How is ibuprofen used for pain relief. What are the recommended dosages for ibuprofen. Can ibuprofen be purchased over the counter. What are the potential side effects of ibuprofen. How does ibuprofen compare to other pain relievers.

Understanding Ibuprofen: A Versatile Pain Reliever

Ibuprofen is a widely used nonsteroidal anti-inflammatory drug (NSAID) that offers both analgesic and antipyretic effects. It’s commonly employed to alleviate pain, reduce fever, and manage inflammation in various conditions. Available in both over-the-counter (OTC) and prescription strengths, ibuprofen has become a staple in many medicine cabinets.

Is ibuprofen different from other pain relievers? Indeed, it belongs to the NSAID class, which sets it apart from acetaminophen. While both can reduce pain and fever, ibuprofen also tackles inflammation, making it particularly effective for conditions like arthritis or menstrual cramps.

The Mechanism of Action: How Ibuprofen Works

Ibuprofen’s effectiveness stems from its ability to inhibit cyclooxygenase enzymes, thereby reducing the production of prostaglandins. These chemical messengers play a crucial role in inflammation, pain, and fever. By decreasing prostaglandin levels, ibuprofen helps mitigate these symptoms.

Does ibuprofen work immediately? Not quite. While it’s absorbed relatively quickly, peak serum levels are typically reached within two hours of ingestion. The medication’s half-life is generally under two hours, with most of it eliminated via urine within 24 hours.

Ibuprofen Dosages: From OTC to Prescription Strength

Ibuprofen is available in various strengths to cater to different needs:

• 200mg tablets (commonly available OTC)
• 400mg tablets
• 600mg tablets
• 800mg tablets (usually prescription-only)

Can you buy 600mg ibuprofen over the counter? In most countries, including the United States, 600mg and 800mg tablets require a prescription. However, lower strengths are readily available OTC.

Recommended Dosages

The appropriate dosage depends on the condition being treated and individual factors. Generally, for adults:

• OTC use: 200-400mg every 4-6 hours, not exceeding 1200mg in 24 hours
• Prescription use: Up to 800mg every 6-8 hours, not exceeding 3200mg in 24 hours

Always consult a healthcare provider for personalized dosing instructions, especially when using higher strengths.

Obtaining Ibuprofen: OTC vs. Prescription

While lower-strength ibuprofen is widely available over the counter, higher doses require a prescription. This regulation helps ensure proper use and minimizes potential risks associated with prolonged high-dose consumption.

Are online prescriptions for ibuprofen available? Yes, some telehealth services offer consultations with medical providers who can prescribe ibuprofen when appropriate. However, it’s crucial to provide accurate medical information and follow professional advice.

Potential Side Effects and Precautions

Like all medications, ibuprofen can cause side effects. Common ones include:

• Stomach upset and indigestion
• Nausea
• Headache
• Dizziness
• Mild rash

More serious side effects, though less common, can include:

• Gastrointestinal bleeding or ulceration
• Increased risk of heart attack or stroke
• Liver or kidney problems
• Allergic reactions

Should ibuprofen be taken with food? It’s often recommended to take ibuprofen with food or milk to reduce the risk of stomach upset. However, this may slightly delay its absorption.

Ibuprofen Interactions and Contraindications

Ibuprofen can interact with various medications and substances, potentially altering its effectiveness or increasing the risk of side effects. Notable interactions include:

• Other NSAIDs (including aspirin)
• Blood thinners (e.g., warfarin)
• Certain antidepressants
• Some blood pressure medications
• Alcohol

Is it safe to take ibuprofen daily? While occasional use is generally safe for most people, long-term daily use should be supervised by a healthcare provider due to potential risks.

Contraindications

Ibuprofen is not suitable for everyone. It should be avoided or used with caution in individuals with:

• History of stomach ulcers or gastrointestinal bleeding
• Heart conditions or high blood pressure
• Liver or kidney disease
• Asthma (in some cases)
• Pregnancy, especially in the third trimester

Comparing Ibuprofen to Other Pain Relievers

Ibuprofen is one of several options for pain relief. How does it stack up against alternatives?

Ibuprofen vs. Acetaminophen (Tylenol)

Both reduce pain and fever, but ibuprofen also addresses inflammation. Acetaminophen may be preferred for headaches and is often considered safer for long-term use, especially in older adults.

Ibuprofen vs. Naproxen (Aleve)

Both are NSAIDs, but naproxen has a longer duration of action, often allowing for less frequent dosing. Some individuals may find one more effective or tolerable than the other.

