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Prescription Strength Advil: Indications, Interactions, and Dosage Guide

by alexxlab

What are the indications for prescription strength Advil. How does it interact with other medications. What is the recommended dosage for prescription strength Advil. What are the potential side effects of using prescription strength Advil.

Содержание

Understanding Prescription Strength Advil: Indications and Usage

Prescription strength Advil, also known as ibuprofen, is a nonsteroidal anti-inflammatory drug (NSAID) that is commonly used to treat various conditions. It is available in higher doses than over-the-counter versions, typically ranging from 400 mg to 800 mg per tablet. But what exactly is it used for?

Prescription strength Advil is primarily indicated for:

  • Moderate to severe pain management
  • Reducing inflammation associated with arthritis
  • Treating menstrual cramps
  • Managing fever
  • Alleviating headaches and migraines

When is prescription strength Advil typically prescribed? Healthcare providers may recommend this higher dose when over-the-counter versions prove insufficient in managing a patient’s symptoms. However, it’s crucial to note that higher doses also come with an increased risk of side effects.

Dosage Guidelines for Prescription Strength Advil

Proper dosing of prescription strength Advil is essential for maximizing its benefits while minimizing potential risks. The appropriate dosage can vary depending on the condition being treated and individual patient factors.

For adults, typical dosage recommendations include:

  • 400-800 mg every 6-8 hours for pain and inflammation
  • 400-800 mg every 4-6 hours for fever reduction
  • Maximum daily dose should not exceed 3200 mg

Can the dosage be adjusted based on specific conditions? Yes, healthcare providers may tailor the dosage based on the severity of symptoms and the patient’s response to treatment. For chronic conditions like arthritis, a lower maintenance dose may be prescribed after initial symptom control.

Special Considerations for Dosing

Certain factors may necessitate dosage adjustments:

  • Elderly patients: Lower doses are often recommended due to increased risk of side effects
  • Patients with kidney or liver impairment: Dosage reduction may be necessary
  • Children: Dosage is typically based on weight and should be determined by a pediatrician

Is it safe to take prescription strength Advil for extended periods? Long-term use should be monitored closely by a healthcare provider due to potential risks associated with prolonged NSAID use.

Potential Side Effects and Precautions

While prescription strength Advil can be highly effective in managing pain and inflammation, it’s not without risks. Understanding potential side effects is crucial for safe usage.

Common side effects may include:

  • Gastrointestinal issues (nausea, stomach pain, heartburn)
  • Headache
  • Dizziness
  • Mild rash

More serious side effects, although less common, can occur:

  • Gastrointestinal bleeding or ulceration
  • Increased risk of heart attack or stroke
  • Kidney problems
  • Severe allergic reactions

How can patients minimize the risk of side effects? Taking the medication with food, avoiding alcohol, and staying well-hydrated can help reduce the likelihood of certain side effects. Additionally, using the lowest effective dose for the shortest duration necessary can help mitigate risks.

Drug Interactions: What You Need to Know

Prescription strength Advil can interact with various medications, potentially altering their effectiveness or increasing the risk of side effects. Understanding these interactions is crucial for safe use.

Some notable interactions include:

  • Anticoagulants (e.g., warfarin, apixaban): Increased risk of bleeding
  • ACE inhibitors and ARBs: Possible reduction in blood pressure-lowering effects
  • Diuretics: Potential decrease in effectiveness
  • Lithium: Increased lithium levels in the blood
  • Other NSAIDs: Increased risk of side effects

How can patients manage potential drug interactions? It’s essential to inform healthcare providers about all medications, including over-the-counter drugs and supplements, before starting prescription strength Advil. In some cases, alternative medications or dosage adjustments may be necessary.

Specific Drug Interaction Examples

Let’s examine some specific interactions mentioned in the original text:

  1. Acebutolol: Ibuprofen may decrease the effects of acebutolol through pharmacodynamic antagonism. Long-term use of NSAIDs can affect prostaglandin synthesis.
  2. Aliskiren: Ibuprofen may decrease the effects of aliskiren, particularly in elderly or volume-depleted patients. This interaction can potentially lead to renal impairment and loss of antihypertensive effects.
  3. Amikacin: Ibuprofen may increase amikacin levels by decreasing renal clearance, particularly in preterm infants.
  4. Apixaban: Both ibuprofen and apixaban increase anticoagulation, potentially leading to an increased risk of bleeding. Alternative medications should be considered.

Why is it important to monitor these interactions closely? These interactions can significantly impact treatment efficacy and patient safety. Healthcare providers may need to adjust dosages, change medications, or implement additional monitoring to manage these interactions effectively.

Prescription Strength Advil in Special Populations

Certain groups of people may require special considerations when using prescription strength Advil. Understanding these nuances is crucial for safe and effective treatment.

Elderly Patients

Older adults may be more susceptible to side effects from prescription strength Advil. Considerations include:

  • Increased risk of gastrointestinal bleeding
  • Potential for kidney function decline
  • Higher likelihood of drug interactions due to polypharmacy

How should dosing be adjusted for elderly patients? Generally, starting with the lowest effective dose and closely monitoring for side effects is recommended. Regular kidney function tests may be necessary for long-term use.

Pregnant and Breastfeeding Women

The use of prescription strength Advil during pregnancy and breastfeeding requires careful consideration:

  • First and second trimesters: Use should be limited to situations where benefits outweigh potential risks
  • Third trimester: Generally contraindicated due to risks of premature closure of the ductus arteriosus
  • Breastfeeding: Considered compatible, but caution is advised

What alternatives are available for pregnant women? Acetaminophen is often considered a safer alternative for pain relief during pregnancy, but any medication use should be discussed with a healthcare provider.

Patients with Cardiovascular Risk Factors

Individuals with a history of heart disease or stroke, or those at high risk for these conditions, require special attention when considering prescription strength Advil:

  • Increased risk of heart attack and stroke with NSAID use
  • Potential for fluid retention and edema
  • Possible interference with the cardioprotective effects of low-dose aspirin

How can cardiovascular risks be mitigated? Using the lowest effective dose for the shortest duration necessary is crucial. In some cases, alternative pain management strategies may be preferable.

Alternatives to Prescription Strength Advil

While prescription strength Advil can be highly effective, it’s not suitable for everyone. Understanding alternative options is important for comprehensive pain management.

Potential alternatives include:

  • Other NSAIDs (e.g., naproxen, celecoxib)
  • Acetaminophen
  • Topical pain relievers
  • Non-pharmacological approaches (e.g., physical therapy, acupuncture)
  • Opioid medications (for severe pain, under strict medical supervision)

How do healthcare providers determine the best alternative? The choice depends on various factors, including the type and severity of pain, patient’s medical history, potential drug interactions, and individual response to different treatments.

Comparing NSAIDs

Different NSAIDs may have varying benefits and risks:

  • Naproxen: May have a lower cardiovascular risk profile compared to ibuprofen
  • Celecoxib: May have a lower risk of gastrointestinal side effects
  • Aspirin: Offers additional cardioprotective benefits but may have a higher bleeding risk

Can combining different pain relief strategies be beneficial? Yes, a multimodal approach to pain management, combining pharmacological and non-pharmacological methods, often provides the best outcomes while minimizing risks.

Monitoring and Follow-up for Prescription Strength Advil Users

Regular monitoring is essential for patients using prescription strength Advil, especially for long-term use. This helps ensure the medication remains effective and safe.

Key aspects of monitoring include:

  • Regular assessment of pain control and functional improvement
  • Monitoring for side effects, particularly gastrointestinal and cardiovascular
  • Periodic blood tests to check kidney and liver function
  • Blood pressure monitoring
  • Reassessment of the need for continued NSAID therapy

How often should follow-up appointments be scheduled? The frequency of follow-ups depends on individual patient factors but typically ranges from every 3 to 6 months for long-term users.

Patient Education and Self-Monitoring

Empowering patients with knowledge is crucial for safe medication use. Patients should be educated on:

  • Signs and symptoms of potential side effects
  • The importance of adhering to prescribed dosages
  • When to seek immediate medical attention
  • The need to inform all healthcare providers about their NSAID use

What role do patients play in ensuring safe use of prescription strength Advil? Patients should actively participate in their care by maintaining open communication with their healthcare providers, reporting any unusual symptoms, and following prescribed guidelines carefully.

In conclusion, prescription strength Advil can be a powerful tool in managing pain and inflammation when used appropriately. However, its use requires careful consideration of individual patient factors, potential risks, and ongoing monitoring. By understanding these aspects, healthcare providers and patients can work together to maximize the benefits of this medication while minimizing potential risks.

Advil, Motrin (ibuprofen) dosing, indications, interactions, adverse effects, and more

  • acebutolol

    Monitor Closely (2)ibuprofen decreases effects of acebutolol by pharmacodynamic antagonism. Use Caution/Monitor. Long term (>1 wk) NSAID use. NSAIDs decrease prostaglandin synthesis.

    acebutolol and ibuprofen both increase serum potassium. Use Caution/Monitor.

  • aceclofenac

    Monitor Closely (2)aceclofenac and ibuprofen both increase anticoagulation. Use Caution/Monitor.

    aceclofenac and ibuprofen both increase serum potassium. Use Caution/Monitor.Minor (1)aceclofenac will increase the level or effect of ibuprofen by acidic (anionic) drug competition for renal tubular clearance. Minor/Significance Unknown.

  • acemetacin

    Monitor Closely (2)acemetacin and ibuprofen both increase anticoagulation. Use Caution/Monitor.

    acemetacin and ibuprofen both increase serum potassium. Use Caution/Monitor.Minor (1)acemetacin will increase the level or effect of ibuprofen by acidic (anionic) drug competition for renal tubular clearance. Minor/Significance Unknown.

  • acyclovir

    Minor (1)ibuprofen will increase the level or effect of acyclovir by acidic (anionic) drug competition for renal tubular clearance. Minor/Significance Unknown.

  • adefovir

    Minor (1)ibuprofen increases levels of adefovir by enhancing GI absorption. Applies only to oral form of both agents. Minor/Significance Unknown.

  • agrimony

    Monitor Closely (1)ibuprofen and agrimony both increase anticoagulation. Use Caution/Monitor.

  • albuterol

    Monitor Closely (1)ibuprofen increases and albuterol decreases serum potassium. Effect of interaction is not clear, use caution. Use Caution/Monitor.

  • alendronate

    Minor (1)ibuprofen, alendronate.
    Either increases toxicity of the other by pharmacodynamic synergism. Minor/Significance Unknown. Increased risk of GI ulceration.

  • alfalfa

    Monitor Closely (1)ibuprofen and alfalfa both increase anticoagulation. Use Caution/Monitor.

  • alfuzosin

    Monitor Closely (1)ibuprofen decreases effects of alfuzosin by pharmacodynamic antagonism. Use Caution/Monitor. NSAIDs decrease prostaglandin synthesis.

  • aliskiren

    Monitor Closely (1)ibuprofen will decrease the level or effect of aliskiren by Other (see comment). Use Caution/Monitor. In patients who are elderly, volume-depleted (including those on diuretic therapy), or with compromised renal function, coadministration of NSAIDs with drugs that affect RAAS may increase the risk of renal impairment (including acute renal failure) and cause loss of antihypertensive effect. Monitor renal function periodically.

  • alteplase

    Monitor Closely (1)ibuprofen and alteplase both increase anticoagulation. Use Caution/Monitor. Potential for increased risk of bleeding, caution is advised.

  • American ginseng

    Monitor Closely (1)ibuprofen and American ginseng both increase anticoagulation. Use Caution/Monitor.

  • amikacin

    Monitor Closely (1)ibuprofen increases levels of amikacin by decreasing renal clearance. Use Caution/Monitor. Interaction mainly occurs in preterm infants.

  • amiloride

    Monitor Closely (1)amiloride and ibuprofen both increase serum potassium. Modify Therapy/Monitor Closely.

  • aminohippurate sodium

    Minor (1)ibuprofen will increase the level or effect of aminohippurate sodium by acidic (anionic) drug competition for renal tubular clearance. Minor/Significance Unknown.

  • aminolevulinic acid oral

    Serious – Use Alternative (1)aminolevulinic acid oral, ibuprofen.
    Either increases toxicity of the other by pharmacodynamic synergism. Avoid or Use Alternate Drug. Avoid administering other phototoxic drugs with aminolevulinic acid oral for 24 hr during perioperative period.

  • aminolevulinic acid topical

    Serious – Use Alternative (1)ibuprofen, aminolevulinic acid topical.
    Either increases toxicity of the other by pharmacodynamic synergism. Avoid or Use Alternate Drug. Each drug may increase the photosensitizing effect of the other.

  • amiodarone

    Minor (1)amiodarone will increase the level or effect of ibuprofen by affecting hepatic enzyme CYP2C9/10 metabolism. Minor/Significance Unknown.

  • amobarbital

    Minor (1)amobarbital will decrease the level or effect of ibuprofen by affecting hepatic enzyme CYP2C9/10 metabolism. Minor/Significance Unknown.

  • anamu

    Minor (1)ibuprofen and anamu both increase anticoagulation. Minor/Significance Unknown.

  • antithrombin alfa

    Monitor Closely (1)antithrombin alfa and ibuprofen both increase anticoagulation. Modify Therapy/Monitor Closely.

  • antithrombin III

    Monitor Closely (1)antithrombin III and ibuprofen both increase anticoagulation. Modify Therapy/Monitor Closely.

  • apixaban

    Serious – Use Alternative (1)ibuprofen and apixaban both increase anticoagulation. Avoid or Use Alternate Drug.

  • arformoterol

    Monitor Closely (1)ibuprofen increases and arformoterol decreases serum potassium. Effect of interaction is not clear, use caution. Use Caution/Monitor.

  • argatroban

    Monitor Closely (1)argatroban and ibuprofen both increase anticoagulation. Modify Therapy/Monitor Closely.

  • asenapine

    Monitor Closely (1)ibuprofen decreases effects of asenapine by pharmacodynamic antagonism. Use Caution/Monitor. NSAIDs decrease prostaglandin synthesis.

  • aspirin

    Monitor Closely (2)aspirin and ibuprofen both increase anticoagulation. Use Caution/Monitor.

    aspirin and ibuprofen both increase serum potassium. Use Caution/Monitor.Serious – Use Alternative (2)ibuprofen increases toxicity of aspirin by anticoagulation. Avoid or Use Alternate Drug. increases risk of bleeding.

    ibuprofen decreases effects of aspirin by Other (see comment). Avoid or Use Alternate Drug.
    Comment: Ibuprofen decreases the antiplatelet effects of low-dose aspirin by blocking the active site of platelet cyclooxygenase. Administer ibuprofen 8 h before aspirin or at least 2-4 h after aspirin. The effect of other NSAIDs on aspirin is not established.Minor (1)aspirin will increase the level or effect of ibuprofen by acidic (anionic) drug competition for renal tubular clearance. Minor/Significance Unknown.

  • aspirin rectal

    Monitor Closely (2)aspirin rectal and ibuprofen both increase anticoagulation. Use Caution/Monitor.

    aspirin rectal and ibuprofen both increase serum potassium. Use Caution/Monitor.Serious – Use Alternative (1)ibuprofen decreases effects of aspirin rectal by Other (see comment). Avoid or Use Alternate Drug.
    Comment: Ibuprofen decreases the antiplatelet effects of aspirin by blocking the active site of platelet cyclooxygenase. The effect of other NSAIDs on aspirin is not established.Minor (1)aspirin rectal will increase the level or effect of ibuprofen by acidic (anionic) drug competition for renal tubular clearance. Minor/Significance Unknown.

  • aspirin/citric acid/sodium bicarbonate

    Monitor Closely (2)aspirin/citric acid/sodium bicarbonate and ibuprofen both increase anticoagulation. Use Caution/Monitor.

    aspirin/citric acid/sodium bicarbonate and ibuprofen both increase serum potassium. Use Caution/Monitor.Serious – Use Alternative (1)ibuprofen decreases effects of aspirin/citric acid/sodium bicarbonate by Other (see comment). Avoid or Use Alternate Drug.
    Comment: Ibuprofen decreases the antiplatelet effects of aspirin by blocking the active site of platelet cyclooxygenase. The effect of other NSAIDs on aspirin is not established.Minor (1)aspirin/citric acid/sodium bicarbonate will increase the level or effect of ibuprofen by acidic (anionic) drug competition for renal tubular clearance. Minor/Significance Unknown.

  • atenolol

    Monitor Closely (2)ibuprofen decreases effects of atenolol by pharmacodynamic antagonism. Use Caution/Monitor. Long term (>1 wk) NSAID use. NSAIDs decrease prostaglandin synthesis.

    atenolol and ibuprofen both increase serum potassium. Use Caution/Monitor.

  • azficel-T

    Monitor Closely (1)azficel-T, ibuprofen. Other (see comment). Use Caution/Monitor.
    Comment: Patients taking NSAIDS may experience increased bruising or bleeding at biopsy and/or injection sites. Concomitant use of NSAIDs is not recommended.

  • azilsartan

    Monitor Closely (2)ibuprofen, azilsartan.
    Either increases toxicity of the other by Other (see comment). Use Caution/Monitor.
    Comment: May result in renal function deterioration, particularly in elderly or volume depleted individuals.

    ibuprofen decreases effects of azilsartan by pharmacodynamic antagonism. Modify Therapy/Monitor Closely. NSAIDs decrease synthesis of vasodilating renal prostaglandins, and thus affect fluid homeostasis and may diminish antihypertensive effect.

  • balsalazide

    Minor (1)ibuprofen will increase the level or effect of balsalazide by acidic (anionic) drug competition for renal tubular clearance. Minor/Significance Unknown.

  • bemiparin

    Monitor Closely (1)bemiparin and ibuprofen both increase anticoagulation. Modify Therapy/Monitor Closely.

  • benazepril

    Monitor Closely (1)benazepril, ibuprofen.
    Either increases toxicity of the other by Other (see comment). Use Caution/Monitor.
    Comment: May result in renal function deterioration, particularly in elderly or volume depleted individuals.Serious – Use Alternative (1)ibuprofen, benazepril. pharmacodynamic antagonism. Avoid or Use Alternate Drug. Coadministration may result in a significant decrease in renal function. NSAIDs may diminish the antihypertensive effect of ACE inhibitors. The mechanism of these interactions is likely related to the ability of NSAIDs to reduce the synthesis of vasodilating renal prostaglandins.

  • bendroflumethiazide

    Monitor Closely (1)ibuprofen increases and bendroflumethiazide decreases serum potassium. Effect of interaction is not clear, use caution. Use Caution/Monitor.Minor (1)bendroflumethiazide will increase the level or effect of ibuprofen by acidic (anionic) drug competition for renal tubular clearance. Minor/Significance Unknown.

