Ibuprofen is a non-steroidal anti-inflammatory drug, or NSAID. It is a propionic acid derivative, and was the first in this group to be introduced. It is popular as an OTC analgesic-antipyretic drug, and is used in both children and adults.
Mechanism of action
Ibuprofen is a non-selective inhibitor of the cyclo-oxygenase (COX 1 and 2) enzymes, which are involved in prostaglandin synthesis. It reduces fever, inflammation and pain by its action on this pathway which plays an important role in inducing inflammation.
It is officially classified under the categories of analgesic, antirheumatic, musculoskeletal agent, and anti-migraine agent.
Uses
Ibuprofen has several important clinical applications, which include:
Patent Ductus Arteriosus (PDA)
PDA is a complication of prematurity, and is usually treated with another NSAID, indomethacin. However, this has serious adverse effects, and therefore ibuprofen has been studied for this use. Currently, it is considered as effective as indomethacin for the closure of PDA.
Arthritic disorders
Inflammatory and rheumatic conditions like rheumatoid arthritis and osteoarthritis respond well to ibuprofen in non-toxic doses, with high effectiveness. Thus a daily dosage of 2400 mg is sufficient to bring about full healing in cases of gouty arthritis, within 72 hours. This dose is also well-tolerated. However, gastric inflammation and hyperacidity do occur in up to a third of cases.
Dental pain
Ibuprofen is widely used after dental procedures, as well as to manage pain arising from the face and the mouth, whether acute or chronic.
Cystic fibrosis
Ibuprofen in higher doses than usual is very useful in reducing lung inflammation, because it inhibits the entry of polymorphonuclear cells. It has been observed that these patients tolerate the drug well and do not have gastrointestinal side effects.
Other common uses
These include dysmenorrhea, fever and headache, orthostatic hypotension. Its use as a preventive for Alzheimer’s disease by reducing the degeneration of cerebral neurons, in Parkinson’s disease by reducing inflammation and oxidative stress which may trigger the disease, and in breast cancer.
Risks of ibuprofen use
- Like most NSAIDs, ibuprofen may increase the incidence of heart attacks or strokes, and the risk may increase with the period of use and with the dosage.
- Death rates in the first year following a first heart attack showed a positive correlation with NSAID use during this period.
- Heart failure may occur with NSAID use.
- Gastrointestinal disease, including ulcers, bleeding or perforations, may occur with NSAID use. Risk factors include prolonged period of use, poor health, older age, three or more drinks a day, the use of other NSAIDs, the use of anticoagulants, and the use of oral steroids. However, these may occur without warning as well.
Side effects of ibuprofen
Ibuprofen is generally safe, but may cause adverse reactions in some patients. If these are severe or prolonged medical aid is necessary. These include:
- constipation or diarrhea
- bloating of the abdomen
- dizziness
- nervousness
- tinnitus
Symptoms of overdosage
An overdose of ibuprofen may manifest as:
- vertigo,
- nystagmus,
- slow breathing or apneic episodes, and
- cyanosis
References
Further Reading