Ibuprofen vs. Aspirin

While both are NSAIDs, aspirin has additional antiplatelet effects, making it useful for cardiovascular protection in some cases. However, this also increases bleeding risk.

Which pain reliever is best? The choice depends on the specific condition, individual response, and potential risks. Consulting a healthcare provider can help determine the most suitable option.

Proper Storage and Handling of Ibuprofen

To maintain ibuprofen’s effectiveness and safety, proper storage is essential:

• Store at room temperature (20-25°C or 68-77°F)
• Keep away from moisture and heat
• Store out of reach of children
• Check expiration dates regularly

Does ibuprofen expire? Yes, like all medications, ibuprofen can degrade over time. Using expired ibuprofen may result in reduced effectiveness or potential safety issues.

Responsible Use of Ibuprofen: Guidelines and Best Practices

To maximize benefits and minimize risks when using ibuprofen:

1. Use the lowest effective dose for the shortest duration necessary
2. Follow recommended dosing intervals
3. Be aware of potential side effects and interactions
4. Consult a healthcare provider before long-term use
5. Avoid alcohol consumption while taking ibuprofen
6. Stay hydrated to support kidney function

Can ibuprofen be used for chronic pain management? While it can be effective for some chronic pain conditions, long-term use should be monitored by a healthcare provider due to potential risks.

Special Considerations for Different Age Groups

The use of ibuprofen may vary depending on age:

• Children: Dosage is typically based on weight; consult a pediatrician
• Elderly: May be more susceptible to side effects; lower doses may be recommended
• Pregnant women: Generally avoided, especially in late pregnancy

Is ibuprofen safe for everyone? No medication is universally safe. Individual factors, including age, health conditions, and other medications, all play a role in determining safety and appropriate use.

Alternatives to Ibuprofen: Exploring Other Options

While ibuprofen is effective for many, some individuals may need alternatives due to contraindications or personal preferences. Options include:

• Other NSAIDs (e.g., naproxen, celecoxib)
• Acetaminophen
• Topical pain relievers
• Non-pharmacological approaches (e.g., physical therapy, acupuncture)

Are natural alternatives to ibuprofen effective? Some natural remedies, such as turmeric or omega-3 fatty acids, have shown anti-inflammatory properties. However, their effectiveness can vary, and they may not be suitable for all conditions.

When to Seek Medical Advice

While ibuprofen is generally safe for occasional use, it’s important to consult a healthcare provider if:

• Pain persists or worsens despite treatment
• You need to use ibuprofen for more than 10 days
• You experience severe side effects
• You have underlying health conditions
• You’re taking other medications regularly

Ibuprofen, when used responsibly and as directed, can be an effective tool for managing pain, fever, and inflammation. However, like all medications, it comes with potential risks and considerations. By understanding its proper use, dosing, and potential side effects, individuals can make informed decisions about incorporating ibuprofen into their pain management strategies. Always consult with a healthcare provider for personalized advice, especially when considering long-term use or higher doses of ibuprofen.

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Ibuprofen – Overview

Ibuprofen is a medication sometimes used for its analgesic and antipyretic effects. People who are interested in a prescription version of ibuprofen can use Push Health to connect with a medical provider who can prescribe ibuprofen medication, including generic ibuprofen 600 mg and ibuprofen 800 mg tablets, when appropriate and clinically indicated to do so.

What Is Ibuprofen Used For?

Ibuprofen, marketed under brand names such as Advil or Motrin, is similar to celecoxib (Celebrex), diclofenac (Pennsaid, Voltaren), etodolac (Lodine), ketoprofen (Orudis, Ourvail), ketorolac (Acular, Toradol), mefenamic acid (Ponstel), meloxicam (Mobic), naproxen (Naprosyn), nabumetone (Relafen) and oxaprozin (Daypro) in that it belongs to a class of medications known as nonsteroidal anti-inflammatory drugs, or NSAIDs. Ibuprofen differs from acetaminophen in this way. Ibuprofen is used in a variety of clinical situations with the general goals of reducing fever or pain. Ibuprofen is thought to work by blocking the production of prostaglandins through the nonselective inhibition of cyclooxygenase enzymes. Prostaglandins increase the amount of inflammation, pain and fever during disease states and reducing their presence is how ibuprofen is thought to exert its clinical effects. Ibuprofen tablets are typically indicated for relief of mild to moderate pain, symptoms related to rheumatoid arthritis and osteoarthritis, and the treatment of primary dysmenorrhea. Ibuprofen is also combined with the drug famotidine in the medication Duexis.