  • betaxolol

    Monitor Closely (2)ibuprofen decreases effects of betaxolol by pharmacodynamic antagonism. Use Caution/Monitor. Long term (>1 wk) NSAID use. NSAIDs decrease prostaglandin synthesis.

    betaxolol and ibuprofen both increase serum potassium. Use Caution/Monitor.

  • betrixaban

    Monitor Closely (1)ibuprofen, betrixaban.
    Either increases levels of the other by anticoagulation. Use Caution/Monitor.

  • bimatoprost

    Monitor Closely (1)bimatoprost, ibuprofen. unspecified interaction mechanism. Use Caution/Monitor. There are conflicting reports from studies of either increased or decreased IOP when ophthalmic prostaglandins are coadministered with NSAIDs (either systemic or ophthalmic).

  • bisoprolol

    Monitor Closely (2)ibuprofen decreases effects of bisoprolol by pharmacodynamic antagonism. Use Caution/Monitor. Long term (>1 wk) NSAID use. NSAIDs decrease prostaglandin synthesis.

    bisoprolol and ibuprofen both increase serum potassium. Use Caution/Monitor.

  • bivalirudin

    Monitor Closely (1)bivalirudin and ibuprofen both increase anticoagulation. Modify Therapy/Monitor Closely.

  • bosentan

    Minor (1)bosentan will decrease the level or effect of ibuprofen by affecting hepatic enzyme CYP2C9/10 metabolism. Minor/Significance Unknown.

  • budesonide

    Monitor Closely (1)ibuprofen, budesonide.
    Either increases toxicity of the other by pharmacodynamic synergism. Use Caution/Monitor. Increased risk of GI ulceration.

  • bumetanide

    Monitor Closely (2)ibuprofen decreases effects of bumetanide by pharmacodynamic antagonism. Use Caution/Monitor. NSAIDs decrease prostaglandin synthesis.

    ibuprofen increases and bumetanide decreases serum potassium. Effect of interaction is not clear, use caution. Use Caution/Monitor.

  • butabarbital

    Minor (1)butabarbital will decrease the level or effect of ibuprofen by affecting hepatic enzyme CYP2C9/10 metabolism. Minor/Significance Unknown.

  • butalbital

    Minor (1)butalbital will decrease the level or effect of ibuprofen by affecting hepatic enzyme CYP2C9/10 metabolism. Minor/Significance Unknown.

  • candesartan

    Monitor Closely (3)candesartan, ibuprofen.
    Either increases toxicity of the other by Other (see comment). Use Caution/Monitor.
    Comment: May result in renal function deterioration, particularly in elderly or volume depleted individuals.

    ibuprofen decreases effects of candesartan by pharmacodynamic antagonism. Modify Therapy/Monitor Closely. NSAIDs decrease synthesis of vasodilating renal prostaglandins, and thus affect fluid homeostasis and may diminish antihypertensive effect.

    candesartan and ibuprofen both increase serum potassium. Use Caution/Monitor.

  • captopril

    Monitor Closely (1)captopril, ibuprofen.
    Either increases toxicity of the other by Other (see comment). Use Caution/Monitor.
    Comment: May result in renal function deterioration, particularly in elderly or volume depleted individuals.Serious – Use Alternative (1)ibuprofen, captopril. pharmacodynamic antagonism. Avoid or Use Alternate Drug. Coadministration may result in a significant decrease in renal function. NSAIDs may diminish the antihypertensive effect of ACE inhibitors. The mechanism of these interactions is likely related to the ability of NSAIDs to reduce the synthesis of vasodilating renal prostaglandins.

  • carbamazepine

    Monitor Closely (1)ibuprofen will increase the level or effect of carbamazepine by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor. Monitor plasma levels when used concomitantlyMinor (1)carbamazepine will decrease the level or effect of ibuprofen by affecting hepatic enzyme CYP2C9/10 metabolism. Minor/Significance Unknown.

  • carbenoxolone

    Monitor Closely (1)ibuprofen increases and carbenoxolone decreases serum potassium. Effect of interaction is not clear, use caution. Use Caution/Monitor.

  • carvedilol

    Monitor Closely (2)ibuprofen decreases effects of carvedilol by pharmacodynamic antagonism. Use Caution/Monitor. Long term (>1 wk) NSAID use. NSAIDs decrease prostaglandin synthesis.

    carvedilol and ibuprofen both increase serum potassium. Use Caution/Monitor.

  • cefadroxil

    Minor (1)cefadroxil will increase the level or effect of ibuprofen by acidic (anionic) drug competition for renal tubular clearance. Minor/Significance Unknown.

  • cefamandole

    Minor (1)cefamandole will increase the level or effect of ibuprofen by acidic (anionic) drug competition for renal tubular clearance. Minor/Significance Unknown.

  • cefdinir

    Minor (1)cefdinir will increase the level or effect of ibuprofen by acidic (anionic) drug competition for renal tubular clearance. Minor/Significance Unknown.

  • cefpirome

    Minor (1)cefpirome will increase the level or effect of ibuprofen by acidic (anionic) drug competition for renal tubular clearance. Minor/Significance Unknown.

  • ceftibuten

    Minor (1)ceftibuten will increase the level or effect of ibuprofen by acidic (anionic) drug competition for renal tubular clearance. Minor/Significance Unknown.

  • celecoxib

    Monitor Closely (2)celecoxib and ibuprofen both increase anticoagulation. Use Caution/Monitor.

    celecoxib and ibuprofen both increase serum potassium. Use Caution/Monitor.Minor (1)celecoxib will increase the level or effect of ibuprofen by acidic (anionic) drug competition for renal tubular clearance. Minor/Significance Unknown.

  • celiprolol

    Monitor Closely (2)ibuprofen decreases effects of celiprolol by pharmacodynamic antagonism. Use Caution/Monitor. Long term (>1 wk) NSAID use. NSAIDs decrease prostaglandin synthesis.

    celiprolol and ibuprofen both increase serum potassium. Use Caution/Monitor.

  • cephalexin

    Minor (1)cephalexin will increase the level or effect of ibuprofen by acidic (anionic) drug competition for renal tubular clearance. Minor/Significance Unknown.

  • chlorothiazide

    Monitor Closely (1)ibuprofen increases and chlorothiazide decreases serum potassium. Effect of interaction is not clear, use caution. Use Caution/Monitor.Minor (1)chlorothiazide will increase the level or effect of ibuprofen by acidic (anionic) drug competition for renal tubular clearance. Minor/Significance Unknown.

  • chlorpropamide

    Monitor Closely (1)ibuprofen increases effects of chlorpropamide by unknown mechanism. Use Caution/Monitor. Risk of hypoglycemia.Minor (1)ibuprofen will increase the level or effect of chlorpropamide by acidic (anionic) drug competition for renal tubular clearance. Minor/Significance Unknown.

  • chlorthalidone

    Monitor Closely (1)ibuprofen increases and chlorthalidone decreases serum potassium. Effect of interaction is not clear, use caution. Use Caution/Monitor.Minor (1)chlorthalidone will increase the level or effect of ibuprofen by acidic (anionic) drug competition for renal tubular clearance. Minor/Significance Unknown.

  • choline magnesium trisalicylate

    Monitor Closely (2)ibuprofen and choline magnesium trisalicylate both increase anticoagulation. Use Caution/Monitor.

    ibuprofen and choline magnesium trisalicylate both increase serum potassium. Use Caution/Monitor.Minor (1)ibuprofen will increase the level or effect of choline magnesium trisalicylate by acidic (anionic) drug competition for renal tubular clearance. Minor/Significance Unknown.

  • cimetidine

    Minor (1)cimetidine will increase the level or effect of ibuprofen by affecting hepatic enzyme CYP2C9/10 metabolism. Minor/Significance Unknown.

  • cinnamon

    Monitor Closely (1)ibuprofen and cinnamon both increase anticoagulation. Use Caution/Monitor.

  • ciprofloxacin

    Monitor Closely (1)ibuprofen, ciprofloxacin. Other (see comment). Modify Therapy/Monitor Closely.
    Comment: Mechanism: unknown. Increased risk of CNS stimulation and seizures with high doses of fluoroquinolones.

  • citalopram

    Monitor Closely (1)citalopram, ibuprofen.
    Either increases toxicity of the other by pharmacodynamic synergism. Use Caution/Monitor. Increased risk of upper GI bleeding. If possible, avoid concurrent use.

  • clobetasone

    Monitor Closely (1)ibuprofen, clobetasone.
    Either increases toxicity of the other by pharmacodynamic synergism. Use Caution/Monitor. Increased risk of GI ulceration.

  • clomipramine

    Monitor Closely (1)clomipramine, ibuprofen.
    Either increases toxicity of the other by pharmacodynamic synergism. Use Caution/Monitor. Increased risk of upper GI bleeding. Clomipramine inhib. serotonin uptake by platelets.

  • clopidogrel

    Monitor Closely (1)clopidogrel, ibuprofen.
    Either increases effects of the other by pharmacodynamic synergism. Modify Therapy/Monitor Closely. Clopidogrel and NSAIDs both inhibit platelet aggregation.

  • cordyceps

    Monitor Closely (1)ibuprofen and cordyceps both increase anticoagulation. Use Caution/Monitor.

  • cortisone

    Monitor Closely (1)ibuprofen, cortisone.
    Either increases toxicity of the other by pharmacodynamic synergism. Use Caution/Monitor. Increased risk of GI ulceration.

  • creatine

    Minor (1)creatine, ibuprofen. Mechanism: pharmacodynamic synergism. Minor/Significance Unknown. (Theoretical interaction) Combination may have additive nephrotoxic effects.

  • cyclopenthiazide

    Monitor Closely (1)ibuprofen increases and cyclopenthiazide decreases serum potassium. Effect of interaction is not clear, use caution. Use Caution/Monitor.Minor (1)cyclopenthiazide will increase the level or effect of ibuprofen by acidic (anionic) drug competition for renal tubular clearance. Minor/Significance Unknown.

  • cyclosporine

    Monitor Closely (1)ibuprofen, cyclosporine.
    Either increases toxicity of the other by nephrotoxicity and/or ototoxicity. Use Caution/Monitor. NSAIDs decrease prostaglandin synthesis, increasing the risk of nephrotoxicity.

  • dabigatran

    Monitor Closely (1)dabigatran and ibuprofen both increase anticoagulation. Use Caution/Monitor. Caution is advised, both drugs have the potential to cause bleeding. Concomitant use may increase risk of bleeding.

  • dalteparin

    Monitor Closely (1)dalteparin and ibuprofen both increase anticoagulation. Modify Therapy/Monitor Closely.

  • danshen

    Minor (1)ibuprofen and danshen both increase anticoagulation. Minor/Significance Unknown.

  • deferasirox

    Monitor Closely (1)deferasirox, ibuprofen. Other (see comment). Use Caution/Monitor.
    Comment: Combination may increase GI bleeding, ulceration and irritation. Use with caution.

  • defibrotide

    Monitor Closely (1)defibrotide increases effects of ibuprofen by P-glycoprotein (MDR1) efflux transporter. Use Caution/Monitor. Defibrotide may enhance effects of platelet inhibitors.

  • deflazacort

    Monitor Closely (1)ibuprofen, deflazacort.
    Either increases toxicity of the other by pharmacodynamic synergism. Use Caution/Monitor. Increased risk of GI ulceration.

  • devil’s claw

    Minor (1)ibuprofen and devil’s claw both increase anticoagulation. Minor/Significance Unknown.

  • dexamethasone

    Monitor Closely (1)ibuprofen, dexamethasone.
    Either increases toxicity of the other by pharmacodynamic synergism. Use Caution/Monitor. Increased risk of GI ulceration.

  • dichlorphenamide

    Monitor Closely (1)dichlorphenamide, ibuprofen.
    Either increases toxicity of the other by pharmacodynamic synergism. Modify Therapy/Monitor Closely. Both drugs can cause metabolic acidosis.

  • diclofenac

    Monitor Closely (2)diclofenac and ibuprofen both increase anticoagulation. Use Caution/Monitor.

    diclofenac and ibuprofen both increase serum potassium. Use Caution/Monitor.Minor (1)diclofenac will increase the level or effect of ibuprofen by acidic (anionic) drug competition for renal tubular clearance. Minor/Significance Unknown.

  • diclofenac topical

    Minor (1)diclofenac topical, ibuprofen.
    Either increases effects of the other by pharmacodynamic synergism. Minor/Significance Unknown. Although low, there is systemic exposure to diclofenac topical; theoretically, concomitant administration with systemic NSAIDS or aspirin may result in increased NSAID adverse effects.

  • diflunisal

    Monitor Closely (2)diflunisal and ibuprofen both increase anticoagulation. Use Caution/Monitor.

    diflunisal and ibuprofen both increase serum potassium. Use Caution/Monitor.Minor (1)diflunisal will increase the level or effect of ibuprofen by acidic (anionic) drug competition for renal tubular clearance. Minor/Significance Unknown.

  • digoxin

    Monitor Closely (1)ibuprofen and digoxin both increase serum potassium. Use Caution/Monitor.Minor (1)ibuprofen increases levels of digoxin by decreasing renal clearance. Minor/Significance Unknown.

  • disulfiram

    Minor (1)disulfiram will increase the level or effect of ibuprofen by affecting hepatic enzyme CYP2C9/10 metabolism. Minor/Significance Unknown.

  • dobutamine

    Monitor Closely (1)ibuprofen increases and dobutamine decreases serum potassium. Effect of interaction is not clear, use caution. Use Caution/Monitor.

  • dong quai

    Monitor Closely (1)ibuprofen and dong quai both increase anticoagulation. Use Caution/Monitor.

  • dopexamine

    Monitor Closely (1)ibuprofen increases and dopexamine decreases serum potassium. Effect of interaction is not clear, use caution. Use Caution/Monitor.

  • doxazosin

    Monitor Closely (1)ibuprofen decreases effects of doxazosin by pharmacodynamic antagonism. Use Caution/Monitor. NSAIDs decrease prostaglandin synthesis.

  • dronabinol

    Monitor Closely (1)ibuprofen will increase the level or effect of dronabinol by affecting hepatic enzyme CYP2C9/10 metabolism. Use Caution/Monitor. Dronabinol is a CYP2C9 substrate.

  • drospirenone

    Monitor Closely (1)drospirenone and ibuprofen both increase serum potassium. Modify Therapy/Monitor Closely.

  • duloxetine

    Monitor Closely (1)duloxetine, ibuprofen.
    Either increases toxicity of the other by pharmacodynamic synergism. Use Caution/Monitor. Increased risk of upper GI bleeding. SSRIs inhib. serotonin uptake by platelets.

  • edoxaban

    Monitor Closely (1)edoxaban, ibuprofen.
    Either increases toxicity of the other by anticoagulation. Modify Therapy/Monitor Closely. Both drugs have the potential to cause bleeding, monitor closely. Promptly evaluate any signs or symptoms of blood loss.

  • efavirenz

    Monitor Closely (1)efavirenz will increase the level or effect of ibuprofen by affecting hepatic enzyme CYP2C9/10 metabolism. Use Caution/Monitor.

  • eltrombopag

    Monitor Closely (1)eltrombopag increases levels of ibuprofen by decreasing metabolism. Use Caution/Monitor. UGT inhibition; significance of interaction unclear.

  • eluxadoline

    Monitor Closely (1)ibuprofen increases levels of eluxadoline by affecting hepatic enzyme CYP2C9/10 metabolism. Use Caution/Monitor. As a precautionary measure due to incomplete information on the metabolism of eluxadoline, use caution when coadministered with strong CYP2C9/10 inhibitors.

  • elvitegravir/cobicistat/emtricitabine/tenofovir DF

    Monitor Closely (1)elvitegravir/cobicistat/emtricitabine/tenofovir DF, ibuprofen.
    Either increases toxicity of the other by decreasing renal clearance. Modify Therapy/Monitor Closely. Toxicity may result from coadministration of emtricitabine and tenofovir with other drugs that are also primarily excreted by glomerular filtration and/or active tubular secretion including high-dose or multiple-dose NSAIDs; alternatives to NSAIDs should be considered.

  • emtricitabine

    Monitor Closely (1)emtricitabine, ibuprofen.
    Either increases levels of the other by decreasing renal clearance. Modify Therapy/Monitor Closely. Toxicity may result from coadministration of emtricitabine with other drugs that are also primarily excreted by glomerular filtration and/or active tubular secretion including high-dose or multiple-dose NSAIDs; alternatives to NSAIDs should be considered.

  • enalapril

    Monitor Closely (1)enalapril, ibuprofen.
    Either increases toxicity of the other by Other (see comment). Use Caution/Monitor.
    Comment: May result in renal function deterioration, particularly in elderly or volume depleted individuals.Serious – Use Alternative (1)ibuprofen, enalapril. pharmacodynamic antagonism. Avoid or Use Alternate Drug. Coadministration may result in a significant decrease in renal function. NSAIDs may diminish the antihypertensive effect of ACE inhibitors. The mechanism of these interactions is likely related to the ability of NSAIDs to reduce the synthesis of vasodilating renal prostaglandins.

  • enoxaparin

    Monitor Closely (1)enoxaparin and ibuprofen both increase anticoagulation. Modify Therapy/Monitor Closely.

  • ephedrine

    Monitor Closely (1)ibuprofen increases and ephedrine decreases serum potassium. Effect of interaction is not clear, use caution. Use Caution/Monitor.

  • epinephrine

    Monitor Closely (1)ibuprofen increases and epinephrine decreases serum potassium. Effect of interaction is not clear, use caution. Use Caution/Monitor.

  • epinephrine racemic

    Monitor Closely (1)ibuprofen increases and epinephrine racemic decreases serum potassium. Effect of interaction is not clear, use caution. Use Caution/Monitor.

  • eplerenone

    Minor (1)ibuprofen decreases effects of eplerenone by pharmacodynamic antagonism. Minor/Significance Unknown. NSAIDs decrease prostaglandin synthesis.

  • epoprostenol

    Monitor Closely (1)ibuprofen and epoprostenol both increase anticoagulation. Use Caution/Monitor.

  • eprosartan

    Monitor Closely (3)ibuprofen decreases effects of eprosartan by pharmacodynamic antagonism. Modify Therapy/Monitor Closely. NSAIDs decrease synthesis of vasodilating renal prostaglandins, and thus affect fluid homeostasis and may diminish antihypertensive effect.

    eprosartan and ibuprofen both increase serum potassium. Use Caution/Monitor.

    eprosartan, ibuprofen.
    Either increases toxicity of the other by Other (see comment). Use Caution/Monitor.
    Comment: May result in renal function deterioration, particularly in elderly or volume depleted individuals.

  • erdafitinib

    Serious – Use Alternative (1)ibuprofen will increase the level or effect of erdafitinib by affecting hepatic enzyme CYP2C9/10 metabolism. Avoid or Use Alternate Drug. If unable to avoid coadministration with strong CYP2C9 inhibitors, monitor closely for adverse reactions and consider decreasing dose accordingly. If strong CYP2C9 inhibitor is discontinued, consider increasing erdafitinib dose in the absence of any drug-related toxicities.

