Ibuprofen belongs to the group of anti inflammatory medications that are not steroids. This is one of the first options for pain, inflammation, and fever.
It’s estimated that half of the population suffers from headaches, and 30 million people suffer from lower back pain.
In addition, others suffer from pain caused by cancer, heart disease, and other illnesses. The main treatment for the pain that comes from majority of these problems is ibuprofen.
What is ibuprofen for?
Ibuprofen comes in pill form, capsule form or in a syrup. In all cases, it’s an anti inflammatory, analgesic and a medicine to reduce fever.
Its fever-reducing effects begin after an hour and last up to 2 to 4 hours. However, the anti inflammatory effects may require a week of treatment.
The principal uses of ibuprofen are the following:
1.Treatments for situations that include pain or inflammation such as headaches, migraines, ear aches, menstrual cramps, sore throat, and muscular pain.
2. Symptoms of fever.
3. Diseases such as juvenile rheumatoid arthritis, and arthrosis (a joint disease).
4. Treatments for wounds of the soft tissue, such as pulled muscles and strains.
How Ibuprofen Functions
Ibuprofen works by inhibiting the synthesis of prostaglandins. This inhibition is due to the competitive and reversible enzyme cyclo-oxygenase, which transforms arichidonic acid into prostaglandins.
Structurally, ibuprofencomes from propionic acid. This is a recemic compound (two compounds that are mirror images of the other). Their activity falls almost completely on the isometric S.
Pharmaco-kinetics: What happens to ibuprofen inside the body?
Ibuprofen is a drug that’s not very water soluble. However, it’s often used in the form of arginate salts or lysine to improve its solubility and its pharmaco-kinetic profile. As a result, its most important characteristics are the following:
- Absorption: Oral and parenteral are the most common methods. Oral administration is fast and effective.
- Distribution: Ibuprofen links effectively with plasmatic proteins (90-99%). It is capable of spreading out throughout the tissues.
- Metabolism: the majority of metabolism takes place in the liver. This occurs by hydroxilation and carboxilation, generating various inactive metabolites.
- Excretion: Urine excretes ibuprofen (90%) and the feces excretes a tiny part. This happens within 24 hours.
The dosage steps depend on the pharmaceutical form for each patient. Doctors recommend that the schedule be very specific.
However, generally, it is the following:
- For adults, the administration should be between 400-600 mg. every 6 to 8 hours, not exceeding 2.4 mg. per day.
- In children from 3 months to 11 years, it should be 20-30 mg. per day divided into 3 or 4 doses.
- This means that there has been no evaluation for the efficacy and the safety for infants under 3 months old.
Doctors recommend oral pill for adults only, never exceeding 600 mg. each 6-8 hours.
Whenever possible, you should not miss taking it. However, you also have to remember to use it with caution, as overuse could lead to kidney or hepatic problems.
Contraindications and precautions when using Ibuprofen
These are the precautions you need to know about Ibuprofen:
- Hypersensitivity to ibuprofen. There are cases of ibuprofen crossing with NSAIDs (non-steroidal anti-inflammatory drugs) in the case of allergies to aspirin. These reactions are especially frequent in asthmatic patients.
- Peptic ulcer, intestinal inflammatory disease, or any process that increase the risk of gastrointestinal bleeding. Due to the inhibition of the synthesis of prostaglandins, ibuprofen may increase the risk of digestive hemorrhaging and perforation. This is why doctors recommend taking ibuprofen and any other NSAID with food to reduce gastric pain.
- Alterations of coagulation. Ibuprofen causes certain anti-coagulent effects that can increase the time of bleeding.
- Weak kidney function. While your urine eliminates it, it can accumulate and become toxic. It can also diminish renal blood flow.
- Uncontrolled hypertension and cardiac conditions.
- Pregnancy. Women should not take it during the last trimester of pregnancy. In addition, they should avoid prolonged use in the first trimester.
There are numerous medications that can change the behavior of ibuprofen and NSAIDs in the body. Because of this, these can reduce their effectiveness or even cause the possibility of adverse effects.
Among these are the following:
- NSAIDs. Ibuprofen can reduce the anti-coagulating effects of aspirin when people take these together.
- Alcohol. There is a potential toxic effect because both metabolize in the liver.
- Anti hypertensives. There is a possible reduction of antihypertensives. In patients with compromised kidney function, it can precipitate deterioration (dehydrated or elderly patients).
- Oral anticoagulants, heparin. There is risk for a possible increase of anticoagulant effects with risk of bleeding. Thus, doctors recommend periodic testing of coagulation indicators.
- Diabetic medications. In addition, there is a possible increase of hypoglycemic effects, reducing renal excretion.
- Acetaminophen. Finally, the simultaneous and prolonged use of acetaminophen and an NSAID can cause a risk of an adverse renal effect.
Adverse reactions to Ibuprofen
Adverse effects principally originate from the action of the NSAID, the inhibition of the cyclooxigenase, and (COX-1). Overall, they frequently appear in doses above 3.2 mg per day.
- Gastrointestinal effects: possible occurrence of dyspepsia, diarrhea, nausea, abdominal pain, gastrointestinal bleeding.
- Dermatological effects: there tend to be hypersensitivity that manifest in skin eruptions, hives, or erythema. However, these reactions occur normally in patients with a history of hyper-sensitivity to aspirin and other NSAIDs.
- Central nervous system: Headaches, dizziness, sleepiness, and circulatory problems.
- Hematologic: can prolong bleeding.
- Cardiovascular: hypertension and heart issues.
- Renal: increase of uric nitrogen and renal crisis.