Ibuprofen

Author: Prof. Dr. med. Peter Altmeyer

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Last updated on: 29.10.2020

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Synonym(s)

2-[4-(2-methylpropyl)phenyl]propanoic acid; 2-(4-isobutylphenyl)propionic acid; CAS-Nummer-15687-27-1; Ibuprofenum; Isobutylphenylpropionic acid

Definition
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White powder with a characteristic odour with analgesic, antipyretic and antiphlogistic effects(non-steroidal antiphlogistic NSAID) Ibuprofen has the molecular formula C13H18O2. It is almost insoluble in water, but is highly soluble in most organic solvents. In suitable bases ibuprofen is well absorbable through the skin and thus systemically effective (triggering of generalized ADRs is possible with topical application).

Spectrum of action
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Ibuprofen inhibits (non-selectively) COX-1 and COX-2 (cyclooxygenase I and cyclooxygenase II), which are responsible in the organism for the formation of prostaglandins that mediate inflammation. The effects of ibuprofen can be deduced from this inhibitory effect. Ibuprofen has analgesic, antiphlogistic and antipyretic effects. Ibuprofen also inhibits the production of mucus in the stomach lining.

Indication
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Acute and chronic joint and spinal disorders, arthrosis and spondylarthrosis, mild to moderate pain: headache, toothache, menstrual pain, fever.

Dosage and method of use
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Ibuprofen can be administered orally, rectally, dermally or intravenously. It is dosed according to age and body weight. When administered orally, 800 mg of ibuprofen is recommended as the maximum single dose and between 1200 and 2400 mg as the total daily dose for adults and adolescents aged fifteen years and older.

  • Adults/adolescents > 18 years: 1200-2400 mg/day (max. 800 mg per ED, max. 2400 mg/day.
  • Children from 8 years of age. 10-15 mg/kg bw/day in 2-4 single doses.

Take it unchewed with sufficient liquid.

In addition, ibuprofen-containing formulations (gels, emulsions, ointments, nanosystems, microneedles) are applied topically. A good dermal absorption of ibuprofen with a systemic effectiveness can be proven in suitable bases (Manoukian MAC et al. 2017).

Undesirable effects
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Exanthema, central nervous disorders, visual and hearing disorders, nausea, diarrhoea, gastrointestinal ulcers, liver dysfunction, sodium and water retention with formation of oedema, hyperkalemia, drop in blood pressure, kidney dysfunction, blood count changes, bronchospasms, worsening of infection-related inflammation.

Interactions
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Potassium-sparing diuretics: hyperkalemia, increase in lithium and digoxin levels, increased risk of bleeding with anticoagulants, enhancement of the blood sugar-lowering effect of oral antidiabetics, etc.

Contraindication
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disorders of the blood count, gastrointestinal ulcerations, severe cardiological diseases

Preparations
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Aktren, Contraneural, Dolgite, Dolormin, Ibuhexal, Ibuprofen, Optalidone, Togal N

Note(s)
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Remember! Impairment of the ability to react with impairment of the ability to participate in road traffic.

The claim propagated by pharmaceutical companies that topical application of an ibuprofen-containing pain gel (emulsions/ointments) has an immediate analgesic/antiphlogistic effect on an underlying joint caused by the active substance is unproven. Rather, this effect is probably based on a systemic effect of the drug.

Literature
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  1. Aranda JV et al (2017) Non-steroidal Anti-inflammatory Drugs in Newborns and Infants. Pediatrics Clinic North Am 64:1327-1340.
  2. Monk AB et al (2017) Pharmacological interventions for pain relief during orthodontic treatment. Cochrane Database Syst Rev 11:CD003976.
  3. Manoukian MAC et al.(2017) Topical Administration of Ibuprofen for Injured Athletes: Considerations, Formulations, and Comparison to Oral Delivery. Sports Med Open 3:36. https://www.ncbi.nlm.nih.gov/pubmed/28983850
  4. Pepine CJ et al(2017) Cardiovascular safety of NSAIDs: Additional insights after PRECISION and point of view.Clin Cardiol 40:1352-1356.
  5. Underwood M et al(2008)Advice to use topical or oral ibuprofen for chronic knee pain in older people: randomised controlled trial and patient preference study. BMJ 336:138-142.

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Last updated on: 29.10.2020