200mg (white), Nurofen 200mg (white), Panafen 200mg
Sustained Release Tablets:
Brufen Retard 800mg
Capsules:
ACT-3 200mg (green), Nurofen liquid capsules 200mg
Oral Suspension:
Fenpaed oral suspension 100mg/5ml, Nurofen for children 100mg/5ml


ADULT DOSE

PO / NG:
400mg 6 hourly

PAEDIATRIC DOSE

PO:
5-10mg/kg 6 hourly

DOSAGE IN RENAL FAILURE AND RENAL REPLACEMENT THERAPY
Dose in renal impairment [GFR (ml/min)]
<10 dose as in normal renal function, but avoid unless ESRF on dialysis
10-20 dose as in normal renal function, but avoid if possible
>20-50 dose as in normal renal function, but avoid if possible

Dose in renal replacement therapy
CAPD dose as in normal renal function
HD dose as in normal renal function
CVVHDF dose as in normal renal function, but avoid unless ESRF on long-term dialysis

Ibuprofen is a non-steroidal anti-inflammatory drug

CONTRAINDICATIONS:

  • Hypersensitivity to ibuprofen

  • The syndrome of nasal polyps, angioedema, and bronchospastic reactivity to aspirin or other nonsteroidal anti-inflammatory agents.


WARNINGS:
Risk of GI Ulceration, Bleeding and Perforation
Serious gastrointestinal toxicity such as bleeding, ulceration, and perforation, can occur at any time, with or without warning symptoms, in patients treated with nonsteroidal anti-inflammatory drugs.
Bleeding Risk:
Ibuprofen, like other nonsteroidal anti-inflammatory agents, can inhibit platelet aggregation but the effect is quantitatively less and of shorter duration than that seen with aspirin. Ibuprofen has been shown to prolong bleeding time (but within the normal range) in normal subjects. Because this prolonged bleeding effect may be exaggerated in patients with underlying haemostatic defects, ibuprofen should be used with caution in persons with intrinsic coagulation defects and those on anticoagulant therapy.
Renal Effects:
As with other nonsteroidal anti-inflammatory drugs, long-term administration of ibuprofen to animals has resulted in renal papillary necrosis and other abnormal renal pathology. In humans, there have been reports of acute interstitial nephritis with haematuria, proteinuria, and occasionally nephrotic syndrome.
A second form of renal toxicity has been seen in patients with prerenal conditions leading to a reduction in renal blood flow or blood volume, where the renal prostaglandins have a supportive role in the maintenance of renal perfusion. In these patients administration of a nonsteroidal anti-inflammatory drug may cause a dose dependent reduction in prostaglandin formation and may precipitate overt renal decompensation. Patients at greatest risk of this reaction are those with impaired renal function, heart failure, liver dysfunction, those taking diuretics and the elderly.

PRECAUTIONS:
General
Liver effects
As with other nonsteroidal anti-inflammatory drugs, borderline elevations of one or more liver function tests may occur in up to 15% of patients. These abnormalities may progress, may remain essentially unchanged, or may be transient with continued therapy. Severe hepatic reactions, including jaundice and cases of fatal hepatitis, have been reported with ibuprofen as with other nonsteroidal anti-inflammatory drugs. Although such reactions are rare, if abnormal liver tests persist or worsen, if clinical signs and symptoms consistent with liver disease develop, or if systemic manifestations occur (e.g., eosinophilia, rash, etc.), ibuprofen should be discontinued.
Aseptic Meningitis
Aseptic meningitis with fever and coma has been observed on rare occasions in patients on ibuprofen therapy. Although it is probably more likely to occur in patients with systemic lupus erythematosus and related connective tissue diseases, it has been reported in patients who do not have an underlying chronic disease.

Laboratory Tests
No tests additional to routine ICU tests are indicated

Drug/Laboratory Test Interactions
None known

Diuretics:
Clinical studies have shown that ibuprofen can reduce the natriuretic effect of furosemide and thiazides in some patients. This response has been attributed to inhibition of renal prostaglandin synthesis. During concomitant therapy with ibuprofen, the patient should be observed closely for signs of renal failure, as well as to assure diuretic efficacy.

Lithium:
Ibuprofen produces an elevation of plasma lithium levels and a reduction in renal lithium clearance in patients on concomitant therapy.
Anticoagulants:
Risk of bleeding is additive with other anticoagulant drugs.

Haematologic
Neutropaenia, agranulocytosis, aplastic anaemia, haemolytic anaemia (sometimes Coombs positive), thrombocytopaenia with or without purpura, eosinophilia,
Cardiovascular
Oedema, palpitations, rrhythmias (sinus tachycardia, sinus bradycardia)
Renal
Acute renal failure, decreased creatinine clearance, polyuria, azotaemia, cystitis, haematuria, renal papillary necrosis
Gastrointestinal
Nausea, epigastric pain , heartburn , diarrhoea, abdominal distress, nausea and vomiting, indigestion, constipation, abdominal cramps or pain, fullness of GI tract (bloating and flatulence) Gastric or duodenal ulcer with bleeding and/or perforation, gastritis, hepatitis, jaundice, abnormal liver function tests; pancreatitis
Central Nervous System
Dizziness, headache, nervousness, depression, insomnia, confusion, emotional lability, somnolence, aseptic meningitis with fever and coma, paraesthesias, hallucinations, dream abnormalities, pseudotumour cerebri
Dermatologic
Rash, (including maculopapular type), pruritus Vesiculobullous eruptions, urticaria, erythema multiform, Stevens-Johnson syndrome, allopecia Toxic epidermal necrolysis, photoallergic skin reactions
Special Senses
Tinnitus Hearing loss, amblyopia (blurred and/or diminished vision, scotomata and/or changes in colour vision) Conjunctivitis, diplopia, optic neuritis, cataracts

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