Ibuprofen is used orally for anti-inflammatory and analgesic effects in the symptomatic treatment of rheumatoid arthritis, juvenile rheumatoid arthritis, and osteoarthritis. Ibuprofen also is used orally to relieve mild to moderate pain and for the management of primary dysmenorrhea.
Ibuprofen has been used orally in the management of pericarditis.
Ibuprofen also may be used orally for self-medication for analgesic effects to provide temporary relief of minor aches and pains, including those of arthritis, and of dysmenorrhea and for its antipyretic effect to reduce fever.
Ibuprofen is used IV to relieve mild to moderate pain, to relieve moderate to severe pain (in conjunction with opiates), and to reduce fever.
Ibuprofen lysine is used IV in the treatment of patent ductus arteriosus (PDA) in premature neonates.
The potential benefits and risks of ibuprofen therapy as well as alternative therapies should be considered prior to initiating ibuprofen therapy. The lowest possible effective dosage and shortest duration of therapy consistent with treatment goals of the patient should be employed.
Rheumatoid Arthritis, Juvenile Arthritis, and Osteoarthritis
Ibuprofen is used orally for anti-inflammatory and analgesic effects in the symptomatic treatment of acute and chronic rheumatoid arthritis and osteoarthritis. Ibuprofen is also used orally for anti-inflammatory and analgesic effects in the symptomatic treatment of nonarticular (e.g., muscular) inflammation.
When used in the treatment of rheumatoid arthritis, ibuprofen has relieved pain and stiffness, reduced swelling, and improved grip strength and joint flexion. The drug does not, however, alter the basic rheumatoid process. Most clinical studies have shown that the analgesic and anti-inflammatory effects of ibuprofen in the treatment of rheumatoid arthritis and/or osteoarthritis are greater than those of placebo, about equal to those of salicylates or indomethacin and less than those of phenylbutazone or prednisolone. Patient response to oral NSAIAs is variable; patients who do not respond to or cannot tolerate one NSAIA might be successfully treated with a different agent. However, NSAIAs generally are contraindicated in patients in whom sensitivity reactions (e.g., urticaria, bronchospasm, severe rhinitis) are precipitated by aspirin or other NSAIAs.
(See Cautions: Precautions and Contraindications.)
In the management of rheumatoid arthritis in adults, NSAIAs may be useful for initial symptomatic treatment; however, NSAIAs do not alter the course of the disease or prevent joint destruction. Disease modifying antirheumatic drugs (DMARDs) (e.g., abatacept, adalimumab, anakinra, etanercept, hydroxychloroquine, infliximab, leflunomide, methotrexate, minocycline, rituximab, sulfasalazine) have the potential to reduce or prevent joint damage and to preserve joint integrity and function. DMARDs are used in conjunction with anti-inflammatory agents (i.e., NSAIAs, intra-articular and oral glucocorticoids) and physical and occupational therapies for the management of rheumatoid arthritis. DMARD therapy should be initiated early in the disease course to prevent irreversible joint damage. For further information on the treatment of rheumatoid arthritis, including considerations in selecting a DMARD regimen, .
Ibuprofen is used orally in the symptomatic management of juvenile rheumatoid arthritis. In a very limited number of patients with juvenile rheumatoid arthritis receiving alternate-day corticosteroid therapy, ibuprofen relieved joint stiffness when administered on the corticosteroid ''off'' day.
Other Inflammatory Conditions
Ibuprofen has been used with some success in other inflammatory diseases including ankylosing spondylitis, gout, and psoriatic arthritis.
Ibuprofen has been used to reduce the pain, fever, and inflammation of pericarditis; however, in the treatment of post-myocardial infarction pericarditis, NSAIAs are potentially harmful and aspirin is considered the treatment of choice. (
See Cautions: Cardiovascular Effectsand Cautions: Precautions and Contraindications.)
Ibuprofen is used orally or IV for the relief of mild to moderate pain. Ibuprofen also may be used orally for self-medication for the temporary relief of minor aches and pains associated with the common cold, influenza, or sore throat; headache (including migraine); toothache; muscular aches; backache; and minor pain of arthritis.
Some experts state that an NSAIA (e.g., ibuprofen) is a reasonable first-line therapy for mild to moderate migraine attacks or for severe attacks that have responded in the past to similar NSAIAs or non-opiate analgesics. For further information on management and classification of migraine headache,
Ibuprofen has been used to relieve postoperative pain (including that associated with dental or orthopedic surgery or episiotomy). In the relief of postoperative pain, ibuprofen has been shown to be more effective than placebo or propoxyphene and at least as effective as aspirin.
Ibuprofen has been used IV in conjunction with opiates to relieve pain following abdominal hysterectomy, other abdominal surgical procedures, or orthopedic surgery.
The fixed-combination preparation containing ibuprofen and hydrocodone bitartrate is used in the short-term (less than 10 days) treatment of acute pain.
The fixed-combination preparation containing ibuprofen and oxycodone hydrochloride is used in the short-term (no more than 7 days) treatment of acute moderate to severe pain.
Ibuprofen is used orally for the relief of primary dysmenorrhea. Ibuprofen also may be used for self-medication for the relief of pain of menstrual cramps (dysmenorrhea). Ibuprofen has been used to relieve dysmenorrhea associated with insertion of an intrauterine contraceptive device.
When used to relieve dysmenorrhea, ibuprofen has been reported to be as effective as mefenamic acid and more effective than placebo, aspirin, or propoxyphene. In patients with primary dysmenorrhea, ibuprofen has reduced resting and active intrauterine pressure and the frequency of uterine contractions, probably as a result of inhibition of prostaglandin synthesis.
Ibuprofen is used orally or IV to reduce fever. Ibuprofen also may be used orally for self-medication to reduce fever.
When used to lower body temperature in febrile children (6 months-12 years of age) with viral infections and temperatures of 39°C or less, single ibuprofen doses of 10 mg/kg have been as effective as single ibuprofen doses of 5 mg/kg or single acetaminophen doses of 10-15 mg/kg; however, in children with temperatures exceeding 39°C, single 10-mg/kg doses of ibuprofen were most effective.
Patent Ductus Arteriosus
Ibuprofen lysine is used IV in the treatment of patent ductus arteriosus (PDA) in premature neonates and is designated an orphan drug by the US Food and Drug Administration (FDA) for use in this condition. The drug is used IV to promote closure of a clinically important PDA in premature neonates weighing 500-1500 g who are no more than 32 weeks' gestational age when usual medical management (e.g., fluid restriction, diuretics, respiratory support) is ineffective. Ibuprofen lysine has been evaluated in premature neonates with echocardiographic evidence of PDA who were asymptomatic from their PDA at the time of study enrollment. Efficacy was determined by the need for rescue therapy (indomethacin, open-label ibuprofen, or surgery) for a hemodynamically important PDA through study day 14. Rescue therapy was indicated if the neonate developed a hemodynamically important PDA that was confirmed by echocardiograph. Rescue therapy was required by 25% of neonates receiving ibuprofen compared with 48% of those receiving placebo. Neonates enrolled in this study were followed for a short period of time (up to 8 weeks) following treatment; long-term consequences of such therapy have not been determined. Use of the drug should be reserved for neonates with clinically important PDA.
Results from a large, prospective, population-based cohort study in geriatric individuals indicate a lower prevalence of Alzheimer's disease among patients who received a NSAIA for 2 years or longer. Similar findings have been reported from some other, but not all, observational studies.