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MUSCULO-SKELETAL SYSTEM › ANTIINFLAMMATORY AND ANTIRHEUMATIC PRODUCTS › ANTIINFLAMMATORY AND ANTIRHEUMATIC PRODUCTS, NON-STEROIDS › Propionic acid derivatives
ibuprofen, combinations
M01AE51
Forms & Strengths
- Ibuprofen / Pseudoephedrine: 200mg/30mg, 400mg/60mg tablets
- Ibuprofen / Oxycodone: 400mg/5mg tablets
- Ibuprofen / Famotidine: 800mg/26.6mg tablets
Adult Dosing
- Ibuprofen/Pseudoephedrine: 1-2 tablets every 4-6 hours as needed for nasal congestion and pain; max 6 tablets/24 hours
- Ibuprofen/Oxycodone: 1 tablet every 6 hours as needed for acute pain; max 5 days duration
- Ibuprofen/Famotidine: 1 tablet twice daily for osteoarthritis or rheumatoid arthritis
Pediatric Dosing
- Ibuprofen/Pseudoephedrine combinations: Not recommended for children under 12 years of age
- Ibuprofen/Oxycodone: Safety and efficacy not established in pediatric patients under 18 years
Indications
- Temporary relief of minor aches, pains, and sinus congestion associated with the common cold or flu
- Management of acute moderate to severe pain requiring opioid and NSAID combination
- Reduction of risk of NSAID-associated gastric ulcers in patients requiring ibuprofen for arthritis
Mechanism of Action
- Ibuprofen: Nonselective inhibitor of cyclooxygenase (COX-1 and COX-2), decreasing prostaglandin synthesis
- Pseudoephedrine: Alpha-adrenergic agonist causing vasoconstriction of nasal mucosa blood vessels
- Oxycodone: Mu-opioid receptor agonist providing central analgesia
- Famotidine: Histamine H2-receptor antagonist reducing gastric acid secretion
Contraindications
- Known hypersensitivity to ibuprofen, aspirin, or other NSAIDs
- History of asthma, urticaria, or allergic-type reactions after taking aspirin or other NSAIDs
- Setting of coronary artery bypass graft (CABG) surgery perioperative pain
- Active peptic ulcer disease or gastrointestinal bleeding
- Severe renal impairment or hepatic failure
Adverse Reactions
- Gastrointestinal: Dyspepsia, nausea, abdominal pain, GI ulceration or bleeding
- Cardiovascular: Hypertension, edema, myocardial infarction, stroke
- Central Nervous System: Dizziness, headache, nervousness or insomnia (from pseudoephedrine), somnolence (from opioids)
- Renal: Acute renal failure, hyperkalemia, fluid retention
Drug Interactions
- Anticoagulants and Antiplatelets: Increased risk of severe bleeding
- ACE inhibitors and ARBs: Diminished antihypertensive effect and increased risk of renal impairment
- Diuretics: Efficacy of diuretics may be reduced; increased risk of nephrotoxicity
- Lithium and Methotrexate: NSAIDs can decrease renal clearance, leading to toxic plasma levels
- CNS depressants (with opioid combinations): Enhanced sedation, respiratory depression, and hypotension
Curated Content: Needs Vetting Before Put to Clinical Use