Ibuprofenإيبوبروفين

Ibuprofen, sold under the brand name Brufen, is a nonsteroidal anti-inflammatory drug (NSAID) used as a pain reliever, fever reducer, and anti-inflammatory.

Ibuprofen works by blocking the COX-1 and COX-2 enzymes, which reduces the body's production of prostaglandins — the chemicals that cause pain, inflammation, and fever.

• Mild to moderate pain, such as headaches, migraines, back pain, dental pain, muscle and joint pain, and menstrual cramps
• Fever and elevated body temperature
• Symptom relief in rheumatoid arthritis and osteoarthritis
• Cold and flu symptoms

Pain and fever, adults

• 200–400 mg every 4–6 hours, as needed
• Over-the-counter maximum: 1,200 mg per day
• Under a doctor's supervision, up to 2,300 mg per day may be used
• Without a doctor's direction, do not use for more than 10 days

Arthritis (rheumatoid or osteoarthritis), adults

• 1,200–3,200 mg per day, divided into 3–4 doses, under medical supervision

See the special-populations section below for children's weight-based dosing.

This is educational background, not an individual prescription — your own doctor sets your exact dose.

Ibuprofen usually begins working within 20–30 minutes of taking a dose.

• Do not take on an empty stomach — take with food or milk to reduce stomach upset
• Swallow tablets whole with water, milk, or juice — do not chew or crush
• Shake the oral suspension well before use, and measure the dose with the spoon or cup provided

Take the missed dose as soon as remembered, unless it is almost time for the next dose — in that case, skip the missed dose and resume the normal schedule. Do not take a double dose.

• Store at room temperature
• Keep away from moisture and light
• Keep out of children's reach

• Nausea, vomiting
• Constipation or diarrhea
• Indigestion and abdominal pain
• Abdominal bloating — reported in roughly 7–16%
• Heartburn — reported in roughly 3–9%
• Rash — reported in roughly 3–9%
• A drop in blood pressure — reported in up to about 10%
• Headache, dizziness

Rare but serious, potentially fatal skin reactions have been reported, including Stevens-Johnson syndrome and toxic epidermal necrolysis. Stop the medicine and seek medical attention immediately if you notice skin blistering, peeling, or a widespread rash.

Seek medical attention immediately for signs of a serious allergic reaction: rash, hives, swelling of the face or throat, difficulty breathing, or severe asthma-like wheezing.

NSAIDs like ibuprofen carry a boxed warning for an increased risk of serious heart and blood vessel problems, including heart attack and stroke, which can be fatal — this risk can appear within the first week of use and increases with long-term use. Ibuprofen should not be used during or right after coronary artery bypass graft (CABG) heart surgery.

Seek medical attention immediately for chest pain, shortness of breath, weakness on one side of the body, or slurred speech.

NSAIDs like ibuprofen carry a boxed warning for an increased risk of serious stomach and intestinal problems, including bleeding, ulcers, and perforation, which can be fatal — the risk is higher in elderly people and anyone with a past stomach ulcer or GI bleeding.

Seek medical attention immediately for black or tarry stools, vomiting blood or material that looks like coffee grounds, or severe stomach pain that doesn't go away.

Ibuprofen can cause kidney injury, including rare but serious cases of papillary necrosis, particularly with long-term use, dehydration, heart failure, liver disease, or existing kidney problems.

Seek medical attention immediately for ankle or leg swelling, blood in the urine, little or no urination, or rapid unexplained weight gain.

• Known hypersensitivity or allergy to ibuprofen or other NSAIDs (such as naproxen or diclofenac), or a history of asthma/hives triggered by aspirin or NSAIDs
• Immediately before or after coronary artery bypass graft (CABG) heart surgery
• An active stomach ulcer with bleeding
• Severe heart failure or severe liver disease

Increased bleeding risk

• Aspirin and warfarin (blood thinners)
• Other NSAIDs such as diclofenac and naproxen
• Smoking or alcohol use further increases the risk of serious GI bleeding

Reduced kidney protection / kidney function

• ACE inhibitors (lisinopril, ramipril)
• Angiotensin receptor blockers (losartan)

Reduced effectiveness of other medicines

• Diuretics such as hydrochlorothiazide and furosemide

Other noted interactions

• Lithium — ibuprofen can increase lithium side effects
• Methotrexate — ibuprofen can raise its blood levels
• Cyclosporine (an immunosuppressant)
• Digoxin (a heart medicine)
• Bisoprolol (a beta-blocker)
• Corticosteroids such as betamethasone and dexamethasone — combined use raises GI bleeding risk
• Certain antidepressants (citalopram, fluoxetine)
• Certain diabetes medicines (gliclazide, glipizide)

Always tell your doctor and pharmacist about every other medicine you take.

Not given to infants under 6 months without a doctor's consultation. From 6 months, dosing is weight-based:

Dosed every 6–8 hours as needed. Daily maximum: 40 mg per kilogram of body weight, or 1,200 mg if weight isn't known. From age 12, adult dosing applies (200–400 mg every 4–6 hours, maximum 1,200 mg a day). The oral suspension is generally used from age 7 and tablets from age 12.

Pregnancy: ibuprofen may be used in the first and second trimesters after checking with a doctor, but should be avoided in the third trimester, when it may cause serious problems with the baby's heart or kidneys.

Breastfeeding: guidance is mixed — see the note below.

• Use the lowest effective dose for the shortest time needed
• Elderly patients have a higher risk of stomach ulcers and side effects; a doctor may prescribe a stomach-protective medicine alongside it, and caution is advised from age 75 and in advanced (stage 4–5) kidney disease
• Use with caution if you take low-dose aspirin for heart protection, or have a history of stomach bleeding, stroke, heart attack, or blood clots
• Use with caution in asthma, heart disease, liver or kidney disease, high blood pressure, lupus, high cholesterol, Crohn's disease, or ulcerative colitis
• Use with caution during chickenpox, and in conditions that increase bleeding risk