  • escitalopram

    Monitor Closely (1)escitalopram, ibuprofen.
    Either increases toxicity of the other by pharmacodynamic synergism. Use Caution/Monitor. Increased risk of upper GI bleeding. SSRIs inhib. serotonin uptake by platelets.

  • esmolol

    Monitor Closely (2)ibuprofen decreases effects of esmolol by pharmacodynamic antagonism. Use Caution/Monitor. Long term (>1 wk) NSAID use. NSAIDs decrease prostaglandin synthesis.

    esmolol and ibuprofen both increase serum potassium. Use Caution/Monitor.

  • ethacrynic acid

    Monitor Closely (1)ibuprofen increases and ethacrynic acid decreases serum potassium. Effect of interaction is not clear, use caution. Use Caution/Monitor.

  • etodolac

    Monitor Closely (2)etodolac and ibuprofen both increase anticoagulation. Use Caution/Monitor.

    etodolac and ibuprofen both increase serum potassium. Use Caution/Monitor.Minor (1)etodolac will increase the level or effect of ibuprofen by acidic (anionic) drug competition for renal tubular clearance. Minor/Significance Unknown.

  • etravirine

    Minor (1)etravirine will increase the level or effect of ibuprofen by affecting hepatic enzyme CYP2C9/10 metabolism. Minor/Significance Unknown.

  • felbamate

    Minor (1)felbamate will increase the level or effect of ibuprofen by affecting hepatic enzyme CYP2C9/10 metabolism. Minor/Significance Unknown.

  • fennel

    Monitor Closely (1)ibuprofen and fennel both increase anticoagulation. Use Caution/Monitor.

  • fenoprofen

    Monitor Closely (2)fenoprofen and ibuprofen both increase anticoagulation. Use Caution/Monitor.

    fenoprofen and ibuprofen both increase serum potassium. Use Caution/Monitor.Minor (1)fenoprofen will increase the level or effect of ibuprofen by acidic (anionic) drug competition for renal tubular clearance. Minor/Significance Unknown.

  • feverfew

    Monitor Closely (1)ibuprofen and feverfew both increase anticoagulation. Use Caution/Monitor.Minor (1)ibuprofen decreases effects of feverfew by pharmacodynamic antagonism. Minor/Significance Unknown.

  • fish oil triglycerides

    Monitor Closely (1)fish oil triglycerides will increase the level or effect of ibuprofen by anticoagulation. Use Caution/Monitor. Prolonged bleeding reported in patients taking antiplatelet agents or anticoagulants and oral omega-3 fatty acids. Periodically monitor bleeding time in patients receiving fish oil triglycerides and concomitant antiplatelet agents or anticoagulants.

  • fluconazole

    Minor (1)fluconazole will increase the level or effect of ibuprofen by affecting hepatic enzyme CYP2C9/10 metabolism. Minor/Significance Unknown.

  • fludrocortisone

    Monitor Closely (1)ibuprofen, fludrocortisone.
    Either increases toxicity of the other by pharmacodynamic synergism. Use Caution/Monitor. Increased risk of GI ulceration.

  • fluoxetine

    Monitor Closely (2)fluoxetine will increase the level or effect of ibuprofen by affecting hepatic enzyme CYP2C9/10 metabolism. Use Caution/Monitor.

    fluoxetine, ibuprofen.
    Either increases toxicity of the other by pharmacodynamic synergism. Use Caution/Monitor. Increased risk of upper GI bleeding. SSRIs inhib. serotonin uptake by platelets.

  • flurbiprofen

    Monitor Closely (2)flurbiprofen and ibuprofen both increase anticoagulation. Use Caution/Monitor.

    flurbiprofen and ibuprofen both increase serum potassium. Use Caution/Monitor.Minor (1)flurbiprofen will increase the level or effect of ibuprofen by acidic (anionic) drug competition for renal tubular clearance. Minor/Significance Unknown.

  • fluvoxamine

    Monitor Closely (1)fluvoxamine, ibuprofen.
    Either increases toxicity of the other by pharmacodynamic synergism. Use Caution/Monitor. Increased risk of upper GI bleeding; SSRIs inhib. srotonin uptake by platelets.

  • fondaparinux

    Monitor Closely (1)fondaparinux and ibuprofen both increase anticoagulation. Modify Therapy/Monitor Closely.

  • formoterol

    Monitor Closely (1)ibuprofen increases and formoterol decreases serum potassium. Effect of interaction is not clear, use caution. Use Caution/Monitor.

  • forskolin

    Monitor Closely (1)ibuprofen and forskolin both increase anticoagulation. Use Caution/Monitor.

  • fosinopril

    Monitor Closely (1)fosinopril, ibuprofen.
    Either increases toxicity of the other by Other (see comment). Use Caution/Monitor.
    Comment: May result in renal function deterioration, particularly in elderly or volume depleted individuals.Serious – Use Alternative (1)ibuprofen, fosinopril. pharmacodynamic antagonism. Avoid or Use Alternate Drug. Coadministration may result in a significant decrease in renal function. NSAIDs may diminish the antihypertensive effect of ACE inhibitors. The mechanism of these interactions is likely related to the ability of NSAIDs to reduce the synthesis of vasodilating renal prostaglandins.

  • furosemide

    Monitor Closely (1)ibuprofen increases and furosemide decreases serum potassium. Effect of interaction is not clear, use caution. Use Caution/Monitor.Minor (1)ibuprofen decreases effects of furosemide by pharmacodynamic antagonism. Minor/Significance Unknown. NSAIDs decrease prostaglandin synthesis.

  • ganciclovir

    Minor (1)ibuprofen will increase the level or effect of ganciclovir by acidic (anionic) drug competition for renal tubular clearance. Minor/Significance Unknown.

  • garlic

    Monitor Closely (1)ibuprofen and garlic both increase anticoagulation. Use Caution/Monitor.

  • gemifloxacin

    Monitor Closely (1)gemifloxacin, ibuprofen. Other (see comment). Modify Therapy/Monitor Closely.
    Comment: Increased risk of CNS stimulation and seizures with high doses of fluoroquinolones.

  • gentamicin

    Monitor Closely (1)ibuprofen increases and gentamicin decreases serum potassium. Effect of interaction is not clear, use caution. Use Caution/Monitor.Minor (1)ibuprofen increases levels of gentamicin by decreasing renal clearance. Minor/Significance Unknown. Interaction mainly occurs in preterm infants.

  • ginger

    Monitor Closely (1)ibuprofen and ginger both increase anticoagulation. Use Caution/Monitor.

  • ginkgo biloba

    Monitor Closely (1)ibuprofen and ginkgo biloba both increase anticoagulation. Use Caution/Monitor.

  • glimepiride

    Monitor Closely (1)ibuprofen increases effects of glimepiride by unknown mechanism. Use Caution/Monitor. Risk of hypoglycemia.

  • glipizide

    Monitor Closely (1)ibuprofen increases effects of glipizide by unknown mechanism. Use Caution/Monitor. Risk of hypoglycemia.

  • glyburide

    Monitor Closely (2)ibuprofen increases effects of glyburide by unknown mechanism. Use Caution/Monitor. Risk of hypoglycemia.

    ibuprofen increases levels of glyburide by affecting hepatic enzyme CYP2C9/10 metabolism. Use Caution/Monitor. Strong CYP2C9 inhibitors may decrease glyburide metabolism.

  • green tea

    Monitor Closely (1)green tea, ibuprofen. Other (see comment). Use Caution/Monitor.
    Comment: Combination may increase risk of bleeding.

  • heparin

    Monitor Closely (1)heparin and ibuprofen both increase anticoagulation. Modify Therapy/Monitor Closely.

  • horse chestnut seed

    Monitor Closely (1)ibuprofen and horse chestnut seed both increase anticoagulation. Use Caution/Monitor.

  • hydralazine

    Monitor Closely (1)ibuprofen decreases effects of hydralazine by pharmacodynamic antagonism. Use Caution/Monitor. NSAIDs decrease prostaglandin synthesis.

  • hydrochlorothiazide

    Monitor Closely (1)ibuprofen increases and hydrochlorothiazide decreases serum potassium. Effect of interaction is not clear, use caution. Use Caution/Monitor.Minor (1)hydrochlorothiazide will increase the level or effect of ibuprofen by acidic (anionic) drug competition for renal tubular clearance. Minor/Significance Unknown.

  • hydrocortisone

    Monitor Closely (1)ibuprofen, hydrocortisone.
    Either increases toxicity of the other by pharmacodynamic synergism. Use Caution/Monitor. Increased risk of GI ulceration.

  • ibrutinib

    Monitor Closely (1)ibrutinib will increase the level or effect of ibuprofen by anticoagulation. Use Caution/Monitor. Ibrutinib may increase the risk of hemorrhage in patients receiving antiplatelet or anticoagulant therapies and monitor for signs of bleeding.

  • imatinib

    Monitor Closely (2)imatinib will increase the level or effect of ibuprofen by affecting hepatic enzyme CYP2C9/10 metabolism. Use Caution/Monitor.

    imatinib, ibuprofen.
    Either increases toxicity of the other by Other (see comment). Modify Therapy/Monitor Closely.
    Comment: Imatinib may cause thrombocytopenia; bleeding risk increased when imatinib is coadministered with anticoagulants, NSAIDs, platelet inhibitors, and thrombolytic agents.

  • imidapril

    Minor (1)ibuprofen decreases effects of imidapril by pharmacodynamic antagonism. Minor/Significance Unknown. NSAIDs decrease prostaglandin synthesis.

  • indapamide

    Monitor Closely (1)ibuprofen increases and indapamide decreases serum potassium. Effect of interaction is not clear, use caution. Use Caution/Monitor.Minor (1)indapamide will increase the level or effect of ibuprofen by acidic (anionic) drug competition for renal tubular clearance. Minor/Significance Unknown.

  • indomethacin

    Monitor Closely (2)ibuprofen and indomethacin both increase anticoagulation. Use Caution/Monitor.

    ibuprofen and indomethacin both increase serum potassium. Use Caution/Monitor.Minor (1)ibuprofen will increase the level or effect of indomethacin by acidic (anionic) drug competition for renal tubular clearance. Minor/Significance Unknown.

  • irbesartan

    Monitor Closely (3)irbesartan, ibuprofen.
    Either increases toxicity of the other by Other (see comment). Use Caution/Monitor.
    Comment: May result in renal function deterioration, particularly in elderly or volume depleted individuals.

    irbesartan and ibuprofen both increase serum potassium. Use Caution/Monitor.

    ibuprofen decreases effects of irbesartan by pharmacodynamic antagonism. Use Caution/Monitor. Antihypertensive effect of angiotensin receptor blockers may be attenuated by NSAIDs; monitor renal function and blood pressure periodically.

  • isoproterenol

    Monitor Closely (1)ibuprofen increases and isoproterenol decreases serum potassium. Effect of interaction is not clear, use caution. Use Caution/Monitor.

  • ketoconazole

    Minor (1)ketoconazole will increase the level or effect of ibuprofen by affecting hepatic enzyme CYP2C9/10 metabolism. Minor/Significance Unknown.

  • ketoprofen

    Monitor Closely (2)ibuprofen and ketoprofen both increase anticoagulation. Use Caution/Monitor.

    ibuprofen and ketoprofen both increase serum potassium. Use Caution/Monitor.Minor (1)ibuprofen will increase the level or effect of ketoprofen by acidic (anionic) drug competition for renal tubular clearance. Minor/Significance Unknown.

  • ketorolac

    Monitor Closely (2)ibuprofen and ketorolac both increase anticoagulation. Use Caution/Monitor.

    ibuprofen and ketorolac both increase serum potassium. Use Caution/Monitor.Serious – Use Alternative (1)ibuprofen, ketorolac.
    Either increases toxicity of the other by pharmacodynamic synergism. Contraindicated.Minor (1)ibuprofen will increase the level or effect of ketorolac by acidic (anionic) drug competition for renal tubular clearance. Minor/Significance Unknown.

  • ketorolac intranasal

    Monitor Closely (2)ibuprofen and ketorolac intranasal both increase anticoagulation. Use Caution/Monitor.

    ibuprofen and ketorolac intranasal both increase serum potassium. Use Caution/Monitor.Serious – Use Alternative (1)ibuprofen, ketorolac intranasal.
    Either increases toxicity of the other by pharmacodynamic synergism. Contraindicated.Minor (1)ibuprofen will increase the level or effect of ketorolac intranasal by acidic (anionic) drug competition for renal tubular clearance. Minor/Significance Unknown.

  • labetalol

    Monitor Closely (2)labetalol and ibuprofen both increase serum potassium. Use Caution/Monitor.

    ibuprofen decreases effects of labetalol by pharmacodynamic antagonism. Use Caution/Monitor. NSAIDs diminish antihypertensive effects of beta-blockers.

  • lacosamide

    Monitor Closely (1)ibuprofen increases levels of lacosamide by affecting hepatic enzyme CYP2C9/10 metabolism. Modify Therapy/Monitor Closely. Consider decreasing lacosamide dose when coadministered with strong CYP2C9 inhibitors.

  • latanoprost

    Monitor Closely (1)latanoprost, ibuprofen. unspecified interaction mechanism. Use Caution/Monitor. There are conflicting reports from studies of either increased or decreased IOP when ophthalmic prostaglandins are coadministered with NSAIDs (either systemic or ophthalmic).

  • latanoprostene bunod ophthalmic

    Monitor Closely (1)latanoprostene bunod ophthalmic, ibuprofen. unspecified interaction mechanism. Use Caution/Monitor. There are conflicting reports from studies of either increased or decreased IOP when ophthalmic prostaglandins are coadministered with NSAIDs (either systemic or ophthalmic).

  • leflunomide

    Minor (1)leflunomide will increase the level or effect of ibuprofen by affecting hepatic enzyme CYP2C9/10 metabolism. Minor/Significance Unknown.

  • lesinurad

    Monitor Closely (1)ibuprofen will increase the level or effect of lesinurad by affecting hepatic enzyme CYP2C9/10 metabolism. Modify Therapy/Monitor Closely.

  • levalbuterol

    Monitor Closely (1)ibuprofen increases and levalbuterol decreases serum potassium. Effect of interaction is not clear, use caution. Use Caution/Monitor.

  • levofloxacin

    Monitor Closely (1)levofloxacin, ibuprofen. Other (see comment). Modify Therapy/Monitor Closely.
    Comment: Risk of CNS stimulation/seizure. Mechanism: Displacement of GABA from receptors in brain.

  • levomilnacipran

    Monitor Closely (1)levomilnacipran, ibuprofen.
    Either increases toxicity of the other by pharmacodynamic synergism. Use Caution/Monitor. SNRIs may further impair platelet activity in patients taking antiplatelet or anticoagulant drugs.

  • lisinopril

    Monitor Closely (1)lisinopril, ibuprofen.
    Either increases toxicity of the other by Other (see comment). Use Caution/Monitor.
    Comment: May result in renal function deterioration, particularly in elderly or volume depleted individuals.Serious – Use Alternative (1)ibuprofen, lisinopril. pharmacodynamic antagonism. Avoid or Use Alternate Drug. Coadministration may result in a significant decrease in renal function. NSAIDs may diminish the antihypertensive effect of ACE inhibitors. The mechanism of these interactions is likely related to the ability of NSAIDs to reduce the synthesis of vasodilating renal prostaglandins.

  • lithium

    Monitor Closely (1)ibuprofen increases levels of lithium by decreasing renal clearance. Use Caution/Monitor.

  • lornoxicam

    Monitor Closely (2)ibuprofen and lornoxicam both increase anticoagulation. Use Caution/Monitor.

    ibuprofen and lornoxicam both increase serum potassium. Use Caution/Monitor.Minor (1)ibuprofen will increase the level or effect of lornoxicam by acidic (anionic) drug competition for renal tubular clearance. Minor/Significance Unknown.

  • losartan

    Monitor Closely (3)losartan, ibuprofen.
    Either increases toxicity of the other by Other (see comment). Use Caution/Monitor.
    Comment: May result in renal function deterioration, particularly in elderly or volume depleted individuals.

    ibuprofen decreases effects of losartan by pharmacodynamic antagonism. Modify Therapy/Monitor Closely. NSAIDs decrease synthesis of vasodilating renal prostaglandins, and thus affect fluid homeostasis and may diminish antihypertensive effect.

    losartan and ibuprofen both increase serum potassium. Use Caution/Monitor.

  • lumacaftor/ivacaftor

    Monitor Closely (1)lumacaftor/ivacaftor will decrease the level or effect of ibuprofen by affecting hepatic enzyme CYP2C9/10 metabolism. Use Caution/Monitor. Ibuprofen it a substrate of CYP2C9. Lumacaftor has the potential to induce CYP2C9 substrates.

  • meclofenamate

    Monitor Closely (2)meclofenamate and ibuprofen both increase anticoagulation. Use Caution/Monitor.

    meclofenamate and ibuprofen both increase serum potassium. Use Caution/Monitor.Minor (1)meclofenamate will increase the level or effect of ibuprofen by acidic (anionic) drug competition for renal tubular clearance. Minor/Significance Unknown.

  • mefenamic acid

    Monitor Closely (2)ibuprofen and mefenamic acid both increase anticoagulation. Use Caution/Monitor.

    ibuprofen and mefenamic acid both increase serum potassium. Use Caution/Monitor.Minor (1)ibuprofen will increase the level or effect of mefenamic acid by acidic (anionic) drug competition for renal tubular clearance. Minor/Significance Unknown.

  • melatonin

    Monitor Closely (1)melatonin increases effects of ibuprofen by anticoagulation. Use Caution/Monitor. Melatonin may decrease prothrombin time.

  • meloxicam

    Monitor Closely (2)ibuprofen and meloxicam both increase anticoagulation. Use Caution/Monitor.

    ibuprofen and meloxicam both increase serum potassium. Use Caution/Monitor.Minor (1)ibuprofen will increase the level or effect of meloxicam by acidic (anionic) drug competition for renal tubular clearance. Minor/Significance Unknown.

  • mesalamine

    Monitor Closely (1)mesalamine, ibuprofen.
    Either increases toxicity of the other by pharmacodynamic synergism. Use Caution/Monitor. Additive nephrotoxicity.Minor (1)ibuprofen will increase the level or effect of mesalamine by acidic (anionic) drug competition for renal tubular clearance. Minor/Significance Unknown.

  • metaproterenol

    Monitor Closely (1)ibuprofen increases and metaproterenol decreases serum potassium. Effect of interaction is not clear, use caution. Use Caution/Monitor.