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Ibuprofen- Dosage and Cost

Generic ibuprofen medication is generally available as ibuprofen 200 mg tablets, ibuprofen 400 mg tablets, ibuprofen 600 mg tablets, and ibuprofen 800 mg tablets. Ibuprofen itself is found as a white powder that dissolves well in organic solvents and has a melting point under 80° C. Ibuprofen is well absorbed and peak levels in the serum are usually achieved within two hours. The serum half life of ibuprofen is typically under two hours and ibuprofen is primarily eliminated via the urine within 24 hours. Generic ibuprofen is relatively inexpensive when compared to other types of medications, costing under $5 for thirty tablets of ibuprofen 800 mg at many pharmacies in the United States. Ibuprofen coupons can frequently be found online. Insurance plans may cover the cost of ibuprofen tablets, particularly when requested as part of an ibuprofen prescription. Ibuprofen should be stored between 20° C and 25° C but consult the package insert for specific instructions.

Can I Buy Ibuprofen Online?

Ibuprofen is available as ibuprofen OTC (over-the-counter) in the United States. However, prescription versions of ibuprofen cannot be dispensed by a pharmacy without a prescription from a medical provider. Additionally, for prescription ibuprofen, one cannot just buy ibuprofen online without first getting a valid prescription. People who want an ibuprofen prescription, however, can use Push Health to connect with a medical provider who can prescribe generic ibuprofen, including ibuprofen 800 mg and 600 mg tablets, when appropriate to do so.

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Ibuprofen – Side Effects

Ibuprofen medication can cause side effects when used. Side effects that can result from ibuprofen use include stomach upset, nausea, indigestion, cramps, rash, dermatitis, weight gain, edema and liver toxicity. Ibuprofen can increase the risk of serious cardiovascular thrombotic events, myocardial infarction, stroke, and serious gastrointestinal adverse events including bleeding, ulceration, and perforation of the stomach or intestines. Ibuprofen should not be used at the same time as alcohol. People who have had a prior hypersensitivity or allergic reaction to ibuprofen or other NSAIDs should not use the generic or branded versions of the medication. Questions and concerns about using ibuprofen tablets should be directed to one’s pharmacist and medical provider before use.

More Ibuprofen Information

• Ibuprofen – Medline

Last updated March 21, 2022. Given the evolving nature of medicine and science, this information might not be accurate and should not be construed as medical advice or diagnosis / treatment recommendations. Please consult a licensed medical provider if you have additional questions. Please call 911 immediately or go to the nearest emergency room if you believe you are experiencing a medical emergency.

How Much Ibuprofen Can I Take Safely?

Written by
Juhi Modi

Medically reviewed by
HaVy Ngo-Hamilton, Pharm.D.
| Jun 13, 2023

Most people occasionally take ibuprofen at home for minor aches and pains such as headaches, toothaches, and fever. Ibuprofen is a non-steroidal anti-inflammatory drug (NSAID) that reduces pain and relieves inflammation. Familiar brand names for this medication include Motrin^® and Advil^®. Lower strengths of ibuprofen are available over the counter, and higher strengths can be obtained with a prescription.

Ibuprofen is available in various dosage strengths and formulations, including tablets, chewable tablets, caplets, liquid gels, and suspensions or oral drops. It is sometimes included in cold and allergy medicines for fever and pain relief.

When taken at the correct dose, ibuprofen is safe and effective for both children and adults. However, it is important to be aware of the maximum dosage of ibuprofen. At large doses, ibuprofen can cause serious adverse effects and may even be fatal. Notably, studies have shown that among all analgesic (pain-reliever) overdoses, nearly one-third included ibuprofen, making ibuprofen the most common NSAID involved in an overdose.  

Continue reading to learn more about the harmful effects caused by taking ibuprofen in excess amounts and find out why it is important to follow dosage instructions as directed on the label. This information will provide useful guidance when using ibuprofen to treat pain and fever in children and adults.

What is ibuprofen used to treat?

Ibuprofen is commonly used to treat mild to moderate aches and pains such as headache, toothache, period pain, and sports injuries like sprains and strains. Due to its anti-inflammatory properties, ibuprofen is also used to control pain and inflammation in the joints, bones, and muscles, for example, in conditions like osteoarthritis and rheumatoid arthritis. Ibuprofen may also be used to reduce fever during a flu-like illness or common cold. 

Why is it important to know the appropriate ibuprofen dosing?

