Ibuprofen

Ibuprofen is non-steroidal anti-inflammatory drug (NSAID) that is available both as a prescription and over-the-counter to treat pain or fever. It is sold under the brand names: Addaprin, Advil, Dolgesic, Genpril, Haltran, IB Pro, Ibifon 600, Ibren, Ibuprohm, Menadol, Midol Cramps & Bodyaches, Motrin, Nuprin, Q-Profen, Rufen, Saleto, Samson, Tab-Profen, Ultraprin, Uni-Pro, and Wal-Profen.

What It's Prescribed For
"Prescription ibuprofen is used to relieve pain, tenderness, swelling, and stiffness caused by osteoarthritis (arthritis caused by a breakdown of the lining of the joints) and rheumatoid arthritis (arthritis caused by swelling of the lining of the joints). It is also used to relieve mild to moderate pain, including menstrual pain (pain that happens before or during a menstrual period)."

Over-the-Counter Uses
"Nonprescription ibuprofen is used to reduce fever and to relieve mild pain from headaches, muscle aches, arthritis, menstrual periods, the common cold, toothaches, and backaches."

Form, Route, and Dosage
Prescription ibuprofen is available as a tablet taken orally. Over-the-counter ibuprofen is available as a tablet, chewable tablet, suspension (liquid), and drops (concentrated liquid). Ibuprofen is available in the over-the-counter strengths of 50mg (infant), 100mg (children's), and 200mg and prescription strengths of 100mg/5ml (suspension), 400mg, 600mg, and 800mg.

For over the counter uses, patients ages 12 and over are directed to take up to 1 tablet or capsule (200mg) every 5 to 6 hours while symptoms persist and no more than 6 tablets or capsules (1200mg) in 24 hours unless directed by a doctor. For infants 6-11 months weighing 12-17 lbs, the over the counter dose is 1.25mL (50mg of naproxen) every 6 to 8 hours, not exceeding 4 doses in 24 hours. Infants ages 12-23 months weighing 18-23 lbs are given the same instructions, but with 1.875mL of the suspension (75mg of naproxen). Children ages 2 to 11 are provided with dosage information based on weight and age.

When taking ibuprofen as a prescription, adults are instructed to take up to 3200mg per day (i.e. 800mg every 6 hours). Children's doses typically do not exceed 50mg/kg per 24 hours. For example, a child weighing 20kg (44 lbs) would be instructed to take no more than 1000mg of ibuprofen in a 24 hour period.

In Combination With Other Drugs
Ibuprofen sometimes comes in combination with other medications. Some ibuprofen combination products are by prescription whereas others are over-the-counter. For example, the following products are combinations that contain Ibuprofen:


 * Advil® Allergy Sinus (containing Chlorpheniramine, Ibuprofen, Pseudoephedrine)
 * Advil® Cold and Sinus (containing Ibuprofen, Pseudoephedrine)
 * Advil® PM (containing Diphenhydramine, Ibuprofen)
 * Combunox® (containing Ibuprofen, Oxycodone)
 * Dayquil® Pressure and Pain (containing Ibuprofen, Pseudoephedrine)
 * Dimetapp® Sinus (containing Ibuprofen, Pseudoephedrine)
 * Dristan® Sinus (containing Ibuprofen, Pseudoephedrine)
 * Ibudone® (containing Hydrocodone, Ibuprofen)
 * Motrin® PM (containing Diphenhydramine, Ibuprofen)
 * Reprexain® (containing Hydrocodone, Ibuprofen)
 * Sine-Aid IB® (containing Ibuprofen, Pseudoephedrine)
 * Vicoprofen® (containing Hydrocodone, Ibuprofen)

Side Effects
Patients may experience a number of side effects from taking ibuprofen. These include:
 * constipation
 * diarrhea
 * gas or bloating
 * nervousness
 * dizziness
 * ringing in the ears
 * unexplained weight gain
 * fever
 * blisters
 * rash
 * itching
 * hives
 * swelling of the eyes, face, throat, arms, hands, feet, ankles, or lower legs
 * difficulty breathing or swallowing
 * hoarseness
 * excessive tiredness
 * pain in the upper right part of the stomach
 * nausea
 * loss of appetite
 * yellowing of the skin or eyes
 * flu-like symptoms
 * pale skin
 * fast heartbeat
 * cloudy, discolored, or bloody urine
 * back pain
 * difficult or painful urination
 * blurred vision, changes in color vision, or other vision problems
 * red or painful eyes
 * stiff neck
 * headache
 * confusion
 * aggression

Overdoses
Patients can overdose on ibuprofen. Symptoms of overdose include dizziness, fast eye movements that you cannot control, slow breathing or short periods of time without breathing, and blue color around the lips, mouth, and nose.

Warnings
Taking NSAIDs like ibuprofen might increase risk of heart attack or stroke. This risk may increase in patients who take NSAIDs for a long time. Therefore, patients are instructed to alert their doctor if they have any of the following risk factors: someone in the patient's immediate family has ever had heart disease, a heart attack, or a stroke; smoking; high blood pressure or a history of high blood pressure; high cholesterol or a history of high cholesterol; or diabetes.

Patients are instructed to avoid taking ibuprofen before or after any coronary artery bypass graft (CABG) surgery.

Additionally, NSAIDs may cause ulcers, bleeding, or holes in the stomach or intestines. The risk of this may increase if patients take NSAIDs for a long time, are older in age, have poor health, or drink more than three alcoholic beverages per day.

As a Pollutant
Because humans and animals often do not fully metabolize pharmaceuticals in their body, they can excrete drugs or their breakdown products, which may the enter the environment.

In Sewage Sludge
Ibuprofen has been found in sewage sludge. In the Targeted National Sewage Sludge Survey, a 2009 test of 84 samples of sewage sludge from around the U.S., the EPA found ibuprofen in 54 samples (64%) in concentrations ranging from 99.5 to 11,900 parts per billion. There are no federal regulations governing how much of this drug may be present in sewage sludge applied to land as fertilizer.

In Drinking Water
An Associated Press investigation found that, of 62 metropolitan areas in the U.S., only 28 tested for pharmaceuticals, and 24 found pharmaceuticals in the drinking water when they tested it. Philadelphia, Portland, OR and Washington, DC all tested positive for ibuprofen.

Related SourceWatch articles

 * Biosolids
 * Sewage sludge
 * Food Rights Network
 * Pharmaceuticals