  • methotrexate

    Serious – Use Alternative (1)ibuprofen increases levels of methotrexate by decreasing renal clearance. Avoid or Use Alternate Drug. Concomitant administration of NSAIDs with high dose methotrexate has been reported to elevate and prolong serum methotrexate levels, resulting in deaths from severe hematologic and GI toxicity. NSAIDs may reduce tubular secretion of methotrexate and enhance toxicity. .

  • methyclothiazide

    Monitor Closely (1)ibuprofen increases and methyclothiazide decreases serum potassium. Effect of interaction is not clear, use caution. Use Caution/Monitor. .Minor (1)methyclothiazide will increase the level or effect of ibuprofen by acidic (anionic) drug competition for renal tubular clearance. Minor/Significance Unknown.

  • methyl aminolevulinate

    Serious – Use Alternative (1)ibuprofen, methyl aminolevulinate.
    Either increases toxicity of the other by pharmacodynamic synergism. Avoid or Use Alternate Drug. Each drug may increase the photosensitizing effect of the other.

  • methylprednisolone

    Monitor Closely (1)ibuprofen, methylprednisolone.
    Either increases toxicity of the other by pharmacodynamic synergism. Use Caution/Monitor. Increased risk of GI ulceration.

  • metolazone

    Monitor Closely (1)ibuprofen increases and metolazone decreases serum potassium. Effect of interaction is not clear, use caution. Use Caution/Monitor.Minor (1)metolazone will increase the level or effect of ibuprofen by acidic (anionic) drug competition for renal tubular clearance. Minor/Significance Unknown.

  • metoprolol

    Monitor Closely (2)ibuprofen decreases effects of metoprolol by pharmacodynamic antagonism. Use Caution/Monitor. Long term (>1 wk) NSAID use. NSAIDs decrease prostaglandin synthesis.

    metoprolol and ibuprofen both increase serum potassium. Use Caution/Monitor.

  • metronidazole

    Minor (1)metronidazole will increase the level or effect of ibuprofen by affecting hepatic enzyme CYP2C9/10 metabolism. Minor/Significance Unknown.

  • miconazole vaginal

    Minor (1)miconazole vaginal will increase the level or effect of ibuprofen by affecting hepatic enzyme CYP2C9/10 metabolism. Minor/Significance Unknown.

  • milnacipran

    Monitor Closely (1)milnacipran, ibuprofen.
    Either increases toxicity of the other by pharmacodynamic synergism. Use Caution/Monitor. Increased risk of upper GI bleeding. SSRIs inhib. serotonin uptake by platelets.

  • mipomersen

    Monitor Closely (1)mipomersen, ibuprofen.
    Either increases toxicity of the other by Other (see comment). Use Caution/Monitor.
    Comment: Both drugs have potential to increase hepatic enzymes; monitor LFTs.

  • mistletoe

    Monitor Closely (1)ibuprofen increases and mistletoe decreases anticoagulation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

  • moexipril

    Monitor Closely (1)moexipril, ibuprofen.
    Either increases toxicity of the other by Other (see comment). Use Caution/Monitor.
    Comment: May result in renal function deterioration, particularly in elderly or volume depleted individuals.Serious – Use Alternative (1)ibuprofen, moexipril. pharmacodynamic antagonism. Avoid or Use Alternate Drug. Coadministration may result in a significant decrease in renal function. NSAIDs may diminish the antihypertensive effect of ACE inhibitors. The mechanism of these interactions is likely related to the ability of NSAIDs to reduce the synthesis of vasodilating renal prostaglandins.

  • moxifloxacin

    Monitor Closely (1)moxifloxacin, ibuprofen. Other (see comment). Modify Therapy/Monitor Closely.
    Comment: Increased risk of CNS stimulation and seizures with high doses of fluoroquinolones.

  • moxisylyte

    Monitor Closely (1)ibuprofen decreases effects of moxisylyte by pharmacodynamic antagonism. Use Caution/Monitor. NSAIDs decrease prostaglandin synthesis.

  • mycophenolate

    Monitor Closely (1)ibuprofen will increase the level or effect of mycophenolate by acidic (anionic) drug competition for renal tubular clearance. Use Caution/Monitor.

  • nabumetone

    Monitor Closely (2)ibuprofen and nabumetone both increase anticoagulation. Use Caution/Monitor.

    ibuprofen and nabumetone both increase serum potassium. Use Caution/Monitor.Minor (1)ibuprofen will increase the level or effect of nabumetone by acidic (anionic) drug competition for renal tubular clearance. Minor/Significance Unknown.

  • nadolol

    Monitor Closely (2)ibuprofen decreases effects of nadolol by pharmacodynamic antagonism. Use Caution/Monitor. Long term (>1 wk) NSAID use. NSAIDs decrease prostaglandin synthesis.

    nadolol and ibuprofen both increase serum potassium. Use Caution/Monitor.

  • naproxen

    Serious – Use Alternative (3)ibuprofen will increase the level or effect of naproxen by acidic (anionic) drug competition for renal tubular clearance. Avoid or Use Alternate Drug. Therapeutic duplication

    ibuprofen and naproxen both increase anticoagulation. Avoid or Use Alternate Drug. Therapeutic duplication

    ibuprofen and naproxen both increase serum potassium. Avoid or Use Alternate Drug. Therapeutic duplication

  • nateglinide

    Minor (1)nateglinide will increase the level or effect of ibuprofen by affecting hepatic enzyme CYP2C9/10 metabolism. Minor/Significance Unknown.

  • nebivolol

    Monitor Closely (2)ibuprofen decreases effects of nebivolol by pharmacodynamic antagonism. Use Caution/Monitor. Long term (>1 wk) NSAID use. NSAIDs decrease prostaglandin synthesis.

    nebivolol and ibuprofen both increase serum potassium. Use Caution/Monitor.

  • nefazodone

    Monitor Closely (1)nefazodone, ibuprofen.
    Either increases toxicity of the other by pharmacodynamic synergism. Use Caution/Monitor. Increased risk of upper GI bleeding. SSRIs inhib. serotonin uptake by platelets.

  • neomycin PO

    Minor (1)ibuprofen increases levels of neomycin PO by decreasing renal clearance. Minor/Significance Unknown. Interaction mainly occurs in preterm infants.

  • nettle

    Monitor Closely (1)ibuprofen increases and nettle decreases anticoagulation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

  • nilotinib

    Minor (1)nilotinib will increase the level or effect of ibuprofen by affecting hepatic enzyme CYP2C9/10 metabolism. Minor/Significance Unknown.

  • noni juice

    Minor (1)ibuprofen and noni juice both increase serum potassium. Minor/Significance Unknown.

  • norepinephrine

    Monitor Closely (1)ibuprofen increases and norepinephrine decreases serum potassium. Effect of interaction is not clear, use caution. Use Caution/Monitor.

  • ofloxacin

    Minor (1)ofloxacin, ibuprofen. Other (see comment). Minor/Significance Unknown.
    Comment: Risk of CNS stimulation/seizure. Mechanism: Displacement of GABA from receptors in brain.

  • olmesartan

    Monitor Closely (3)olmesartan, ibuprofen.
    Either increases toxicity of the other by Other (see comment). Use Caution/Monitor.
    Comment: May result in renal function deterioration, particularly in elderly or volume depleted individuals.

    ibuprofen decreases effects of olmesartan by pharmacodynamic antagonism. Modify Therapy/Monitor Closely. NSAIDs decrease synthesis of vasodilating renal prostaglandins, and thus affect fluid homeostasis and may diminish antihypertensive effect.

    olmesartan and ibuprofen both increase serum potassium. Use Caution/Monitor.

  • ospemifene

    Monitor Closely (2)ibuprofen increases levels of ospemifene by affecting hepatic enzyme CYP2C9/10 metabolism. Use Caution/Monitor.

    ibuprofen, ospemifene.
    Either increases levels of the other by plasma protein binding competition. Modify Therapy/Monitor Closely.

  • oxaprozin

    Serious – Use Alternative (3)ibuprofen and oxaprozin both increase anticoagulation. Avoid or Use Alternate Drug. Therapeutic duplication

    ibuprofen will increase the level or effect of oxaprozin by acidic (anionic) drug competition for renal tubular clearance. Avoid or Use Alternate Drug. Therapeutic duplication

    ibuprofen and oxaprozin both increase serum potassium. Avoid or Use Alternate Drug. Therapeutic duplication

  • panax ginseng

    Monitor Closely (1)ibuprofen and panax ginseng both increase anticoagulation. Use Caution/Monitor.

  • parecoxib

    Monitor Closely (2)ibuprofen and parecoxib both increase anticoagulation. Use Caution/Monitor.

    ibuprofen and parecoxib both increase serum potassium. Use Caution/Monitor.Minor (1)ibuprofen will increase the level or effect of parecoxib by acidic (anionic) drug competition for renal tubular clearance. Minor/Significance Unknown.

  • paromomycin

    Minor (1)ibuprofen increases levels of paromomycin by decreasing renal clearance. Minor/Significance Unknown. Interaction mainly occurs in preterm infants.

  • paroxetine

    Monitor Closely (1)paroxetine, ibuprofen.
    Either increases toxicity of the other by pharmacodynamic synergism. Use Caution/Monitor. Increased risk of upper GI bleeding. SSRIs inhib. serotonin uptake by platelets.

  • pau d’arco

    Monitor Closely (1)ibuprofen and pau d’arco both increase anticoagulation. Use Caution/Monitor.

  • pegaspargase

    Monitor Closely (1)pegaspargase increases effects of ibuprofen by pharmacodynamic synergism. Use Caution/Monitor. Increased risk of bleeding events.

  • peginterferon alfa 2b

    Monitor Closely (1)peginterferon alfa 2b decreases levels of ibuprofen by affecting hepatic enzyme CYP2C9/10 metabolism. Use Caution/Monitor. When patients are administered peginterferon alpha-2b with CYP2C9 substrates, the therapeutic effect of these drugs may be altered.

  • pemetrexed

    Serious – Use Alternative (1)ibuprofen increases levels of pemetrexed by unspecified interaction mechanism. Avoid or Use Alternate Drug. Especially in pts. w/mild moderate renal insufficiency. D/C NSAIDs 2 5 d before and 2 d after pemetrexed administration.

  • penbutolol

    Monitor Closely (2)ibuprofen decreases effects of penbutolol by pharmacodynamic antagonism. Use Caution/Monitor. Long term (>1 wk) NSAID use. NSAIDs decrease prostaglandin synthesis.

    penbutolol and ibuprofen both increase serum potassium. Use Caution/Monitor.

  • pentobarbital

    Minor (1)pentobarbital will decrease the level or effect of ibuprofen by affecting hepatic enzyme CYP2C9/10 metabolism. Minor/Significance Unknown.

  • perindopril

    Monitor Closely (1)perindopril, ibuprofen.
    Either increases toxicity of the other by Other (see comment). Use Caution/Monitor.
    Comment: May result in renal function deterioration, particularly in elderly or volume depleted individuals.Serious – Use Alternative (1)ibuprofen, perindopril. pharmacodynamic antagonism. Avoid or Use Alternate Drug. Coadministration may result in a significant decrease in renal function. NSAIDs may diminish the antihypertensive effect of ACE inhibitors. The mechanism of these interactions is likely related to the ability of NSAIDs to reduce the synthesis of vasodilating renal prostaglandins.

  • pexidartinib

    Serious – Use Alternative (1)ibuprofen and pexidartinib both increase Other (see comment). Avoid or Use Alternate Drug. Pexidartinib can cause hepatotoxicity. Avoid coadministration of pexidartinib with other products know to cause hepatoxicity.

  • phenindione

    Monitor Closely (1)phenindione and ibuprofen both increase anticoagulation. Modify Therapy/Monitor Closely.

  • phenobarbital

    Minor (1)phenobarbital will decrease the level or effect of ibuprofen by affecting hepatic enzyme CYP2C9/10 metabolism. Minor/Significance Unknown.

  • phenoxybenzamine

    Monitor Closely (1)ibuprofen decreases effects of phenoxybenzamine by pharmacodynamic antagonism. Use Caution/Monitor. NSAIDs decrease prostaglandin synthesis.

  • phentolamine

    Monitor Closely (1)ibuprofen decreases effects of phentolamine by pharmacodynamic antagonism. Use Caution/Monitor. NSAIDs decrease prostaglandin synthesis.

  • phytoestrogens

    Monitor Closely (1)ibuprofen and phytoestrogens both increase anticoagulation. Use Caution/Monitor.

  • pindolol

    Monitor Closely (2)ibuprofen decreases effects of pindolol by pharmacodynamic antagonism. Use Caution/Monitor. Long term (>1 wk) NSAID use. NSAIDs decrease prostaglandin synthesis.

    pindolol and ibuprofen both increase serum potassium. Use Caution/Monitor.

  • pirbuterol

    Monitor Closely (1)ibuprofen increases and pirbuterol decreases serum potassium. Effect of interaction is not clear, use caution. Use Caution/Monitor.

  • piroxicam

    Monitor Closely (2)ibuprofen and piroxicam both increase anticoagulation. Use Caution/Monitor.

    ibuprofen and piroxicam both increase serum potassium. Use Caution/Monitor.Minor (1)ibuprofen will increase the level or effect of piroxicam by acidic (anionic) drug competition for renal tubular clearance. Minor/Significance Unknown.

  • pivmecillinam

    Monitor Closely (2)pivmecillinam, ibuprofen.
    Either increases levels of the other by plasma protein binding competition. Use Caution/Monitor.

    pivmecillinam, ibuprofen.
    Either increases levels of the other by decreasing renal clearance. Use Caution/Monitor.

  • potassium acid phosphate

    Monitor Closely (1)ibuprofen and potassium acid phosphate both increase serum potassium. Modify Therapy/Monitor Closely.

  • potassium chloride

    Monitor Closely (1)ibuprofen and potassium chloride both increase serum potassium. Modify Therapy/Monitor Closely.

  • potassium citrate

    Monitor Closely (1)ibuprofen and potassium citrate both increase serum potassium. Modify Therapy/Monitor Closely.

  • potassium iodide

    Monitor Closely (1)potassium iodide and ibuprofen both increase serum potassium. Use Caution/Monitor.

  • pralatrexate

    Monitor Closely (1)ibuprofen increases levels of pralatrexate by decreasing renal clearance. Use Caution/Monitor. NSAIDs may delay pralatrexate clearance, increasing drug exposure. Adjust the pralatrexate dose as needed.

  • prasugrel

    Monitor Closely (1)ibuprofen, prasugrel.
    Either increases effects of the other by anticoagulation. Use Caution/Monitor. Chronic use of NSAIDs with prasugrel may increase bleeding risk.

  • prazosin

    Monitor Closely (1)ibuprofen decreases effects of prazosin by pharmacodynamic antagonism. Use Caution/Monitor. NSAIDs decrease prostaglandin synthesis.

  • prednisolone

    Monitor Closely (1)ibuprofen, prednisolone.
    Either increases toxicity of the other by pharmacodynamic synergism. Use Caution/Monitor. Increased risk of GI ulceration.

  • prednisone

    Monitor Closely (1)ibuprofen, prednisone.
    Either increases toxicity of the other by pharmacodynamic synergism. Use Caution/Monitor. Increased risk of GI ulceration.

  • pretomanid

    Serious – Use Alternative (1)ibuprofen, pretomanid.
    Either increases toxicity of the other by Other (see comment). Avoid or Use Alternate Drug.
    Comment: Pretomanid regimen associated with hepatotoxicity. Avoid alcohol and hepatotoxic agents, including herbal supplements and drugs other than bedaquiline and linezolid.

  • primidone

    Minor (1)primidone will decrease the level or effect of ibuprofen by affecting hepatic enzyme CYP2C9/10 metabolism. Minor/Significance Unknown.

  • probenecid

    Monitor Closely (1)ibuprofen will increase the level or effect of probenecid by acidic (anionic) drug competition for renal tubular clearance. Use Caution/Monitor.

  • propranolol

    Monitor Closely (2)ibuprofen decreases effects of propranolol by pharmacodynamic antagonism. Use Caution/Monitor. Long term (>1 wk) NSAID use. NSAIDs decrease prostaglandin synthesis.

    propranolol and ibuprofen both increase serum potassium. Use Caution/Monitor.

  • protamine

    Monitor Closely (1)protamine and ibuprofen both increase anticoagulation. Modify Therapy/Monitor Closely.

  • quinapril

    Monitor Closely (1)quinapril, ibuprofen.
    Either increases toxicity of the other by Other (see comment). Use Caution/Monitor.
    Comment: May result in renal function deterioration, particularly in elderly or volume depleted individuals.Serious – Use Alternative (1)ibuprofen, quinapril. pharmacodynamic antagonism. Avoid or Use Alternate Drug. Coadministration may result in a significant decrease in renal function. NSAIDs may diminish the antihypertensive effect of ACE inhibitors. The mechanism of these interactions is likely related to the ability of NSAIDs to reduce the synthesis of vasodilating renal prostaglandins.

  • ramipril

    Monitor Closely (1)ramipril, ibuprofen.
    Either increases toxicity of the other by Other (see comment). Use Caution/Monitor.
    Comment: May result in renal function deterioration, particularly in elderly or volume depleted individuals.Serious – Use Alternative (1)ibuprofen, ramipril. pharmacodynamic antagonism. Avoid or Use Alternate Drug. Coadministration may result in a significant decrease in renal function. NSAIDs may diminish the antihypertensive effect of ACE inhibitors. The mechanism of these interactions is likely related to the ability of NSAIDs to reduce the synthesis of vasodilating renal prostaglandins.

  • reishi

    Monitor Closely (1)ibuprofen and reishi both increase anticoagulation. Use Caution/Monitor.

  • reteplase

    Monitor Closely (1)ibuprofen and reteplase both increase anticoagulation. Use Caution/Monitor. Potential for increased risk of bleeding, caution is advised.

  • rifampin

    Minor (1)rifampin will decrease the level or effect of ibuprofen by affecting hepatic enzyme CYP2C9/10 metabolism. Minor/Significance Unknown.

  • rifapentine

    Minor (1)rifapentine will decrease the level or effect of ibuprofen by affecting hepatic enzyme CYP2C9/10 metabolism. Minor/Significance Unknown.

  • rivaroxaban

    Monitor Closely (1)rivaroxaban, ibuprofen. Other (see comment). Use Caution/Monitor.
    Comment: NSAIDs are known to increase bleeding. Bleeding risk may be increased when NSAIDs are used concomitantly with rivaroxaban. Monitor for signs/symptoms of blood loss.

  • rivastigmine

    Monitor Closely (1)rivastigmine increases toxicity of ibuprofen by pharmacodynamic synergism. Use Caution/Monitor. Monitor patients for symptoms of active or occult gastrointestinal bleeding.

  • rose hips

    Minor (1)rose hips will increase the level or effect of ibuprofen by acidic (anionic) drug competition for renal tubular clearance. Minor/Significance Unknown.