You should know how much ibuprofen is safe because taking too much ibuprofen can be very harmful. Although higher strengths of ibuprofen require a prescription,  over-the-counter ibuprofen can be purchased and self-administered by patients at a higher than recommended maximum daily dose.  

Ibuprofen should be used with extreme caution in children and pregnant women as their metabolism rate of ibuprofen may be different than a healthy adult. Therefore, consulting a gynecologist and pediatrician is highly recommended for this patient population. Last but not least, since ibuprofen is a household name, it is very crucial to know when to avoid ibuprofen usage with certain medications. For example, ibuprofen should not be taken with other NSAIDs such as Aleve (naproxen), high doses of aspirin, or prescription NSAIDs such as ketorolac and celecoxib. Ibuprofen should also be avoided in patients who have a heart condition such as atrial fibrillation who are on blood-thinning agents such as warfarin, rivaroxaban, or apixaban, as ibuprofen or NSAIDs in general increase the risk of bleeding. Please consult your pharmacist or doctor before taking ibuprofen if you are already taking other medications to avoid drug interaction.   

What doses is ibuprofen available in?

As noted above, over-the-counter and prescription ibuprofen is available in various dosage forms like tablets and suspensions. The most commonly available formulations and dosage strengths of ibuprofen include tablets (100 mg, 200 mg, 400 mg, 600 mg, and 800 mg), capsules (200 mg), chewable tablets (100 mg), oral suspension, or liquid (100 mg per 5 mL), and concentrated oral suspension for infants (50 mg per 1.25 mL). Notably, the 400 mg, 600 mg, and 800 mg tablets of ibuprofen are available by prescription only. 

What is a safe dose of ibuprofen?

The recommended dose of ibuprofen is 200-400 mg by mouth every 4-6 hours as needed for pain or fever. The recommended maximum daily dose is 1200 mg for over-the-counter ibuprofen and 3200 mg for prescription-strength ibuprofen.

In children, the safe dosage of ibuprofen depends on the child’s weight as well as the condition that is being treated. A doctor or pharmacist can help you determine the correct dosing for your child. It is not recommended to give ibuprofen to children under six months of age.

Can I take 3 tablets of ibuprofen at once?

It depends on the strength of the ibuprofen. If you are using 100 mg OTC ibuprofen tablets, it is safe to take 3 tablets at once to make up the total dose of 300 mg since the recommended dose is 200 to 400 mg orally every 4-6 hours as long as the maximum recommended daily dose of 1200 mg is not exceeded. However, if you are using prescription-strength ibuprofen such as the 800 mg tablet, then taking 3 of these tablets at once is not recommended because taking more than 800 mg of ibuprofen in a single dose can potentially cause both short-term and long-term side effects, even though the three of the 800 mg ibuprofen tablet make up a total dose of 2400 mg and it does not exceed the recommended total daily dose of 3200 mg. 

Can I take 3 tablets of ibuprofen 200 mg at once?

For over-the-counter ibuprofen, 200 mg to 400 mg is the dose that should be taken at one time. Therefore, it is not recommended to take 3 of the 200 mg ibuprofen tablets since that makes up a total of 600 mg which exceeds the maximum 400 mg per dose. 

Taking too much ibuprofen can result in side effects such as nausea, vomiting, stomach ache, gassiness, indigestion, dizziness, and headache.

How often can I take ibuprofen 800 mg?

Ibuprofen 800 mg is a prescription-strength dosage. The total recommended dose is 3200 mg per day. Therefore, you can take ibuprofen 800 mg 4 times a day or every 6 hours. As mentioned above, even though the maximum daily dose of prescription ibuprofen is 3200 mg, it is potentially harmful to exceed 800 mg per dose. 

Can I take ibuprofen with other painkillers?

It is safe to take ibuprofen with paracetamol/acetaminophen (Tylenol^®) . However, taking ibuprofen with other NSAIDS like naproxen, ketorolac, or aspirin is not recommended unless it is indicated for certain medical conditions and your healthcare providers are aware of such a combination. Taking ibuprofen with other NSAIDs can increase your risk of side effects such as stomach ulcers, increased risk of bleeding, and acute kidney injury that can lead to chronic kidney disease.

What are the harmful effects of excess ibuprofen intake?

The maximum amount of ibuprofen in adults is 800 milligrams per dose or 3200 milligrams per day. You should keep these numbers in mind because a large ibuprofen overdose can lead to potentially life-threatening complications. Overdose symptoms can be mild to severe. Mild overdose symptoms include nausea, vomiting, diarrhea, and dizziness. Severe overdose symptoms are convulsions, hypotension (low blood pressure), little to no urine production, and even coma. Notably, a large ibuprofen overdose is extremely rare unless it is an intentional overdose in an adult or an accidental overdose in a child. 

