IMPORTANT SAFETY INFORMATION ABOUT IBUPROFEN/NUROFEN – PLEASE READ!!:
Do NOT use Nurofen for chickenpox. Doing so may result in a potentially life-threatening skin-reaction. Use Calpol/paracetamol instead to treat fever and pain.
IBUPROFEN FOR STOMACH PAIN IS NOT RECOMMENDED:
Ibuprofen (Nurofen) is quite hard on the stomach and is not recommended for stomach pain as it could make it worse or even cause stomach ulcers. Use paracetamol instead to treat stomach pain or Gaviscon/Rennie if heartburn-related pain.
Ibuprofen is a painkiller used to mild-moderate pain. It also helps to relieve swelling and fever.
It falls under the drug class (Non-Steroidal Anti-Inflammatory Drugs; NSAIDs)
Ibuprofen normally comes as a tablet or capsule to be swallowed.
It may also come as a flavoured liquid for young children under 12 and those who have swallowing difficulties.
Ibuprofen tablets (generic)
Nurofen tablets (branded ibuprofen)
Nurofen liquid
Other Nurofen variants
Nurofen Express – fast-acting ibuprofen
Feminax – ibuprofen lysine for period pain
Nurofen cold and flu – ibuprofen with a decongestant
ABOUT IBUPROFEN
HOW TO GIVE/TAKE IBUPROFEN:
IBUPROFEN FOR CHILDREN
Ibuprofen can be bought for children from the age of 3 months and above, provided they weigh at least 5kg (11lbs). Most babies at 3 months will weigh over this.
The dose for children can vary greatly depending on their age
VERY IMPORTANT SAFETY INFORMATION: Child weight and giving Nurofen 4 times a day:
Ibuprofen is normally given 3 times a day with an interval of at least 6 hours in between doses. It can be given up to 4 times a day (in 24 hour period) under medical supervision if needed. If given 4 times a day, leave at least 4 hours in between doses.
However, the maximum daily Ibuprofen dose is weight based. Maximum 30mg/kg per day. Consider this before giving 4 times daily.
Eg: 1 year old female = 7kg (lower end)
Maximum daily dose = 30 x 7 = 210mg per day
Even the recommended Nurofen dose (between 1 and 3 years) of 5mL (100mg) THREE times daily = 300mg = over the recommended weight-based limit
In practice it’s OK to go a bit over
But FOUR times daily would be almost double the limit (400mg)!
Slightly over this limit is generally safe, especially in the short term as Ibuprofen has quite a “wide acceptable window”.
However overdosing in the long term can lead to potential adverse effects such as kidney and digestive system damage.
Be vigilant about your child’s weight before giving ibuprofen 4 times daily and only give if their weight allows it.
The variations and going even slightly over this limit can increase risk of adverse effects, which is why it is recommended for short-term use only, especially in children.
Speak to a doctor for further advice if child is:
- under 6 months old and need it for more than a day
- Over 6 months old and need it for more than 3 days
- Symptoms continue to get worse despite Nurofen treatment.
NUROFEN 3 MONTHS TO 12 YEARS (ALSO COMES IN 3 MONTHS TO 9 YEARS) – IBUPROFEN 100mg/5mL
Comes in either Strawberry or Orange flavour
Please see below for the correct dose by age:
For children over 5kg:
Nurofen must be taken with food.
3-5 months: 2.5mL (50mg), THREE times a day
6-11 months: 2.5mL (50mg), THREE TO FOUR times a day
1-3 years: 5mL (100mg), THREE times a day
4-6 years: 7.5mL (150mg), THREE times a day
7-9 years: 10mL (200mg). THREE times a day
10-12 years: 15mL (300mg), THREE times a day
Nurofen comes with a 5mL spoonful for measurements.
IBUPROFEN FOR ADULTS AND CHILDREN OVER 12
Ibuprofen must be taken with food.
Contact a doctor if 12-18 and symptoms do not improve within 3 days.
Contact a doctor if 18+ and symptoms to not improve within 10 days.
The usual dose for Ibuprofen (immediate release) for 12+ is 200-400mg, three times daily
200mg tablets
- Take 1-2 tablets THREE times daily
- No more than 6 tablets in 24 hours
- Leave at least 6 hour gap in between doses
400mg tablets
- Take 1 tablet THREE times daily
- Leave at least 6 hour gap
- No more than 3 tablets in 24 hours
Ibuprofen long lasting capsules, lasts up to 12 hours
- lasts up to 12 hours; normal ibuprofen lasts around 6-8 hours
300mg long-lasting (prolonged-release tablets)
- Take 1-2 capsules up to TWICE daily
- Leave at least 8 hours between doses
- No more than 4 capsules per 24 hours
Prescription doses of ibuprofen
Ibuprofen also exists in higher strengths of 600mg, immediate release and 800mg, prolonged release.
These are not available over-the-counter and have to be prescribed by a doctor.
IBUPROFEN IN PREGNANCY AND BREASTFEEDING
Pregnancy – should be avoided in majority of cases
First 6 months (first 2 trimesters)
- Avoid unless no alternative and doctor advises
Last 3 months (last trimester)
- Avoid. Can harm an unborn baby and can cause delivery problems.
- Harm to baby likelier during the later stages of pregnancy.