  • sacubitril/valsartan

    Monitor Closely (3)sacubitril/valsartan, ibuprofen.
    Either increases toxicity of the other by Other (see comment). Use Caution/Monitor.
    Comment: May result in renal function deterioration, particularly in elderly or volume depleted individuals.

    ibuprofen decreases effects of sacubitril/valsartan by pharmacodynamic antagonism. Modify Therapy/Monitor Closely. NSAIDs decrease synthesis of vasodilating renal prostaglandins, and thus affect fluid homeostasis and may diminish antihypertensive effect.

    sacubitril/valsartan and ibuprofen both increase serum potassium. Use Caution/Monitor.

  • salicylates (non-asa)

    Monitor Closely (2)ibuprofen and salicylates (non-asa) both increase anticoagulation. Use Caution/Monitor.

    ibuprofen and salicylates (non-asa) both increase serum potassium. Use Caution/Monitor.Minor (1)ibuprofen will increase the level or effect of salicylates (non-asa) by acidic (anionic) drug competition for renal tubular clearance. Minor/Significance Unknown.

  • salmeterol

    Monitor Closely (1)ibuprofen increases and salmeterol decreases serum potassium. Effect of interaction is not clear, use caution. Use Caution/Monitor.

  • salsalate

    Monitor Closely (2)ibuprofen and salsalate both increase anticoagulation. Use Caution/Monitor.

    ibuprofen and salsalate both increase serum potassium. Use Caution/Monitor.Minor (1)ibuprofen will increase the level or effect of salsalate by acidic (anionic) drug competition for renal tubular clearance. Minor/Significance Unknown.

  • saw palmetto

    Monitor Closely (1)saw palmetto increases toxicity of ibuprofen by unspecified interaction mechanism. Use Caution/Monitor. May increase risk of bleeding.

  • secobarbital

    Minor (1)secobarbital will decrease the level or effect of ibuprofen by affecting hepatic enzyme CYP2C9/10 metabolism. Minor/Significance Unknown.

  • sertraline

    Monitor Closely (1)sertraline, ibuprofen.
    Either increases toxicity of the other by pharmacodynamic synergism. Use Caution/Monitor. Increased risk of upper GI bleeding. SSRIs inhib. serotonin uptake by platelets.

  • Siberian ginseng

    Monitor Closely (1)ibuprofen and Siberian ginseng both increase anticoagulation. Use Caution/Monitor.

  • silodosin

    Monitor Closely (1)ibuprofen decreases effects of silodosin by pharmacodynamic antagonism. Use Caution/Monitor. NSAIDs decrease prostaglandin synthesis.

  • siponimod

    Serious – Use Alternative (1)ibuprofen will increase the level or effect of siponimod by affecting hepatic enzyme CYP2C9/10 metabolism. Avoid or Use Alternate Drug. Coadministration of siponimod with drugs that cause moderate CYP2C9 AND a moderate or strong CYP3A4 inhibition is not recommended. Caution if siponimod coadministered with moderate CYP2C9 inhibitors alone.

  • sodium picosulfate/magnesium oxide/anhydrous citric acid

    Monitor Closely (1)ibuprofen, sodium picosulfate/magnesium oxide/anhydrous citric acid.
    Either increases toxicity of the other by Other (see comment). Use Caution/Monitor.
    Comment: May be associated with fluid and electrolyte imbalances.

  • sodium sulfate/?magnesium sulfate/potassium chloride

    Monitor Closely (1)sodium sulfate/?magnesium sulfate/potassium chloride increases toxicity of ibuprofen by Other (see comment). Use Caution/Monitor.
    Comment: Coadministration with medications that cause fluid and electrolyte abnormalities may increase the risk of adverse events of seizure, arrhythmias, and renal impairment.

  • sodium sulfate/potassium sulfate/magnesium sulfate

    Monitor Closely (1)sodium sulfate/potassium sulfate/magnesium sulfate increases toxicity of ibuprofen by Other (see comment). Use Caution/Monitor.
    Comment: Coadministration with medications that cause fluid and electrolyte abnormalities may increase the risk of adverse events of seizure, arrhythmias, and renal impairment.

  • sodium sulfate/potassium sulfate/magnesium sulfate/polyethylene glycol

    Monitor Closely (1)ibuprofen, sodium sulfate/potassium sulfate/magnesium sulfate/polyethylene glycol. Other (see comment). Use Caution/Monitor.
    Comment: Caution when bowel preps are used with drugs that cause SIADH or NSAIDs; increased risk for water retention or electrolyte imbalance.

  • sotalol

    Monitor Closely (2)ibuprofen decreases effects of sotalol by pharmacodynamic antagonism. Use Caution/Monitor. Long term (>1 wk) NSAID use. NSAIDs decrease prostaglandin synthesis.

    sotalol and ibuprofen both increase serum potassium. Use Caution/Monitor.

  • spironolactone

    Monitor Closely (1)spironolactone and ibuprofen both increase serum potassium. Modify Therapy/Monitor Closely.

  • streptomycin

    Minor (1)ibuprofen increases levels of streptomycin by decreasing renal clearance. Minor/Significance Unknown. Interaction mainly occurs in preterm infants.

  • succinylcholine

    Monitor Closely (1)ibuprofen and succinylcholine both increase serum potassium. Use Caution/Monitor.

  • sulfamethoxazole

    Minor (1)sulfamethoxazole will increase the level or effect of ibuprofen by affecting hepatic enzyme CYP2C9/10 metabolism. Minor/Significance Unknown.

  • sulfasalazine

    Monitor Closely (2)ibuprofen and sulfasalazine both increase anticoagulation. Use Caution/Monitor.

    ibuprofen and sulfasalazine both increase serum potassium. Use Caution/Monitor.Minor (1)ibuprofen will increase the level or effect of sulfasalazine by acidic (anionic) drug competition for renal tubular clearance. Minor/Significance Unknown.

  • sulindac

    Monitor Closely (2)ibuprofen and sulindac both increase anticoagulation. Use Caution/Monitor.

    ibuprofen and sulindac both increase serum potassium. Use Caution/Monitor.Minor (1)ibuprofen will increase the level or effect of sulindac by acidic (anionic) drug competition for renal tubular clearance. Minor/Significance Unknown.

  • tacrolimus

    Serious – Use Alternative (1)ibuprofen, tacrolimus.
    Either increases toxicity of the other by Other (see comment). Avoid or Use Alternate Drug.
    Comment: Concomitant administration increases risk of nephrotoxicity.

  • tafluprost

    Monitor Closely (1)tafluprost, ibuprofen. unspecified interaction mechanism. Use Caution/Monitor. There are conflicting reports from studies of either increased or decreased IOP when ophthalmic prostaglandins are coadministered with NSAIDs (either systemic or ophthalmic).

  • telmisartan

    Monitor Closely (3)telmisartan, ibuprofen.
    Either increases toxicity of the other by Other (see comment). Use Caution/Monitor.
    Comment: May result in renal function deterioration, particularly in elderly or volume depleted individuals.

    ibuprofen decreases effects of telmisartan by pharmacodynamic antagonism. Modify Therapy/Monitor Closely. NSAIDs decrease synthesis of vasodilating renal prostaglandins, and thus affect fluid homeostasis and may diminish antihypertensive effect.

    telmisartan and ibuprofen both increase serum potassium. Use Caution/Monitor.

  • temocillin

    Monitor Closely (2)temocillin, ibuprofen.
    Either increases levels of the other by plasma protein binding competition. Use Caution/Monitor.

    temocillin, ibuprofen.
    Either increases levels of the other by decreasing renal clearance. Use Caution/Monitor.

  • tenecteplase

    Monitor Closely (1)ibuprofen and tenecteplase both increase anticoagulation. Use Caution/Monitor. Potential for increased risk of bleeding, caution is advised.

  • tenofovir DF

    Monitor Closely (1)tenofovir DF, ibuprofen.
    Either increases levels of the other by decreasing renal clearance. Modify Therapy/Monitor Closely. Toxicity may result from coadministration of tenofovir DF with other drugs that are also primarily excreted by glomerular filtration and/or active tubular secretion including high-dose or multiple-dose NSAIDs; alternatives to NSAIDs should be considered.

  • terazosin

    Monitor Closely (1)ibuprofen decreases effects of terazosin by pharmacodynamic antagonism. Use Caution/Monitor. NSAIDs decrease prostaglandin synthesis.

  • terbinafine

    Monitor Closely (1)ibuprofen will increase the level or effect of terbinafine by affecting hepatic enzyme CYP2C9/10 metabolism. Use Caution/Monitor.

  • terbutaline

    Monitor Closely (1)ibuprofen increases and terbutaline decreases serum potassium. Effect of interaction is not clear, use caution. Use Caution/Monitor.

  • ticagrelor

    Monitor Closely (1)ticagrelor, ibuprofen.
    Either increases effects of the other by anticoagulation. Use Caution/Monitor. Increased risk of bleeding with use of ticagrelor and chronic NSAID use. .

  • ticarcillin

    Monitor Closely (2)ticarcillin, ibuprofen.
    Either increases levels of the other by plasma protein binding competition. Use Caution/Monitor.

    ticarcillin, ibuprofen.
    Either increases levels of the other by decreasing renal clearance. Use Caution/Monitor.

  • ticlopidine

    Monitor Closely (2)ticlopidine will increase the level or effect of ibuprofen by affecting hepatic enzyme CYP2C9/10 metabolism. Use Caution/Monitor.

    ticlopidine increases toxicity of ibuprofen by anticoagulation. Use Caution/Monitor.

  • timolol

    Monitor Closely (2)ibuprofen decreases effects of timolol by pharmacodynamic antagonism. Use Caution/Monitor. Long term (>1 wk) NSAID use. NSAIDs decrease prostaglandin synthesis.

    timolol and ibuprofen both increase serum potassium. Use Caution/Monitor.

  • tobramycin

    Minor (1)ibuprofen increases levels of tobramycin by decreasing renal clearance. Minor/Significance Unknown. Interaction mainly occurs in preterm infants.

  • tobramycin inhaled

    Monitor Closely (1)tobramycin inhaled and ibuprofen both increase nephrotoxicity and/or ototoxicity. Modify Therapy/Monitor Closely. Avoid concurrent or sequential use to decrease risk for ototoxicity

  • tolazamide

    Monitor Closely (1)ibuprofen increases effects of tolazamide by unknown mechanism. Use Caution/Monitor. Risk of hypoglycemia.

  • tolbutamide

    Monitor Closely (1)ibuprofen increases effects of tolbutamide by unknown mechanism. Use Caution/Monitor. Risk of hypoglycemia.

  • tolfenamic acid

    Monitor Closely (2)ibuprofen and tolfenamic acid both increase anticoagulation. Use Caution/Monitor.

    ibuprofen and tolfenamic acid both increase serum potassium. Use Caution/Monitor.Minor (1)ibuprofen will increase the level or effect of tolfenamic acid by acidic (anionic) drug competition for renal tubular clearance. Minor/Significance Unknown.

  • tolmetin

    Monitor Closely (2)ibuprofen and tolmetin both increase anticoagulation. Use Caution/Monitor.

    ibuprofen and tolmetin both increase serum potassium. Use Caution/Monitor.Minor (1)ibuprofen will increase the level or effect of tolmetin by acidic (anionic) drug competition for renal tubular clearance. Minor/Significance Unknown.

  • tolvaptan

    Monitor Closely (1)ibuprofen and tolvaptan both increase serum potassium. Use Caution/Monitor.

  • torsemide

    Monitor Closely (1)ibuprofen increases and torsemide decreases serum potassium. Effect of interaction is not clear, use caution. Use Caution/Monitor.

  • trandolapril

    Monitor Closely (1)trandolapril, ibuprofen.
    Either increases toxicity of the other by Other (see comment). Use Caution/Monitor.
    Comment: May result in renal function deterioration, particularly in elderly or volume depleted individuals.Serious – Use Alternative (1)ibuprofen, trandolapril. pharmacodynamic antagonism. Avoid or Use Alternate Drug. Coadministration may result in a significant decrease in renal function. NSAIDs may diminish the antihypertensive effect of ACE inhibitors. The mechanism of these interactions is likely related to the ability of NSAIDs to reduce the synthesis of vasodilating renal prostaglandins.

  • travoprost ophthalmic

    Monitor Closely (1)travoprost ophthalmic, ibuprofen. unspecified interaction mechanism. Use Caution/Monitor. There are conflicting reports from studies of either increased or decreased IOP when ophthalmic prostaglandins are coadministered with NSAIDs (either systemic or ophthalmic).

  • trazodone

    Monitor Closely (1)trazodone, ibuprofen.
    Either increases toxicity of the other by pharmacodynamic synergism. Use Caution/Monitor. Increased risk of upper GI bleeding. SSRIs inhib. serotonin uptake by platelets.

  • treosulfan

    Minor (1)treosulfan decreases effects of ibuprofen by Mechanism: unspecified interaction mechanism. Minor/Significance Unknown.

  • triamcinolone acetonide injectable suspension

    Monitor Closely (1)ibuprofen, triamcinolone acetonide injectable suspension.
    Either increases toxicity of the other by pharmacodynamic synergism. Use Caution/Monitor. Concomitant use of NSAIDS and corticosteroids increases the risk of gastrointestinal side effects. .

  • triamterene

    Monitor Closely (1)triamterene and ibuprofen both increase serum potassium. Modify Therapy/Monitor Closely.Minor (2)triamterene, ibuprofen. Other (see comment). Minor/Significance Unknown.
    Comment: Risk of acute renal failure. Mechanism: NSAIDs decrease prostaglandin synthesis, which normally protect against nephrotoxicity.

    ibuprofen increases toxicity of triamterene by pharmacodynamic antagonism. Minor/Significance Unknown. NSAIDs decrease prostaglandin synthesis, increasing the risk of nephrotoxicity.

  • valganciclovir

    Minor (1)ibuprofen will increase the level or effect of valganciclovir by acidic (anionic) drug competition for renal tubular clearance. Minor/Significance Unknown.

  • valproic acid

    Minor (1)valproic acid will increase the level or effect of ibuprofen by affecting hepatic enzyme CYP2C9/10 metabolism. Minor/Significance Unknown.

  • valsartan

    Monitor Closely (3)valsartan, ibuprofen.
    Either increases toxicity of the other by Other (see comment). Use Caution/Monitor.
    Comment: May result in renal function deterioration, particularly in elderly or volume depleted individuals.

    ibuprofen decreases effects of valsartan by pharmacodynamic antagonism. Modify Therapy/Monitor Closely. NSAIDs decrease synthesis of vasodilating renal prostaglandins, and thus affect fluid homeostasis and may diminish antihypertensive effect.

    valsartan and ibuprofen both increase serum potassium. Use Caution/Monitor.

  • vancomycin

    Minor (1)ibuprofen increases levels of vancomycin by decreasing renal clearance. Minor/Significance Unknown. Interaction mainly occurs in neonates.

  • venlafaxine

    Monitor Closely (1)venlafaxine, ibuprofen.
    Either increases toxicity of the other by pharmacodynamic synergism. Use Caution/Monitor. Increased risk of upper GI bleeding. SSRIs inhib. serotonin uptake by platelets.

  • vitamin K1 (phytonadione)

    Monitor Closely (1)ibuprofen increases and vitamin K1 (phytonadione) decreases anticoagulation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

  • voclosporin

    Monitor Closely (1)voclosporin, ibuprofen.
    Either increases toxicity of the other by nephrotoxicity and/or ototoxicity. Modify Therapy/Monitor Closely. Coadministration with drugs associated with nephrotoxicity may increase the risk for acute and/or chronic nephrotoxicity.

  • vorapaxar

    Monitor Closely (1)ibuprofen, vorapaxar.
    Either increases effects of the other by pharmacodynamic synergism. Use Caution/Monitor. Additive antiplatelet effect may occur.

  • voriconazole

    Minor (1)voriconazole will increase the level or effect of ibuprofen by affecting hepatic enzyme CYP2C9/10 metabolism. Minor/Significance Unknown.

  • vortioxetine

    Monitor Closely (1)ibuprofen, vortioxetine.
    Either increases effects of the other by anticoagulation. Use Caution/Monitor.

  • warfarin

    Monitor Closely (1)warfarin and ibuprofen both increase anticoagulation. Modify Therapy/Monitor Closely.

  • willow bark

    Minor (1)ibuprofen will increase the level or effect of willow bark by acidic (anionic) drug competition for renal tubular clearance. Minor/Significance Unknown.

  • zafirlukast

    Minor (1)zafirlukast will increase the level or effect of ibuprofen by affecting hepatic enzyme CYP2C9/10 metabolism. Minor/Significance Unknown.

  • zanubrutinib

    Monitor Closely (1)ibuprofen, zanubrutinib.
    Either increases effects of the other by anticoagulation. Modify Therapy/Monitor Closely. Zanubrutinib-induced cytopenias increases risk of hemorrhage. Coadministration of zanubritinib with antiplatelets or anticoagulants may further increase this risk.

  • zotepine

    Monitor Closely (1)ibuprofen decreases effects of zotepine by pharmacodynamic antagonism. Use Caution/Monitor. NSAIDs decrease prostaglandin synthesis.

    • New safety information for prescription-strength ibuprofen: Risk of heart attack and stroke at high doses

    Health Canada is working with the Canadian manufacturers of prescription oral ibuprofen products to update the safety information regarding the risk of serious cardiovascular side effects (e.g., heart attack and stroke) when these products are used at high doses (at 2400 mg/day). This risk increases with dose and duration of use.

    Ibuprofen is a non-steroidal anti-inflammatory drug (NSAID) used for pain and fever relief, and to reduce inflammation. The majority of ibuprofen products in Canada are available over-the-counter. These products have a maximum recommended dose of 1200 mg per day and are to be used for a short duration of time (seven days or less). No evidence of an increased cardiovascular risk has been found with over-the-counter ibuprofen when used as directed.

    Serious heart- and stroke-related events are a known risk with all NSAIDs and the prescribing information contains extensive warnings on this risk.

    The new information is in light of a Health Canada safety review that found that oral ibuprofen taken at high doses (at or above 2400 mg per day) increases the risk of heart attack and stroke. The increased risk with high doses of ibuprofen is similar to the risk seen with some other NSAIDs, including COX-2 inhibitors (e.g. celecoxib) and diclofenac. Health Canada recently communicated new prescribing recommendations regarding the cardiovascular safety of diclofenac.

    Health Canada’s review concluded that the benefits of prescription oral ibuprofen products continue to outweigh the risks as an effective pain and inflammation treatment, but that additional measures are needed for these products to further reduce the cardiovascular risk.

    Prescription oral ibuprofen products have a maximum recommended daily dose of 2400 mg, and are authorized to relieve the pain and inflammation of rheumatoid arthritis and osteoarthritis.