Besides the risk of an overdose, taking ibuprofen over the recommended dose can lead to serious side effects. Side effects of ibuprofen include an increased risk of cardiovascular adverse events such as heart failure, heart disease, and stroke, kidney injury that leads to kidney failure, and gastrointestinal complications such as ulceration, bleeding, and stomach or intestinal perforation.

What if I forget to take an ibuprofen dose?

If you are using ibuprofen regularly long-term and have missed a dose, take it as soon as you remember. However, if it is nearly time for your next dose, do not double up to make up for the forgotten dose. Skip the missed dose and take the next dose as usual. 

What to do if I take too much ibuprofen?

If you have taken too much ibuprofen due to a mistake or misinformation, obtain medical advice from a healthcare professional as soon as possible. Stop taking the medicine and be vigilant for side effects like fatigue, sleepiness, stomach pain, nausea, vomiting, blood in the vomit, black stools, and tinnitus (ringing in the ears). If you experience any of these symptoms, please seek medical attention at the nearest emergency room without delay. Please call 911 or have someone drive you to the emergency department if the symptoms are severe and affecting your capability to operate a motor vehicle safely. 

The bottom line

In general, NSAIDs such as ibuprofen are well-tolerated and safe to use with a low risk of adverse events provided you take the medication as directed on the label or by your healthcare professional. Overall, ibuprofen can be safely used to treat pain, fever, and inflammation in both children and adults, as long as it is used as directed.

References:

1. https://www.ncbi.nlm.nih.gov/books/NBK526078/
2. https://www.nhs.uk/medicines/ibuprofen-for-adults/

Ibuprofen: instruction, price, analogues | Compendium – Drug Guide

Ibuprofen – NSAID

Ibuprofen is a widely prescribed NSAID, is considered one of the safest drugs in this group and is generally well tolerated, but, nevertheless, may rarely cause clinically significant and severe acute liver injury. Ibuprofen has anti-inflammatory, analgesic and antipyretic effects.

The drug is prescribed for the symptomatic treatment of various types of pain, including headache, toothache, dysmenorrhea, neuralgia, back pain, joint pain, muscle pain, rheumatic pain, as well as signs of SARS and influenza. Ibuprofen is given alone or in combination with other analgesics, antihistamines, or anticholinergics, usually at doses of 200, 400, 600, or 800 mg. Pediatric formulations of this drug are also available from pharmacies. Ibuprofen is part of many combined drugs for the symptomatic treatment of dysmenorrhea, headache, allergies, and acute respiratory viral infections.

Ibuprofen. FDA Approved Indications

Ibuprofen is indicated and FDA approved for the symptomatic treatment of inflammatory diseases and rheumatoid arthritis. Ibuprofen was discovered in the search for an alternative non-corticosteroid treatment for rheumatoid arthritis. This disease was the impetus for the creation of the substance that eventually became known as ibuprofen. Patented as 2-(4-isobutylphenyl)propionic acid (ibuprofen) by Dr. Stuart Adams and John Nicholson, it has become and remains one of the most widely used NSAIDs in the world (Halford G.M. et al., 2012). Today, ibuprofen is used as a monotherapy for the symptomatic treatment of pain in rheumatoid arthritis and inflammatory diseases, with some research being conducted into the introduction of new treatments or dosage forms. One of these studies includes the creation of complex drugs based on NSAIDs and a carbonic anhydrase inhibitor for the symptomatic treatment of pain in rheumatoid arthritis (Akgul O. et al., 2018).

Ibuprofen is FDA approved for symptomatic use in mild to moderate pain. As an over-the-counter drug, it is used as a symptomatic treatment for muscle strain, joint pain, migraine, sore throat, SARS / influenza. Postoperative pain is one type of pain. One randomized, double-blind study demonstrated the therapeutic efficacy of i.v. ibuprofen, with i.v. acetaminophen being the comparator. The effectiveness of drugs was compared in the treatment of postoperative pain in patients undergoing laparoscopic cholecystectomy. As a result of the study, in the first 24 hours after the procedure, it was found that with intravenous ibuprofen therapy, the severity of pain decreases and thus it is possible to reduce the dose of opioids (Ekinci M. et al., 2019). Ibuprofen is widely used as an effective drug for the symptomatic treatment of pain, but research is constantly aimed at improving the effectiveness of its clinical use.