Ibuprofen can cause heart and kidney issues in unborn babies.
Breastfeeding – OK
- Is OK
ABOUT IBUPROFEN DRUG
Ibuprofen is a painkiller used for mild-moderate pain. It also helps to relieve swelling and fever.
It falls under the drug class (Non-Steroidal Anti-Inflammatory Drugs; NSAIDs)
HOW DOES IBUPROFEN WORK?
It blocks enzymes responsible for signalling pain, inflammation and fever (Cyclo-Oxygenase 1 and 2, COX-1 and 2)
WHO IS IBUPROFEN SUITABLE FOR?
Do not take ibuprofen if:
- Pregnant – unless in first 20 weeks and recommended by a doctor
- Currently have any bleeding from the digestive system (including stomach ulcers)
- Digestive system ulceration
- Severe heart failure
- Chickenpox infection (varicella)
- Previous bad reaction to ibuprofen or other NSAIDs (such as aspirin or naproxen) – involving digestive system bleeding, ulceration, worsening of asthma or allergic reaction.
- History of recurring digestive system bleeding or ulceration (at least two episodes)
- Any other current significant bleeding
- Severe liver impairment
- Severe kidney impairment
Use ibuprofen within caution if:
- Mild-moderate liver impairment
- Mild-moderate kidney impairment (avoid unless no alternatives – risk of fluid retention and kidney failure). Ibuprofen gel can be used within caution as even gel can affect kidney function.
- May mask symptoms of infection
- Systemic use
- Allergic disorders
- Heart problems
- Asthmatic (may worsen)
- Dehydration – Ibuprofen may impair kidney function
- Cerebrovascular disease – problems involving blood supply to brain
- Blood clot disorders – excessive bleeding caused by lack of blood clotting
- Connective-tissue disorders
- Inflammatory Bowel Diseases – Crohn’s disease and Ulcerative colitis (may be worsened)
- Elderly (risk of serious side-effects and fatalities)
- Heart failure
- Ischaemic heart disease – narrowed heart arteries
- Peripheral arterial disease – fat build up in arteries; restricting blood flow to legs
- High risk of heart problems or heart attack/stroke
- High blood pressure not well controlled – ibuprofen can raise blood pressure
FOR IBUPROFEN GEL:
Avoid contact with:
- Eyes
- Inflamed/broken skin
- Lips, mouth, nasal canals
- Not for use with dressings
- Applying too much can result in effects inside the body like asthma flare-up; some of the cream gets absorbed into the bloodstream especially when applied in high amounts
IBUPROFEN WITH OTHER MEDICATIONS
Ibuprofen can interfere with a number of medications including:
Other NSAIDS; aspirin, naproxen etc…
- Blood-thinning medications; clopidogrel, edoxaban, apixaban
- Steroid medications; beclometasone, dexamethasone, fluticasone, hydrocortisone
- Anti-cancer drugs; carboplatin,
- Some anitbiotics such as ciprofloxacin
- Men’s health medications; alprostadil, dapoxetine
- Lithium for bipolar disorder
- Methotrexate
- Antidepressants; sertraline, duloxetine, venlafaxine
The main concerns are increased risk of bleeding and ulceration
SIDE EFFECTS OF IBUPROFEN
Common side effects include
- Headache
- Nausea/vomiting
- Stomach pain
- Skin reactions
Stop taking and tell your doctor if these persist:
Heartburn, indigestion, feeling sick, stomach pain
Worsening of asthma or experiencing asthma symptoms.
Rash
Rare but Serious side effects – STOP taking the medication and seek immediate medication if experienced:
Call 999 (UK) or go to the hospital if:
- Intestinal bleeding – signs include: vomiting blood/coffee grounds, blood in the stool, bright red faeces, black tarry stools,
- Serious allergic reaction (anaphylaxis) – difficulty breathing, dizziness, tachycardia, peeling skin
- Kidney problems signs – back pain, urinating less or more than normal, cloudy urine, hematuria
- Shock – weakness in general, coldness, paleness, dizziness, rapid breathing, fast but weak pulse, thirsty and sick
- Aseptic meningitis signs – stiff neck, severe headache, nausea-vomiting, fever.
Severe skin reaction; DRESS syndrome – skin rash, fever, swelling of lymph nodes. Other Severe cutaneous adverse reactions (SCARs) may occur rarely
Seek an immediate doctors appointment (111 in UK) if:
- Fever, shortness of breath, fatigue, easier infected than usual, sore throat and/or easier bruising; sign of reduced blood count or other blood issues
- Yellowing of skin or eye whites – sign of liver damage
- Kidney damage – back pain, fever, blood in urine, shaking or generally unwell
Unknown frequency:
- Crohn’s disease worsening
- Increased risk of heart failure
- Fluid retention
- Breathing difficulties
- High blood pressure
OTHER WARNINGS AND PRECAUTIONS
- Take with food to minimise risk of digestive system side effects such as bleeding and ulcers.
- Ibuprofen may reduce female fertility; this stops upon stopping ibuprofen
SOURCES:
https://www.nhs.uk/conditions/necrotising-fasciitis/
https://www.nhs.uk/medicines/ibuprofen-for-children/how-and-when-to-give-ibuprofen-for-children/
https://bnfc.nice.org.uk/drugs/ibuprofen/
Shobz Pharmacy 