    Health Canada will be working with Teva Canada Ltd., Apotex Inc., and Pharmascience Inc., the Canadian manufacturers of prescription oral ibuprofen products, to strengthen the existing cardiovascular safety warnings in the prescribing information (product monographs), including recommending that doses of 2400 mg per day should not be used in patients with a history of heart disease and stroke, or who have risk factors for cardiovascular disease. Risk factors include — but are not limited to — smoking, diabetes, high blood pressure, high blood cholesterol and strong family history of cardiovascular disease.

    Health Canada has also posted a Summary Safety Review with more information on its review.

    What you should do

    • Patients currently taking high doses of prescription ibuprofen (2400 mg per day) should talk to their healthcare professional about whether or not ibuprofen use is right for them. This applies in particular to patients who have risk factors or who have already had a heart attack or a stroke. Risk factors include: smoking, high blood pressure, diabetes, high blood cholesterol, heart failure, and heart disease.
    • Canadians taking ibuprofen or any NSAID product, be it prescription or over-the counter, are reminded that these drugs should be used at the lowest effective dose and for the shortest period of time necessary. Over-the-counter ibuprofen products should not be taken for more than seven days unless recommended by a healthcare professional. 
    • Patients with questions or concerns about their ibuprofen treatment are encouraged to speak to their healthcare professional.

    Additional information for health professionals:

    • Healthcare professionals should consider the cardiovascular risks when prescribing ibuprofen for all patients. These risks increase with dose and duration of therapy.
    • Ibuprofen doses of 2400 mg per day should not be given in patients with ischemic heart disease, cerebrovascular disease, congestive heart failure or with risk factors for cardiovascular disease. 
    • Other management strategies that do not include NSAIDs — particularly COX-2 inhibitors, ibuprofen or diclofenac NSAIDs — should be considered first for patients with a high risk of a cardiovascular event.

    Report health or safety concerns

    To report a side effect to a health product to Health Canada:

    • Call toll-free at 1-866-234-2345
    • Visit MedEffect Canada’s web page on Adverse Reaction Reporting for information on how to report online, by mail or by fax.

    Health Canada
    (613) 957-2983

    Public enquiries

    (613) 957-2991
    1-866 225-0709

    ibuprofen (Advil, Motrin) Side Effects (Alcohol), Uses, Dosage & Pregnancy Safety

    Migraine vs. Headache: Differences and Similarities

    Headaches are the most common reason why a person goes to the doctor or other healthcare professional for treatment. There are different types of headaches, for example, migraine, tension, and cluster headaches. The most common type of headache is tension headache. Migraine is much less common. There are few similarities between migraine and other headaches, for example, the severity of the pain can be the same, mild, moderate, or severe; and they can occur on one side or both sides of the head. However, there are many differences between migraine and other types of headaches. Migraine headaches also have different names, for example, migraine with aura and menstrual migraine.
    Symptoms of migraine that usually aren’t experienced by a person with another type of headache include nausea, vomiting, worsens with mild exercise, debilitating pain, eye pain, throbbing head pain.
    Migraine trigger include light, mild exercise, strong smells, certain foods like red wine, aged cheese, smoked meats, artificial sweeteners, chocolate, alcohol, and dairy products, menstrual period, stress, oversleeping, and changes in barometric pressure.
    Untreated migraine attacks usually last from 4 to 72 hours, but may last for weeks. Most headaches resolve within 24-48 hours. Doctors don’t know exactly what causes migraine headaches; however, other headaches like tension headaches have more specific triggers and causes. Additional tests usually are required to diagnose migraine from other types of headaches, diseases, or other medical problems. Most headaches can be treated and cured with home remedies like essential oils, massage, and over-the-counter pain medication like acetaminophen (Tylenol) and NSAIDs (nonsteroidal anti-inflammatory drugs) like naproxen (Aleve, Anaprox, Naprosyn) or ibuprofen (Advil, Midol, Motrin). Most headaches resolve with OTC and home remedy treatment, while your doctor may need to prescribe medication to treat your migraines. If you have the “worst headache of your life,” seek medical care immediately.

    Advil Oral: Uses, Side Effects, Interactions, Pictures, Warnings & Dosing

    See also Warning section.

    Upset stomach, nausea, vomiting, headache, diarrhea, constipation, dizziness, or drowsiness may occur. If any of these effects persist or worsen, tell your doctor or pharmacist promptly.

    If your doctor has prescribed this medication, remember that your doctor has judged that the benefit to you is greater than the risk of side effects. Many people using this medication do not have serious side effects.

    This medication may raise your blood pressure. Check your blood pressure regularly and tell your doctor if the results are high.

    Tell your doctor right away if you have any serious side effects, including: easy bruising/bleeding, hearing changes (such as ringing in the ears), mental/mood changes, unexplained stiff neck, signs of kidney problems (such as change in the amount of urine), vision changes, symptoms of heart failure (such as swelling ankles/feet, unusual tiredness, unusual/sudden weight gain).

    This drug may rarely cause serious (possibly fatal) liver disease. Get medical help right away if you have any symptoms of liver damage, including: dark urine, persistent nausea/vomiting/loss of appetite, stomach/abdominal pain, yellowing eyes/skin.

    A very serious allergic reaction to this drug is rare. However, get medical help right away if you notice any symptoms of a serious allergic reaction, including: fever, swollen lymph nodes, rash, itching/swelling (especially of the face/tongue/throat), severe dizziness, trouble breathing.

    This is not a complete list of possible side effects. If you notice other effects not listed above, contact your doctor or pharmacist.

    In the US –

    Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088 or at www.fda.gov/medwatch.

    In Canada – Call your doctor for medical advice about side effects. You may report side effects to Health Canada at 1-866-234-2345.

    OTC Pain Relief Dosing Information

    When recommending an OTC analgesic, discuss the ingredients, directions, and maximum single and daily doses with your patients, as they may not know the right dose for their current pain and might rely on past dosing recommendations. Also address any possible confusion between prescription and OTC pain reliever doses. Below, find patient dosing charts that can guide your discussion and help patients at home.

    As a healthcare professional, you may use your discretion to recommend acetaminophen up to 4,000 mg in a 24-hour period for patients whose pain or fever persists.

  • The OTC maximum daily dose of acetaminophen remains 4,000 mg

  • Beginning in 2011, companies lowered the labeled total daily dose of acetaminophen in certain acetaminophen-containing OTC products in order to lessen the possibility of accidental overdose from using more than one acetaminophen-containing product at the same time. For example, adults and children 12 years and over are directed not to exceed 3,000 mg in 24 hours (for acetaminophen 500 mg tablet strength) unless directed by a healthcare professional

     

    • The maximum single and total daily doses for NSAIDs vary, depending on the ingredient and whether the product is prescription or OTC. Example: The ibuprofen Rx maximum daily dose is 3,200 mg, while the OTC maximum daily dose is 1,200 mg.

  • You may occasionally recommend prescription-strength doses of OTC NSAIDs such as ibuprofen and naproxen. Some patients, however, may continue to believe that these higher doses are appropriate for any future occasion or duration

  • Specify the dose and duration every time you make a recommendation because the risk of side effects increases with higher doses and longer duration of use. If your recommendation differs from previous occasions, explain to the patient why

  • Recommend that patients start with a 1-pill dose and increase as needed according to product directions

    • Advil 12 Hour Extended Release Tablets (Ibuprofen) Drug / Medicine Information

    Ibuprofen

    Consumer Medicine Information

    What is in this leaflet

    This leaflet answers some common questions about Advil 12Hour Extended Release Tablet
    (referred as Advil 12Hour). It does not contain all the available information. It
    does not take the place of talking to your pharmacist or doctor.

    All medicines have benefits and risks. Your pharmacist or doctor will have weighed
    the risks of you taking Advil 12Hour against the benefits they expect it will have
    for you.

    If you have any concerns about taking this medicine, talk to your pharmacist or doctor

    Keep this leaflet with your medicine.

    You may need to read it again.

    What Advil 12Hour is used for

    Advil 12Hour is used for the temporary relief of persistent pain likely to last for
    more than 6 hours associated with:

    body pain

    back pain

    neck and shoulder pain

    muscle pain

    sprains and strains

    osteoarthritis

    arthritic, joint and rheumatic conditions

    period pain

    dental pain

    sinus pain

    cold and flu

    Who should use Advil 12Hour

    Advil 12Hour is recommended for adults and children 12 years of age and over.

    How Advil 12Hour works

    Ibuprofen belongs to a group of medicines called non-steroidal anti-inflammatory drugs
    (NSAIDs). Ibuprofen, like all non-steroidal anti-inflammatory drugs, is an analgesic,
    antipyretic, and anti-inflammatory medication. There is strong evidence to support
    the view that the main mechanism of action of ibuprofen (like other NSAIDs) is related
    to decreasing formation of prostaglandins. Prostaglandins are naturally-occurring
    fatty acid derivatives that are widely distributed in the tissues. They are believed
    to be a common factor in the production of pain, fever, and inflammation.

    Ask your pharmacist or doctor if you have any questions about this medicine. Your
    pharmacist or doctor may have given it for another reason.

    This medicine is not addictive.

    It is only available from your pharmacist.

    Before you take Advil 12Hour

    When you must not take it

    Do not take Advil 12Hour if you are allergic to:

    any medicines containing ibuprofen, aspirin or other NSAIDs.

    any of the ingredients in Advil 12Hour listed at the end of this leaflet.

    Some of the signs and symptoms of an allergic reaction may include:

    shortness of breath

    wheezing or difficulty breathing

    swelling of the face, lips, tongue or other parts of the body

    rash, itching or hives on the skin

    Do not take Advil 12Hour if you have/are:

    asthma that is sensitive to aspirin or NSAIDs

    a current or a past history of stomach bleeding or ulceration

    Talk to your pharmacist or doctor about taking this medicine if you are over 65 years
    of age.

    Taking this medicine may increase the risk of you getting stomach, heart or kidney
    problems.

    signs of gastrointestinal bleeding, such as vomiting blood, bleeding from the back
    passage (rectum), or have black or bloody stools

    heart failure

    kidney disease

    severe liver impairment

    have recently had coronary artery bypass surgery (CABG).

    Do not take Advil 12Hour if you are pregnant or trying to become pregnant.

    Do not take Advil 12Hour if the expiry date (EXP.) printed on the pack has passed
    or if the packaging shows signs of tampering or the tablets do not look quite right.

    If you are not sure whether you should start taking this medicine, talk to your pharmacist
    or your doctor.

    Before you start to take it

    Tell your pharmacist or doctor if you:

    are allergic to any other medicines, foods, dyes or preservatives.

    you have asthma

    you have a stomach or duodenal ulcer

    you have liver or kidney disease

    you have cardiac impairment or high blood pressure

    if you are taking any products containing aspirin or salicylates

    you are taking other medications

    you are under the care of a doctor for any serious condition

    Ask your pharmacist or doctor about taking the medicine if you are breastfeeding.

    Very small amounts of ibuprofen pass into the breast milk. Your pharmacist or doctor
    will discuss the potential benefits and risks of taking the medicine if you are breastfeeding.

    Taking other medicines

    Tell your pharmacist or doctor if you are taking any other medicines, including any
    that you buy without a prescription from a pharmacy, supermarket or health food shop.

    Some medicines and ibuprofen may interfere with each other. These include:

    aspirin, salicylates and other non-steroidal anti-inflammatory drugs (NSAIDs)

    warfarin or any other medicine used to prevent blood clots

    lithium, a medicine used to treat mood swings and some types of depression

    medicines used to lower blood pressure

    methotrexate, a medicine used to treat arthritis and some types of cancer

    medicines used to treat heart failure

    medicines such as prednisone, prednisolone and cortisone, which reduce the activity
    of your immune system. Taking together with ibuprofen may increase the risk of gastrointestinal
    bleeding.

    zidovudine, a medicine used to treat HIV infection

    probenecid, medicines used to treat diabetes and phenytoin

    SSRIs (selective serotonine reuptake inhibitors) taken together with ibuprofen may
    increase the risk of gastrointestinal bleeding

    Tell a pharmacist or doctor if you are taking aspirin for heart attack or stroke,
    because ibuprofen may decrease this benefit of aspirin.

    Your pharmacist or doctor will have more information on these and other medicines
    to be careful with or avoid while taking this medicine.

    If you have not told your pharmacist or doctor about any of the above, tell him/her
    before you start taking Advil 12Hour

    How to take Advil 12Hour

    Follow all directions given to you by your pharmacist or doctor carefully.

    They may differ from the information contained in this leaflet.

    If you do not understand the instructions on the pack, ask your pharmacist or your
    doctor for help.

    How to take Advil 12Hour

    Adults and children 12 years and over:

    Take 1 tablet every 12 hours while symptoms persist. Swallow the tablet whole with
    water – do not crush, chew, split or dissolve.

    Do not take more than 1 tablet at a time.

    Do not exceed 2 tablets in 24 hours.

    Do not give this product to children under 12 years.

    How long to take Advil 12Hour for:

    Advil 12Hour should not be used for more than a few days at a time except on medical
    advice. If pain gets worse or last for more than a few days stop use and ask your
    pharmacist or your doctor.

    If the pain usually lasts less than 6 hours or pain is expected to last less than
    6 hours, Advil 12Hour should not be used. It is recommended to use regular Advil Tablets
    or Liquid Capsules.

    Advil 12Hour is a bi-layer tablet. The first layer dissolves quickly to relieve pain
    fast. The second layer is sustained-release to give relief of persistent pain for
    up to 12 hours.

    If Advil 12Hour does not relieve your symptoms, do not take extra tablets or any other
    products containing ibuprofen or other non-steroidal anti-inflammatory drugs (NSAIDs).
    Tell your pharmacist or your doctor.

    Excessive or prolonged use can be harmful and may increase the risk of heart attack,
    stroke or liver damage.

    If you take too much Advil 12Hour (overdose)

    Immediately telephone your doctor, or the Poisons Information Centre (telephone 13
    11 26, Australia or go to Accident and Emergency at the nearest hospital, if you think
    you or anyone else may have taken too much Advil 12Hour. Do this even if there are
    no signs of discomfort or poisoning.

    While you are taking Advil 12Hour

    Things you must do

    If you become pregnant while taking Advil 12Hour, tell your doctor immediately and
    stop using this product.

    Tell all doctors, dentists and pharmacists who are treating you that you are taking
    Advil 12Hour.

    Ask your doctor or pharmacist before you start taking any new medicines.

    If you are going to have surgery tell your doctor you are taking Advil 12Hour

    If you are going to have any laboratory tests, tell your doctor that you are taking
    Advil 12Hour.

    Advil 12Hour can affect the results of some of these tests.

    Tell your doctor if, for any reason, you have not taken your medicine exactly as prescribed.

    Otherwise, your doctor may think that it was not effective and change your treatment
    unnecessarily.

    Tell your doctor if you feel the tablets are not helping your condition.

    Things to be careful of

    Be careful driving or operating machinery until you know how Advil 12Hour affects
    you.

    This medicine may cause dizziness in some people. If this happens, do not drive or
    operate heavy machinery.

    Side effects

    Tell your pharmacist or doctor as soon as possible if you do not feel well while you
    are taking Advil 12Hour

    All medicines can have side effects.

    Ask your pharmacist or doctor to answer any questions you may have.

    Tell your doctor if you notice any of the following and they worry you. Although most
    people will not experience any side effects, some of the side effects that may occur
    with Advil 12Hour are:

    heartburn, nausea or stomach pain

    vomiting

    constipation

    abdominal pain

    bloating

    loss of appetite

    diarrhoea

    abnormal vision

    headache

    fatigue

    dizziness

    nervousness

    ringing or buzzing in the ears

    skin blisters

    Side effects may be minimized by using the smallest dose for the shortest duration
    of time.

    Tell your doctor as soon as possible if you notice any of the following:

    get sunburnt more quickly than usual

    If any of the following happen, stop use and tell your doctor immediately or go to
    Accident and Emergency at your nearest hospital:

    fluid retention

    vomiting blood, bleeding from the back passage, or bloody or black stools

    shortness of breath

    wheezing or difficulty breathing

    swelling of the face, lips, tongue or other parts of the body

    an allergic reaction including skin reddening, rash, blisters, itching, or hives on
    the skin

    The above list includes serious and very serious side effects. You may need urgent
    medical attention or hospitalisation. These side effects are very rare for low doses
    of this medicine and when used for a short period of time.

    Tell your pharmacist or doctor if you notice anything that is making you feel unwell
    even if is not in this list.

    Other side effects not listed above may also occur in some patients.

    After taking Advil 12Hour

    Storage

    Keep Advil 12Hour where children cannot reach it.

    A locked cupboard at least one-and-a-half metres above the ground is a good place
    to store medicines.

    Keep your tablets in the pack until it is time to take them.

    If you take the tablets out of the pack they will not keep well.

    Keep your tablets in a cool dry place where the temperature stays below 25C.

    Do not store Advil 12Hour or any other medicine in the bathroom or near a sink.

    Do not leave Advil 12Hour in the car or on window sills.

    Heat and dampness can destroy some medicines.

    Disposal

    If your pharmacist or doctor tells you to stop taking Advil 12Hour, or your tablets
    have passed their expiry date, ask your pharmacist what to do with any that are left
    over.

    Product description

    What Advil 12Hour looks like

    Advil 12Hour is a white, film-coated, capsule-shaped tablet printed in blue ink on
    one side.

    Pack sizes of 1 (professional sample), 8, 12, 14, 16, 24, 25, 28 and 32 tablets. Not
    all presentations may be marketed.

    Ingredients

    Each Advil 12Hour tablet contains ibuprofen 600 mg, 200 mg immediate release, and
    400 mg extended release.

    The tablet also contains the following inactive ingredients:

    carnauba wax

    colloidal anhydrous silica

    maize satrch

    croscarmellose sodium

    hypromellose

    microcrystalline cellulose

    polydextrose

    macrogol 400

    pregelatinised maize starch

    sodium lauryl sulfate

    stearic acid

    titanium dioxide

    pharmaceutical ink (Opacode WB Blue NS-78-10521)

    Sponsor

    GlaxoSmithKline Consumer Australia Pty Limited

    82 Hughes Avenue Ermington NSW 2115

    Australia Toll Free Phone Number 1800 028 533

    Web: www.advil.net.au

    Australian registration number:

    Advil 12Hour

    AUST R 306571

     

    This leaflet was prepared on Sep 2020.

     

    ® Registered trademark

    Ibuprofen Dosing Table for Fever and Pain

    ​​​​Ibuprofen (also known as Motrin® and Advil®) is a medicine used to reduce fever and pain. It is an “over-the-counter” medicine, meaning that you can get it without a doctor’s prescription.

    This table* can help you figure out the right amount to give. (Find a print-friendly version here.) Use your child’s weight to decide on the right amount to give. If you do not know your child’s weight, use your child’s age. Be sure to check with your child’s doctor to make sure you are giving the right amount.