Ibuprofen is also FDA-approved as an antipyretic drug used to reduce body temperature in both adults and children. NSAIDs are much more commonly used in the treatment of fever in children, and much current research is focused on making ibuprofen more effective for this purpose.

Dysmenorrhea is a disease characterized by pain during menstruation, which can vary. Dysmenorrhea can be either primary, which is usually mediated by prostaglandin production during ovulation, or secondary to another disease such as endometriosis or pelvic inflammatory disease (Durain D., 2004). NSAIDs are often the therapeutic choice and are FDA approved for the treatment of primary dysmenorrhea. Transdermal drug delivery has been a topic of research in the context of the use of ibuprofen for the symptomatic treatment of primary dysmenorrhea. One study examined the use of essential oils as penetration enhancers for the transdermal delivery of ibuprofen in patients with dysmenorrhea. As a result of the study, one of the essential oils (Chuanxiong oil) was found to have a positive effect on the permeability and relief of pain symptoms when administered with ibuprofen hydrogel (Chen J. et al., 2015).

Ibuprofen and other NSAIDs are also FDA approved for the treatment of osteoarthritis. The results of a comparative study of celecoxib (a group of coxibs) and ibuprofen demonstrated the same tolerability and efficacy in the treatment of patients with osteoarthritis of the knee (Gordo A.C. et al., 2015).

Ibuprofen has been studied for the symptomatic treatment of gout attacks. In 1978, a study by Schweitz et al. reported rapid improvement and reduction in pain in 10 patients with acute gouty arthritis (patients were treated with ibuprofen 2400 mg) (Schweitz M.C. et al., 1978). Ibuprofen is usually used as monotherapy for mild attacks and colchicine as therapy for moderate to severe gout attacks.

NSAIDs and colchicine are also often used in combination in the treatment of pericarditis due to the anti-inflammatory and analgesic properties of NSAIDs. Since 2011, ibuprofen has been one of the most widely used NSAIDs in the treatment of pericarditis. Its efficacy has been demonstrated in the CORP and CORP-2 trials in the treatment and prevention of multiple relapses of idiopathic pericarditis compared to acetylsalicylic acid. The study found no significant difference between the two drugs in the treatment or prevention of idiopathic pericarditis (Schwier N. et al., 2017). In a 2014 review, colchicine was shown to be effective in reducing the incidence of recurrent pericarditis when used as add-on therapy to NSAIDs such as ibuprofen, acetylsalicylic acid, or indomethacin, but with limited study numbers (Bayes-Genis A. et al. , 2017).

Intravenous ibuprofen has been approved by the FDA for the treatment of patent ductus arteriosus in preterm infants. As a result of studies, a similar efficacy of ibuprofen with indomethacin was recorded in this pathology. Differences exist in the incidence of systemic vasoconstriction and renal toxicity; probably due to the lower selectivity for COX-1, ibuprofen was found to have reduced rates of both outcomes (Ferguson J.M., 2019).

Since 2007, USPSTF guidelines recommend the use of acetylsalicylic acid and NSAIDs for the prevention of colorectal cancer in certain populations. In 2016, they updated these recommendations, as well as recommendations from 2009 on the use of acetylsalicylic acid and NSAIDs in the prevention of cardiovascular diseases (Bibbins-Domingo K. et al., 2016). Although these recommendations do not apply specifically to ibuprofen, they do provide a solid basis for research that confirms the potentially great role of NSAIDs in the treatment and prevention of cancer. The results of a study on the effectiveness of NSAIDs in the treatment of cancer, as well as some studies on the effectiveness of ibuprofen, have shown promising results. A review by Hil’ovska et al documented the potential use of NSAIDs in reducing the growth, morphology, and invasion of cancer cells; in the induction of cancer cell death and in the use of a lower dose of cytotoxic drugs (Hiľovská L. et al., 2015). The reviewed studies were mainly devoted to COX-2 inhibitors. With regard to ibuprofen specifically, some studies have suggested that it has a stronger antitumor effect compared to acetylsalicylic acid, namely in studies conducted in the treatment of breast and lung cancer (Harris R. E. et al., 2005). Also, when using ibuprofen or acetylsalicylic acid, the risk of developing breast cancer is reduced (Cuzick J. et al., 2009).