     *Table notes:


    • Age of child: Do not use ibuprofen in children who are less than 6 months old unless your child’s doctor tells you to. This is because it has not been found to be safe in children less than 6 months old. The use of the medicine in children less than 6 months is also not approved by the FDA. It is also best not to give medicines with more than one ingredient in it to children less than 6 years of age.


    • Dosage: Determine by finding child’s weight in the top row of the dosage table.


    • Measuring the dose for liquid medicines (should be in “mL” or metric units): It is easier to give the right amount of liquid medicine when using a syringe than when using a kitchen teaspoon or tablespoon. Use the syringe or dosing cup that comes with the medicine. If a tool does not come with the medicine, ask your pharmacist for one.

    • Ibuprofen drops: Ibuprofen infant drops come with a measuring syringe.


    • Adult dosage: 400 mg


    • How often to give the medicine (frequency): You can give ibuprofen every 6-8 hours if needed.

    More information


    The information contained on this Web site should not be used as a substitute for the medical care and advice of your pediatrician. There may be variations in treatment that your pediatrician may recommend based on individual facts and circumstances.

    Recommendations for indicating the dosage (quantitative content of active ingredients) in the name of medicinal products

    Table of Contents

    1. General recommendations

    The medicinal product is marked as “(trade) name + dosage + dosage form”. Such an indication is considered as the full name of the drug, and therefore the concept of “name” in these Recommendations should be understood as the full name of the drug containing the indicated 3 elements.The active substance must be indicated directly under the full name of the medicinal product.

    In accordance with paragraph 1 of Section III of the Requirements for instructions for the medical use of a medicinal product and the general characteristics of a medicinal product for medical use, a dosage in the name of a medicinal product means the amount (content) of an active substance in a unit of a dosage form, as well as in a unit of mass or volume of a medicinal product. a drug that is significant for the correct identification and use of the drug.The dosage in the name of the medicinal product must correspond to the information specified in sections 2 and 4.2 of the general characteristics of the medicinal product for medical use (hereinafter referred to as the SmPC).

    The content of the active substance in a unit of mass or volume of a medicinal product is also called concentration and is given mainly for non-metered medicinal products.

    For some types of dosage forms, the dosage is expressed by the amount of active substance released from the dosage form per unit of time.

    The purpose of indicating the dosage in the name of a medicinal product is to provide the most significant information about the amount of a medicinal product during use, easy identification and differentiation from other forms of release, as well as prescription by a doctor, taking into account other aspects of the process of prescribing and using medicinal products. The indication of dosage should be based on criteria of convenience for the consumer (prescriber) and not on quality criteria (analytical criteria).

    The granularity between sections 1 and 2 of the SmPC may differ, therefore, when specifying the dosage in section 1 of the SmPC, it is often not necessary to include redundant information that is contained in other sections of the SmPC and the labeling of the medicinal product. If the dosage in the name of the medicinal product reflects only the total amount of the active substance in the primary packaging, in other sections of the SmPC and labeling of the medicinal product it is necessary to clearly indicate the total volume and concentration per unit volume.Similarly, if the dosage in 3 names of the medicinal product is indicated as a concentration per unit volume, in other sections of the SmPC and labeling of the medicinal product, it is necessary to clearly indicate the total amount of the active substance and the total volume of the medicinal product. The exact indication of these key elements in the proposed labeling and on the packaging material by the applicant is a key aspect in the examination of dummies and samples, aimed at reducing the risk of dosing error.The design used by the pharmaceutical company must ensure that key information is visible and unambiguous for the correct use of the drug.

    The dosage (concentration) is indicated, as a rule, for one-, two- and three-component drugs. In some cases, it is allowed to indicate the dosage (concentration) for four- and five-component drugs.

    The dosage (concentration) of medicinal products is indicated on the primary and secondary packaging and is included in the information about the medicinal product provided to patients and healthcare professionals in the instructions for the medical use of medicinal products, in official and reference publications, and electronic information retrieval systems.

    These Recommendations are aimed not only at achieving harmonization between similar medicinal products and dosage forms, but also at improving the labeling of medicinal products to ensure the correct and safe use of medicinal products and to minimize dosing errors.

    The Recommendations apply exclusively to the indication of the dosage in the name of medicinal products and do not automatically affect other regulatory procedures (for example, the rules for assigning registration certificate numbers, calculating the amount of fees, choosing between a change requiring and not requiring a new registration, etc.).

    2. Recommendations for indicating the dosage in the name of medicinal products

    The most appropriate indication of “dosage” in the name of a medicinal product is determined on an individual basis.

    In addition to the factors specified in section 1 of these Requirements, the factors that must be taken into account in order to correctly determine the most appropriate indication of “dosage” are highlighted, for example, the dosage in the labeling of medicinal products investigated in clinical trials (ideally, the same approach to expressing dosages should be used when labeling investigational medicinal products), or when a dispensing device is available.If a suitable dispensing device is included in the package and one or more fixed doses will be administered with it, its effect on the indication of dosage should be taken into account.

    2.1. To indicate the dosage (concentration), the following abbreviations of units of measurement are used:

    • g – gram
    • mg –

      • milligram

    • mcg – mcg
    • ml –

      • ml

    For the indication of the dosage, the activities specified in subparagraph 1 are also used.1. section III of the Requirements for instructions for medical use of a medicinal product and general characteristics of a medicinal product for medical use.

    When indicating the dosage, the name of the unit of the dosage form is not given. For example, 200 mg, not 200 mg / tablet, 20 IU, not 20 IU / vial.

    2.2. Quantitative indication of dosage (concentration)

    2.2.1. When specifying a dosage (concentration), its numerical value should be expressed in a rational form, which is achieved by choosing the appropriate units of measurement or appropriate prefixes to form decimal multiples and sub-multiples of measurement.

    2.2.2. When specifying the dosage (concentration), the units of measurement are selected that allow the use of integers rather than fractional numbers, or whole numbers with a fractional digit of the 1st and 2nd order. For example, 50 μg, not 0.05 mg, 200 mg, not 0.2 g, 1.5 mg, not 0.0015 g.

    2.2.3. When specifying the dosage (concentration), the units of measurement are selected to avoid numbers containing more than three digits (1000 or more). For example, 1.5 g, not 1500 mg, 5 mg, not 5000 mcg.

    In cases where the dosage is not expressed in units of mass, in particular in IU or other units, abbreviations “mln.”,“ Billion ”, for example 5 million IU, however, they should not be used in the SmPC and LP.

    2.2.4. If a manufacturer produces a medicinal product of the same name in one dosage form with a different amount of the active substance, the dosages are indicated in the same units for the entire product line. 6 For example, 0.75 g, 1 g and 1.5 g, not 750 mg, 1 g and 1.5 g, 250 mg, 500 mg and 1000 mg, not 250 mg, 500 mg and 1 g.

    2.2.5. In the case of using esters, salts, solvates as active substances, the content of the active substance is indicated in terms of the active part of the molecule (acid, base, anhydrous or dry substance).For example, when using ketotifen fumarate as an active ingredient, the content of the active ingredient in terms of ketotifen is indicated.

    If the salts and esters used differ in their pharmacological action, it is allowed to indicate the dosage in terms of the entire molecule of the active substance (for example, benzylpenicillin sodium salt).

    2.2.6. For two-component medicinal products, the content of each of the two active substances is indicated using the sign and the same units of measurement, for example, “25 mg / 50 mg”.

    For multicomponent medicinal products, the content of each of the active substances is indicated sequentially in the order corresponding to the grouping (generally accepted) name, using the “+” or “/” sign.

    For example:

    “Amlodipine + Valsartan + Hydrochlorothiazide” – “5 mg + 160 mg + 12.5 mg”, where 5 mg – amlodipine content, 160 mg – valsartan content, 12.5 mg – hydrochlorothiazide content;

    “Amlodipine / Valsartan / Hydrochlorothiazide” – “5 mg / 160 mg / 12.5 mg”, where 5 mg – amlodipine content, 160 mg – valsartan content, 12.5 mg – hydrochlorothiazide content.

    In this case, the same units of measurement are used to indicate the content of each of the active substances (in the case of using mass units of expression).

    2.3. Concentration indication for medicinal products

    2.3.1. To indicate the concentration, a combination of the ratios of units of measurement given in sub-clause 2.1 of these Recommendations is used:

    • g / ml grams per milliliter
    • mg / ml milligram per milliliter
    • μg / ml micrograms per milliliter
    • mg / g milligram per gram
    • μg / g micrograms per gram
    • μg / mg micrograms per milligram
    • IU / ml international unit of biological activity per milliliter
    • IU / g international unit of biological activity per gram
    • IU / mg international unit of biological activity per milligram.

    2.3.2. Percentage indication of dosage is not allowed, with the exception of registered medicinal products (or new dosages of such medicinal products), the dosages of which have traditionally been expressed in this way (in particular, infusion and injection solutions: isotonic sodium chloride solution, glucose and albumin solutions). In this case, it is allowed to use the percent “%” in the values:

    • mass percent, expressing the number of grams of active ingredient in 100 grams of the medicinal product;
    • mass-volume percent, expressing the number of grams of active ingredient in 100 milliliters of the medicinal product;
    • volume percent, the number of milliliters of active ingredient in 100 milliliters of the drug.

    2.3.3. When indicating the concentration of an active substance in a unit of mass or volume of a medicinal product, the number “1” is not indicated. For example, 200 IU / ml, not 200 IU / 1 ml.

    2.3.4. It is allowed to indicate the content of the active substance in a different amount of mass or volume of the drug, while giving this amount of the drug, for example, 200 IU / 0.5 ml.

    2.3.5. For multicomponent medicinal products, the concentration is indicated taking into account subparagraph 2.2.6 of these Recommendations, for example (25 mg / 50 mg) / 5 ml or (25 mg + 50 mg) / 5 ml.

    Indication of dosage (concentration) for different dosage forms is given in the table, where the following conventions are used: x mg / ml = concentration; z mg = total active ingredient; y ml = total volume; z mg / y ml = total active ingredient in total volume.

    Dosage form Type of primary packaging 1 Preferred dosage designation 2 Way of expressing dosage (concentration) 3
    Oral drugs
    Solid single-dose dosage forms (e.g. tablets, capsules) single-dose quantity per dosage unit z mg
    Solid dosage forms (e.g. granules) multi-dose quantity per unit of mass x mg / g
    Soft dosage forms (e.g. paste, oral gel) single-dose total in primary packaging z mg
    multi-dose quantity per unit of mass x mg / g
    Liquid dosage forms (e.g. ampoules, sachets) single-dose total in primary packaging z mg
    multi-dose quantity per unit volume x mg / ml
    Powders (granules) for the preparation of liquid dosage forms single-dose total in primary packaging z mg
    multi-dose quantity per unit volume after dissolution x mg / ml
    Medicines for parenteral administration
    Liquid dosage forms single-dose (with a single administration 4 ) total in primary packaging z mg5
    single-dose (with partial administration 4 ) quantity per unit volume x mg / ml5
    multi-dose quantity per unit volume x mg / ml
    Powders for the preparation of liquid dosage forms6 single-dose total in primary packaging z mg
    multi-dose quantity per unit volume after dissolution x mg / ml
    Concentrates single-dose (with a single administration4) total in primary packaging z mg5
    single-dose (with partial administration 4 ) quantity per unit volume before dilution x mg / ml5
    single-dose (with partial administration4) quantity per unit volume before dilution x mg / ml5
    Concentrates multi-dose quantity per unit volume before dilution x mg / ml
    Implants
    Implants total in implant z mg
    Medicines for external, transdermal, rectal, vaginal administration, application to the mucous membrane of the oral cavity, gums
    Solid dosage forms (e.g. suppository, tablet, capsule) single-dose quantity per dosage unit z mg
    Solid dosage forms (e.g. powder) multi-dose quantity per unit of mass x mg / g
    Transdermal preparations for systemic use (e.g. transdermal patch) single-dose nominal quantity released per unit of time x mg / y h
    Topical transdermal preparations (e.g. transdermal patch) single-dose total in patch z mg
    Soft dosage forms (for example, cream, gel, ointment) single-dose multi-dose quantity per unit of mass x mg / g
    Liquid dosage forms single-dose total in primary packaging z mg
    multi-dose quantity per unit volume x mg / ml
    Medicines for inhalation
    Inhalation dosage forms (e.g. hard capsules, aerosols, gases) single-dose multi-dose quantity in delivered dose x mg / dose
    Solution (suspension, emulsion) for nebulizer single-dose total in primary packaging z mg
    Solution (suspension, emulsion) for nebulizer multi-dose quantity per unit volume x mg / ml
    Ophthalmic, ear and nasal medications
    Liquid dosage forms single-dose multi-dose quantity per unit volume x mg / ml
    Soft dosage forms (e.g. ointment) single-dose multi-dose quantity per unit of mass x mg / g

    1 Single-dose primary packaging contains the amount of the drug intended for full or partial use in 1 reception.A multi-dose primary package contains an amount of the drug suitable for two or more doses.

    2 Amount of pharmaceutical substance or active substance, respectively.

    3 In addition to the methods of expressing dosage (concentration) indicated in the table, other acceptable units of measurement may be used to express dosage (concentration).

    4 Single administration: application of the entire amount of the active substance contained in the primary packaging at a time within the framework of one administration.Partial administration: the administered dose is calculated on an individual basis (in mg / kg of body weight, in mg / m2), and the unused part of the drug is destroyed.

    5 If the concentration in the name of the medicinal product is indicated as a “dosage”, the package must clearly indicate the total content in the total volume. If in the name of a medicinal product the total amount of active substance in the primary packaging is indicated in the form of “dosage”, the package must also indicate the total volume or total content in the total volume and concentration.If the name of the medicinal product indicates the total amount in the total volume in the form of “dosage”, the concentration should also be indicated on the package.

    6 If there is a specific recommendation for the volume for dissolution, the dosage may alternatively be indicated as the total amount in the total volume after dissolution “z mg / y ml”.

    2.4. Special cases of indication of dosage (concentration)

    2.4.1. For medicinal products for oral administration in a multi-dose package, the form of application of which differs from the original form (transformation is required by dissolution, dilution), the dosage is indicated for the form of use.For example, “powder for preparation of a suspension for oral administration of 4 mg / ml” – in the absence of a dosing device, “powder for preparation of a suspension for oral administration of 20 mg / 5 ml” – when equipped with a dosing device.

    2.4.2. For radiopharmaceutical drugs, the total radioactivity is indicated, expressed by the radioactivity of the nuclide in becquerels (GBq, MBq, kBq) per dose unit (for dosed drugs) or the radioactive concentration expressed by the radioactivity of the nuclide in becquerels (GBq, MBq, kBq) in the primary packaging unit ( for non-metered drugs).

    2.4.3. The dosage (concentration) is not indicated for the following medicinal products:

    • in the dosage form “medical gas”, “oil”, “liquid”; in the form of packaged medicinal raw materials and intended for the preparation of aqueous extracts;
    • complex saline solutions for infusion administration;

      • 90,035 homeopathic remedies;

    • multivitamin preparations and preparations containing multivitamins in combination with mineral components and others.

    2.4.5. On the packaging (label) of liquid medicinal products for injection, in addition to the dosage, the concentration of the active substance in 1 ml may be indicated. For the contents of a package with a volume of less than 1 ml, it is allowed to indicate the content of the active substance in the total volume of the package, for example, 12.5 mg / 0.625 ml. If the prescription of a medicinal product depends on its concentration in percent, it is allowed to indicate along with it the content of the active substance in the total volume of the package, for example, 1% (100 mg / 10 ml).

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    Foreign pharmaceutical manufacturers against government purchases of low-dose insulin

    The Association of Foreign Pharmaceutical Manufacturers (AIPM) appealed to the Federal Antimonopoly Service (FAS) with a request to withdraw the letter to the regional departments of the department, in which it allows participation in government procurement of the drug with international non-procurement of the drug the name (INN) of insulin glargine in different dosages. A similar document, which Vedomosti got acquainted with, was sent to the Ministry of Health.

    Now, on the recommendation of doctors, insulin glargine is purchased under the state order at a dosage of 300 U / ml. But the FAS decided that when forming the tender documentation, it is advisable to indicate the possibility of supplying the drug with a dosage of 100 U / ml. The service informed its subdivisions about this in a letter, which was signed by the former head Igor Artemyev on November 10 this year. It indicates, in particular, that insulin glargine in both dosages has the same active ingredient, release form and indications for use, and the purchase of the drug exclusively in a dosage of 300 U / ml may lead to restriction of competition on the market.

    AIPM (includes more than 60 companies, including Johnson & Johnson, AstraZeneca, Bayer, etc.) do not agree with the position of the FAS. In its appeal, the association indicates that only the Ministry of Health has the right to determine the possibility of interchangeability of certain drugs on the basis of the testimony of doctors, otherwise it may harm the health of the population. Representatives of the Ministry of Health and the Federal Antimonopoly Service did not respond to inquiries.

    According to the State Register of Medicines, the only manufacturer of insulin glargine at a dosage of 300 U / ml is the French Sanofi, which in 2016.received a patent for it. But a similar drug in a dosage of 100 U / ml, according to DSM Group, apart from Sanofi, is also produced by the St. Petersburg company Geropharm. The latter, in September of this year, managed to challenge the legality of the grant of a patent to a French company in an intellectual property court. Sanofi is now challenging the relevant decision in cassation.

    The representative of Geropharm believes that the patent for the drug of the French company was issued inappropriately, since it lacks the necessary principles of novelty and inventive step.In addition, according to him, a foreign manufacturer continues to remain a monopolist in this market due to the patent. He does not hide the fact that the company has repeatedly drawn public attention to the illegality of specifying a specific dosage when purchasing insulin glargine. “It was after the renewal of Sanofi’s patent that this began to happen,” he says. Yuri Mochalin, director of corporate relations at Sanofi in the Eurasian region, told Vedomosti that the company intends to defend a patent for its invention in all instances.He also points out that patient communities are also expressing concern about the FAS letter. So, on November 25, the National Medical Research Center of Endocrinology of the Ministry of Health published an open letter from the Russian Diabetes Association to Prime Minister Mikhail Mishustin with a request not to use the recommendations mentioned in the FAS letter.

    Development Director of RNC Pharma Nikolay Bespalov does not exclude that the FAS letter to the regions and Geropharm’s contestation of the Sanofi patent are interrelated processes.He recalls that initially the drug Sanofi appeared on the Russian market and was prescribed by doctors at a dosage of 100 U / ml. But in 2016, the patent for it expired, and it has analogues. Then the French company released the drug in a dosage of 300 U / ml and already patented it. Doctors began to prescribe him, says Bespalov. In this regard, the expert believes that the transfer of patients to an analogue with the initial dosage is possible under the supervision of the attending physician.