Similar to previous authors, Wawro et al. in their studies demonstrated potential indications for the use of NSAIDs, especially acetylsalicylic acid and ibuprofen, in the treatment of cancer in patients with colorectal cancer treated with vincristine monotherapy. The proposed role of NSAIDs is primarily to prevent chemoresistance by inhibiting the proliferation of cancer-associated fibroblast formation. Vincristine stimulates the growth of cancer-associated fibroblasts through the secretion of tumor growth factors beta (TGF-β) and IL-6; when using acetylsalicylic acid and ibuprofen, scientists recorded an inhibitory effect of the drug on this pathological process. Their studies were based on the assumption that the probable mechanism of this inhibitory effect is associated with NSAIDs that affect the rate of regulation of microtubule polymerization dynamics (Wawro M. E. et al., 2019).

Ibuprofen. Pain in the pediatric population

Pain is a common symptom in children. For more than 30 years, the use of ibuprofen in the pediatric population has been the subject of research. The scientific literature has reviewed information on childhood illnesses over the past 20 years, drawing conclusions about the efficacy and side effects associated with the use of ibuprofen as an analgesic. Ibuprofen has been effective in several pain conditions in children such as musculoskeletal pain, ear pain and acute otitis media, toothache and inflammatory diseases of the mouth and throat. The drug is a reasonable and effective alternative for postoperative pain, including tonsillectomy and adenoidectomy. It also remains the choice in the symptomatic treatment of pain in chronic inflammatory diseases such as arthritis. Side effects associated with ibuprofen are minor. It has the lowest gastrointestinal toxicity among NSAIDs, although some cases of GI toxicity (gastrointestinal toxicity) may occur. Adverse reactions from the kidneys are minimal, but dehydration plays an important role in the occurrence of kidney damage, so ibuprofen should not be given to patients with vomiting and diarrhea. Ibuprofen therapy has demonstrated a good safety profile and evidence of efficacy in the symptomatic treatment of mild to moderate pain in children of various backgrounds. The analgesic effect of NSAIDs such as ibuprofen is mainly to inhibit the biosynthesis of prostaglandins. A decrease in the synthesis of prostaglandins leads to a decrease in the production of glutathione and renal perfusion.

Benefits of ibuprofen and acetaminophen combined/alternating

Benefits of using NSAIDs and acetaminophen concomitantly or alternately have been suggested due to their potential synergism in antinociceptive effects, as well as the convenience of using an additional analgesic drug for pain that is not amenable to monotherapy at any dose of age. In acetaminophen, C _max in plasma is reached after 30 minutes compared to 60 minutes for ibuprofen. In studies of antipyretic effects, acetaminophen maximally reduces high body temperature after 2 hours, and ibuprofen after 3 hours. The recommended dosing intervals are every 6 and 8 hours for acetaminophen and ibuprofen, respectively; thus, theoretically, they can be rotated every 3 hours. Short-term use of an alternating dosing regimen may be considered for the symptomatic treatment of pain that is not relieved by monotherapy (Massimo Barbagallo et al., 2019)

There are several randomized controlled trials of symptomatic treatment of headache in children. They concluded that only ibuprofen and sumatriptan were significantly more effective than placebo in reducing headache severity.

One Cochrane review included 27 pediatric randomized controlled trials of NSAIDs. Each of them compared the therapeutic efficacy of one of the drugs in this group with placebo. Efficacy was evaluated 2 hours after administration of the study drug. Based on a systematic review, ibuprofen appeared to be more effective, making it the drug of choice for the symptomatic treatment of headache. If migraine is suspected, NSAIDs and triptans should be considered. In case of nausea and vomiting, antiemetics and IV rehydration should be used (Raucci U., 2019).

Conclusions. Ibuprofen – safety profile among NSAIDs

Ibuprofen first appeared on the market about 50 years ago and quickly became a popular drug. In April 2019, the National Agency for the Safety of Medicines and Health Products (ANSM) of France issued a warning against the use of NSAIDs in patients with infectious diseases, based on an analysis of 20 years of real data on the safety of ibuprofen and ketoprofen. Nevertheless, ibuprofen remains the basic drug used in the symptomatic treatment of pain of various origins, which is clearly confirmed in numerous randomized clinical trials and clinical experience. There is a review of the literature on the safety of ibuprofen and how it compares favorably with other NSAIDs. Ibuprofen therapy is characterized by adverse reactions not only from the gastrointestinal tract, which are dose-dependent and are especially characteristic for a certain patient population. Among NSAIDs, ibuprofen causes a relatively low risk of cardiovascular side effects. Overall, ibuprofen has a favorable safety profile and is effective in many acute and chronic pain conditions (Varrassi G. et al., 2020).

Hangover as a path to the invention of ibuprofen

November 22, 2015

Photo by SAMUEL KIRBY. BOOTS UK

Photo caption,

Dr. Stuart Adams is honored for inventing ibuprofen in the 1960s

Dr. Stuart Adams became convinced he had invented a promising pain reliever when ibuprofen saved him from a hangover before an important speech.

“I was supposed to go first, but I had a bit of a headache after a party with friends the day before. So I took 600mg of the drug – to be sure – and I felt its effectiveness.”

Dr. Adams, now 92, remembers well years of research, endless testing of various compounds, and many disappointments before he, along with his research team, developed a formula that saw potential. This was over 50 years ago.

Since then, ibuprofen has become one of the most popular pain relievers in the world. Not a single first-aid kit can do without it today.

Are you feverish? Headache? Aching lower back? Painful teeth? Then you will most likely choose ibuprofen, because it is fast acting and available without a prescription.

Its popularity as a pain reliever is not just a British phenomenon. It is often resorted to, for example, in India, fleeing from high fever or pain. It has been available in the US without a prescription since 1984. They also relieve inflammation, for example, in diseases such as arthritis.

And, as Dr. Adams discovered during a visit to Afghanistan in the 1970s, his miracle cure is sold even in pharmacies in remote villages along the Khyber Pass.

However, as he modestly states, this discovery did not change his life in any way.

Looking for a worthy task

Once upon a time he was a simple 16-year-old boy from Northamptonshire who had finished school and had no idea what to do next.

He took a job as an assistant pharmacist for the pharmaceutical chain Boots, which sparked his interest and ambition for a more challenging career.

He graduated in pharmacy from the University of Nottingham and received his PhD from the University of Leeds before returning to work in the research department of the Boots Pure Drug Company Ltd in 1952.

By that time, his mission was to develop new drugs for rheumatoid arthritis that would be as effective as steroids, but without the side effects.

He began to consider how anti-inflammatory drugs, in particular aspirin, worked, which none of his contemporaries did.

Aspirin is the first non-steroidal anti-inflammatory drug (NSAID) developed in 1897.

Although aspirin was widely used at the time, it had to be taken in very large doses, which increased the risk of side effects such as an allergic reaction, bleeding, and upset stomach. Therefore, in Britain 19In the 50s, he gradually lost mass popularity.

Decade Research

Seeking an alternative, Dr. Adams hired chemist Dr. John Nicholson and technician Colin Burroughs to test the qualities of over six hundred chemical compounds together. They set a goal to develop a drug that would be well received by the body.

In their laboratory in an old Victorian house in the suburbs of Nottingham, the small team patiently tested new compounds until they found something worth protesting on patients.

Caption before photo,

Dr. Stuart Adams spent his entire professional life at Boots UK researching and developing NSAIDs

Dr. Adams was aware of the meager chances of success, and yet he and his colleagues did not stop trying for a long 10 years.

“I knew that sooner or later success would come to us – I always believed that we would succeed.”

He was always ready to serve as a guinea pig and tested two or three connections on himself.

It would never be allowed these days, he admits, but he and his colleagues carefully tested them for toxicity before drinking a new drug.

“It was important to test these drugs and I’m very happy to be the first to take ibuprofen,” he recalls.

Four of their products made it to clinical trials but failed; however, in 1961 success came to a drug called “2 (4-isobutylphenyl) propionic acid”, which was later called “ibuprofen”.

In 1962, the Boots Company received a patent for this product, and seven years later it was approved for prescription use in patients.

According to Dave McMillan, former Head of Medical Development at Boots UK, ibuprofen has been extremely important to the company.

“He saved Boots, helped us enter the US and the world market. It was Boots’ #1 drug.”

Today, pharmaceutical companies around the world produce an incredible amount of ibuprofen under various commercial names every year – 20 thousand tons. It also has various forms, in particular the form of syrup for children.

Photo credit, Science Photo Library

Photo caption,

Ibuprofen is now marketed by many companies under various trade names society. He worked for Boots until his retirement as Chairman of the Pharmaceutical Science Department.

What pleases him most is that the drug he invented helps hundreds of millions of people around the world.

It was a long but very important journey. And it all started with a headache.

How does ibuprofen work?

Ibuprofen is a non-steroidal anti-inflammatory drug (NSAID). Since it has a different chemical structure than steroids, it is not as toxic.

It relieves pain by counteracting compounds called prostaglandins that cause inflammation in the body.

Inflammation can lead to swelling, fever, redness, loss of function and pain.

Pain begins to subside immediately after taking the drug, but inflammation may take longer to subside.