    Senior lawyer of Eversheds Sutherland, Alexander Gavrilov, points out that the FAS letter does not have the status of a regulatory document, therefore it is advisory and not mandatory for government customers.Accordingly, when forming the tender documents, the latter have the right not to indicate the possibility of supplying the drug in a dosage of 100 U / ml. At the same time, according to him, if a company wishing to participate in the auction turns out to be dissatisfied with the fact that the tender provides for the supply of insulin only in a dosage of 300 U / ml, it can appeal to the territorial body of the FAS with a complaint. The regional branch of the FAS, in turn, will follow the recommendations of the central office. As a result, an unhappy bidder will be able to appeal against them or invalidate such an auction.In this case, state customers will have to follow the decision of the antimonopoly authority, Gavrilov says.

    when form and dosage requirements do not limit competition

    No tablet division allowed

    The decision of the Novosibirsk OFAS dated June 8, 2017 in case No. 08-01-207 says the following. The customer for the treatment of patients with tuberculosis needed a drug with INN “Linezolid” in the form of release: “film-coated tablets” and in a dosage of 300 mg.However, in connection with this formation of the requirements of the auction documentation, a complaint was filed with the antimonopoly authority, motivated by the fact that the dosage of 300 mg is a biased characteristic and limits the possibility of offering medicines with an equivalent dosage (in particular, 600 mg).

    As part of the consideration of the case, the customer explained that the drug was intended for the treatment of tuberculosis in such categories of patients as those infected with HIV, patients with multidrug-resistant mycobacterium tuberculosis, patients with severe concomitant chronic pathologies.The customer indicated that, according to federal clinical guidelines, in the listed categories of patients, the drug with INN “Linezolid” is included in the fifth chemotherapy regimen. Moreover, as a rule, such patients have an acute deficit in body weight: the weight of patients is approximately 50-60 kg. Taking this factor into account, the dose of the drug is selected individually and is 600 mg in two doses: one 300 mg tablet in the morning and in the evening. In accordance with the current regulations for the provision of medical care, dividing the tablet into two parts is not allowed.In this regard, when prescribing a two-time dose of the drug, the use of a tablet with a dosage of 600 mg does not correspond to the described treatment regimen.

    In addition, the antimonopoly authority, when considering the complaint, analyzed the instructions for use of the drug in dosages of 300 mg and 600 mg. The antimonopoly authority found that a single dose of 600 mg is indicated for patients with community-acquired pneumonia, hospital-acquired pneumonia, complicated infections of the skin and soft tissues, etc.but not for patients with tuberculosis. Based on an analysis of all the circumstances of the case, the antimonopoly authority concluded that the requirement for the form and dosage of the drug had been established objectively.

    In the Decision of the Magadan OFAS dated July 12, 2017 in case No. 04-30 / 60-2017, the legitimacy of the customer establishing the requirements for the dosage form of the drug purchased for the treatment of tuberculosis was confirmed. In particular, the customer established a requirement for the supply of the drug with the INN “Aminosalicylic acid” in enteric-coated granules.

    In connection with this formation of auction documentation, a complaint was filed with the antimonopoly authority. Among other things, it stated that drugs with the INN “Aminosalicylic acid” in dosage forms “enteric-coated tablets” and “enteric-coated granules” are interchangeable.

    In the framework of the proceedings, the customer explained that the need for the indicated dosage form was due to the peculiarities of therapy for patients with tuberculosis.In particular, the drug was intended for patients who have difficulty swallowing large tablets; for those suffering from disorders of the nervous system and mental disorders; and other categories of patients with certain comorbidities in which therapy requires a slow release of the drug. The drug with INN “Aminosalicylic acid” in enteric-coated granules ensures the achievement of an optimal therapeutic effect for the indicated categories of patients, and also helps to prevent the development of toxic, dispersed reactions.The customer also noted that for the treatment of other categories of patients in whom the corresponding pathologies are not observed, the drug with the INN “Aminosalicylic acid” in tablet form was previously purchased.

    Based on the analysis of the described circumstances of the case, the antimonopoly authority concluded that the need for the dosage form “enteric-coated granules” was objectively due to the applied therapy.

    Does equivalence prevail?

    At the same time, there are other approaches in practice.See, for example, the decision of the Vologda OFAS dated July 10, 2017 in case No. 04-11 / 169-17. In this case, a complaint was also considered about the formation of auction documentation when purchasing a drug with the INN “Aminosalicylic acid” for the treatment of patients with tuberculosis. The complaint was based on the indication in the auction documentation of a specific dosage, dosage form and amount of the drug in the consumer package (without indicating the possibility of supplying an equivalent). In particular, the complaint contained the argument that drugs with the INN “Aminosalicylic acid” in dosage forms: “enteric-coated tablets” and “enteric-coated granules” were equivalent.

    The customer, in turn, explained that the drug with the INN “Aminosalicylic acid” in the dosage form “enteric-coated granules” is used in the treatment of tuberculosis in children, since a child, especially a preschool age, cannot swallow tablets due to their size. This form is also used in adult patients who, due to the characteristics of the body, are unable to take pills.

    The customer also noted that the dosage of the drug with the INN “Aminosalicylic acid” in the dosage form “enteric-coated tablets” is 1 gram.In this case, the daily dose of the drug in an adult is from 8 to 12 grams. Given that at least six anti-tuberculosis drugs must be used simultaneously in the treatment regimen for resistant tuberculosis, an additional increase in the volume of drugs taken negatively affects adherence to treatment.

    However, the given arguments of the customer were not supported by the antimonopoly authority, including with reference to the letter of the FAS Russia dated October 18, 2016 No.No. IA / 71493/16 “On the procurement of medicinal products with the INN” Aminosalicylic acid “”. The antimonopoly authority concluded that drugs with the INN “Aminosalicylic acid” in the dosage forms “enteric-coated tablets” and “enteric-coated granules” contain the same active substance, have the same route of administration and belong to the same product market. In this regard, the FAS considered that the formation of documentation for the purchase of drugs with the INN “Aminosalicylic acid” indicating the specific dosage, dosage form and amount of the drug in the consumer package (without indicating the possibility of supplying an equivalent) may lead to a limitation of the number of participants in the procurement.

    Conclusions and recommendations

    Law enforcement practice in the field of drug procurement is not uniformly formed. In the event of a disputable situation, the customer’s task is to objectively substantiate his need. This can be done by referring to established treatment regimens supported by clinical guidelines, standards of care, and drug instructions for use.At the same time, the customer needs to take into account the existing explanations of the FAS Russia and the emerging practice of applying the legislation on the federal contract system.

    90,000 Daily intake of calcium for men, women and children

    Contents

    There is not a single organ or tissue in the human body that does not contain calcium. Most of the calcium in the body is in the bones and teeth. Together with vitamin D, it is responsible for the proper formation of bone tissue.Due to its high content in the body, it received the name of a macroelement – a compound that is found in high concentration in human tissues.

    More than 95% of calcium is in bone mass, providing bone growth together with other minerals – phosphorus. It prevents osteoporosis by maintaining bone strength and normal structure. The rest of the calcium is contained in cells, intercellular space and blood, participating in many vital processes:

    • Muscle contractility and transmission of nerve impulses.
    • Signal-receptor function.
    • Maintenance of normal blood clotting.
    • Participation in the synthesis of neurotransmitters and hormonal substances.
    • Regulation of heart rate and conduction.
    • Modulator of the activity of the body’s enzyme systems.

    Calcium enters the body of an adult with food, for infants – with mother’s milk. Its absorption takes place in the intestine, from where it is distributed throughout the tissues. The state of the gastrointestinal tract affects the intake and assimilation of calcium – in the presence of diseases occurring with syndromes of malabsorption, its intake into the bloodstream worsens.In this case, even with a sufficient amount of it consumed with food, a deficiency state develops. Calcium is excreted by the urinary system, its loss increases when taking diuretics (for example, in the treatment of cardiovascular diseases).

    Deficiency of this element leads to various problems such as osteoporosis, impaired growth of hair and nails, decreased neuromuscular excitability. Its excess is also dangerous to health, therefore, there are established daily calcium intake rates for different age groups.

    The daily requirement of the body

    The daily intake of calcium for a person depends on several factors: age, gender, the presence of diseases, especially the gastrointestinal tract with impaired absorption of various substances.

    The total amount of calcium per day for a child in the blood increases with every year of life. According to the norms of physiological needs for energy and nutrients for various groups of the population of the Russian Federation, the need for macronutrients in children is:

    • Children in the first year of life: the daily rate of calcium in the blood is 400-600 mg.
    • From 1 to 3 years old – the need for calcium in a child is 800 mg.
    • From 3 to 11 years old – 900-1100 mg.
    • From 11 to 18 years – 1200 mg.

    The norm of calcium per day in infants is provided if the child is breastfed, and the mother’s diet complies with the nutritional rules of a nursing woman, and she herself does not suffer from a deficiency of this element. The daily calcium requirement in children during periods of active skeletal growth increases sharply, therefore, its deficiency during this period can lead to serious degenerative processes in the bones.

    The daily calcium intake for men aged 18-50 is 1000-1200 mg. At the same time, there are fluctuations in dosage depending on age:

    • 18-60 years old – 1000 mg.
    • 60 years and older – 1200 mg.

    The rate of calcium intake increases in persons over 60 years of age due to the increased risk of osteoporosis on the background of age-related changes and nutritional deficiencies.
    The daily calcium intake for women takes into account not only age, but also the corresponding reproductive status – pregnancy and lactation, menopause.The norm of calcium per day for women is presented in the table:

    C woman’s age 2 Calcium norm in mg
    18-60 years old 1000 mg
    At the onset of climacteric pause 1200 mg
    Pregnancy and lactation period 1300-1400 mg

    The daily calcium intake for women after 40 usually rises due to a decrease in the concentration of sex hormones and the risk of osteoporosis.When prescribing hormone replacement therapy during the climacteric pause, the daily dose is adjusted.

    Prevention and treatment of deficiency conditions

    Calcium deficiency can be avoided with the help of a complete diet. Dairy products, especially those artificially fortified, contain large amounts of calcium. Less of it is found in cereals, nuts and greens. The listed sources of calcium should be present in the diet on a daily basis.

    However, dietary adjustments are not always sufficient to cover the daily requirement.In this case, calcium supplementation is indicated. It is possible to use only this macroelement, as well as a complex of substances necessary for the body.

    For the prevention and elimination of calcium deficiency in the body, you can take the combined drug Calcemin Advance. In addition to calcium, it contains a number of other useful substances: magnesium, copper, zinc, vitamin D, manganese and boron
    . One tablet contains 500 mg of calcium, depending on the indications, up to three tablets can be taken per day in a total dosage of 1500 mg.It should not be forgotten that the daily intake consists of calcium that has entered the body along with food, as well as taking into account the drugs taken. In this regard, one should not independently increase the dosage without the appropriate recommendation of the doctor.

    L.RU.MKT.CC.03.2020.3102

    Russia

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    Regulatory constraints and medical practices vary from country to country. Consequently, the information provided on the site in which you enter may not be suitable for use in your country.

    how to choose, dosages, combinations, contraindications

    Among a large number of various dietary supplements, Omega-3 occupies a well-deserved leadership position.This dietary supplement is necessary for pregnant women, children, athletes who are losing weight 1 , women who seek to preserve their beauty and youth 2 , as well as elderly people 3 .

    Not so long ago, preparations with Omega-3 (salmon oil, krill oil, herring, etc.) have become widespread among dog and cat lovers. The results, which were not always clearly visible in humans, were demonstrated by the pets quite clearly.Shiny coat, lack of dandruff, thicker undercoat, less brittle or flaking nails (in dogs that have had problems with this) – such photos “before” and “after” the course of taking Omega are replete with the Internet. Sufficient demonstration of the visual results from the use of the supplement, which dispelled the doubts of many skeptics. This effect is supported by research on the effects of various sources of Omega-3, fish oil, krill oil and green-lipped mussel against cytokine-mediated degradation of canine cartilage 4 .

    One of the important features of dietary supplements with Omega-3 are recommendations for the course of taking the drug. In fact, you can drink Omega all year round, without a break.

    What is the best way to combine it to get the maximum effect?

    Omega-3 and Her Best Friends

    Among the Omega-3 companion nutrients, we would like to highlight collagen. Some pharmaceutical companies make supplements that already have this combination, but we would recommend purchasing two separate products.First, Omega-3 is in oil form, while quality collagen is in powder form. To get the most out of collagen, you need to choose the right dosage (5,000 mg to 10,000 mg) and prepare a collagen drink in the morning on an empty stomach. For better assimilation, collagen should be combined with vitamin C. How to fit it all in one capsule or tablet with Omega-3 without losing quality and effectiveness is a big question. So just buy two different packs and take these supplements together in the morning, or Omega-3s during the day with food.

    Vitamin D3 and Omega-3 are a great combination. At the same time, Omega improves the absorption of vitamin D3, but does not lead to excess dosages, as if you are taking fish oil. Omega-3 also works well with vitamin K2, which is known to have a beneficial effect on the absorption of D3.

    Attention: polyunsaturated fatty acids are better absorbed in the presence of vitamins B and D.

    At the mention of this duo, many may have thought of adding calcium to the complex.And this is a great solution! Omega-3 improves the absorption of calcium by ensuring the transport of this mineral across the cell membranes.

    It also works well with coenzyme Q10, lecithin, fat-soluble vitamins A and E, as well as B vitamins and vitamin C.

    But it is better not to take Omega-3 together with iron, copper and chromium.

    How to choose a dietary supplement with Omega-3?

    • Source of raw materials.If possible, it is necessary to know not only from what parts and what fish the raw materials are taken from, but also who is the country of origin. For example, Evalar buys raw materials for “Triple Omega-3” and other dietary supplements with Omega from a well-known Norwegian brand. That, in turn, uses fish oil in production, obtained exclusively from carcasses of small varieties of commercial fish caught in natural reservoirs.

    • Concentration of active substances: directly Omega-3, as well as DHA and EPA.In one capsule, the permissible concentration level of Omega-3 is at least 900-1000 mg, DHA and EPA is at least 300 mg.

    • Vitamin E should ideally be used as a preservative (also referred to as “tocopherol” or “mixture of tocopherols”).

    • The product should not contain any additional additives. Unless, in children’s Omega, small deviations in the form of flavoring additives are permissible so that kids can eat healthy capsules without whims and with pleasure.

    • Format – ideally in capsules. In liquid form, there is a high risk of getting an oxidized product, which, unfortunately, will lose some of its properties.

    You can read more about this in the article “Omega-3: How to Choose?”

    How to take Omega-3 correctly?

    Omega-3 should be taken separately from minerals with which it is poorly compatible (we wrote about this above).The optimal time of admission is the first half of the day, half an hour after a meal. You can also combine Omega-3s with your morning collagen supplement.

    The duration of the course can be as long as 3-6 months, and there are no restrictions. Omega-3 is one of the few supplements that make sense to drink all year round.

    Of course, the lack of Omega-3 in the diet is a marker of the need to adjust the diet, but not everyone can find high-quality fish and introduce it into the diet on an ongoing basis, so dietary supplements in this case are the best alternative.

    Contraindications for taking Omega-3

    It is undesirable to take Omega-3 if you are undergoing medication. This rule applies in general for any dietary supplements that have not been prescribed by a therapist who also prescribed medications.

    Omega-3 is not recommended for use in the following cases:

      clear Allergic reactions to seafood.
      clear Children under 3 years old.
      clear Individual intolerance to the substances that make up the drug.
      clear Liver diseases.
      clear Various pathologies of the gastrointestinal tract in the acute or chronic period.
      clear Postoperative time.

    For those who are undergoing a period of rehabilitation after surgery or have injuries of various etiologies, we recommend that you consult with your doctor before starting or resuming taking Omega-3.

    **

    1.A high ratio of dietary n-3 / n-6 polyunsaturated fatty acids improves obesity-linked inflammation and insulin resistance through suppressing activation of TLR4 in SD rats
    Han-Qiang Liu , Ya Qiu , Ying Mu , Xian-Jiao Zhang , Lu Liu , Xiang-Hong Hou , Lei Zhang , Xiao-Na Xu , Ai-Ling Ji , Rui Cao , Rui-Hua Yang , Feng Wang

    2.Nutritional deficiencies and phospholipid metabolism
    María S Gimenez , Liliana B Oliveros , Nidia N Gomez

    3. Roles of unsaturated fatty acids (especially omega-3 fatty acids) in the brain at various ages and during aging
    J M Bourre

    4.Effects of different omega-3 sources, fish oil, krill oil, and green-lipped mussel against cytokine-mediated canine cartilage degradation
    Kittisak Buddhachat , Puntita Siengdee , Siriwadee Chomde , Kumpanart Soontornvipart , Korakot Nganvongpanit

    Union of Pediatricians of Russia

    Vitamin D

    – Why is it needed?

    Vitamin D helps the body use calcium and phosphorus; promotes the formation of strong teeth and bones.

    Recent studies show that vitamin D deficiency plays a role in the development of endocrine, cardiovascular, autoimmune and oncological diseases, as well as infectious diseases.

    – How does the body get vitamin D?

    Most of the vitamin D is produced in the skin under the influence of sunlight, but it can also enter the body with certain foods (milk, fatty fish, egg yolk, butter, etc.)).

    However, few (especially children of the first years of life) use the above products and there are not many sunny days in our strip. In addition, exposure to direct sunlight increases the risk of photoaging and skin cancer, so sunscreen should be used, which also hinders vitamin D production.

    – A blood test to determine the level of vitamin D, is it necessary?

    Children of all ages are advised to take preventive doses of vitamin D, which are prescribed without determining its level in the blood.

    If the child requires the appointment of therapeutic doses of vitamin D, then the doctor prescribes this analysis in order to choose the right dose of the drug.

    – Values ​​of the level of vitamin D (content of 25 (OH) D) in the blood:

    • absolutely toxic level:> 200ng / ml;
    • level with possible toxicity:> 100ng / ml;
    • norm: 30-100 ng / ml;
    • deficiency: 21-29 ng / ml;
    • deficit: less than 20 ng / ml.

    – How much vitamin D should you take?

    In 2021, the national program for correcting vitamin D deficiency in children and adolescents in the Russian Federation was updated, according to which the following prophylactic doses were established, regardless of the type of feeding (no dose recalculation for children with mixed or artificial feeding is required):

    0-1 month: 500 ME / day

    1 month-1 year: 1000 ME / day

    1-3years: 1500ME / day

    3-18 years old: 1000 ME / day

    Children from risk groups (premature and low birth weight children, children with overweight and obesity, children with clinical signs of rickets, children with chronic kidney and liver diseases, etc.) are considered separately.), and the region of residence is also important, therefore, before taking the drug, be sure to consult your doctor.

    Sources: National program “Vitamin D deficiency in children and adolescents of the Russian Federation: modern approaches to correction”, 2021

    For more information see parenting brochure Vitamin D

    .