Ibuprofen Gen.Orph (Ibuprofen)

Ibuprofen injection acts systemically to reduce pain, fever, and inflammation by inhibiting cyclooxygenase enzymes.

• Pain: Provides rapid relief of moderate to severe acute pain when oral NSAIDs are unsuitable.
• Fever: Lowers elevated body temperature in patients with high fever unresponsive to oral antipyretics.
• Inflammation: Decreases swelling and inflammatory response in acute musculoskeletal or postoperative settings.

• Ibuprofen exerts its effect by non‑selectively inhibiting cyclooxygenase‑1 (COX‑1) and cyclooxygenase‑2 (COX‑2) enzymes, which catalyze the conversion of arachidonic acid to prostaglandins. Reduced prostaglandin synthesis diminishes peripheral sensitization of nociceptors, lowers the hypothalamic set‑point for temperature regulation, and limits inflammatory mediator release, resulting in analgesic, antipyretic, and anti‑inflammatory actions. The inhibition is reversible and dose‑dependent, allowing titration of therapeutic effect while maintaining a safety margin.

Intravenous ibuprofen may be associated with a range of adverse reactions, varying from mild to severe.

Common Side Effects

• Nausea: mild stomach upset or queasiness.
• Dyspepsia: discomfort or pain in the upper abdomen.
• Headache: transient head pain.
• Injection site pain: local discomfort at the infusion site.
• Elevated liver enzymes: mild, transient increase in hepatic transaminases.

Serious or Rare Side Effects

• Gastrointestinal bleeding: serious bleeding in the stomach or intestines.
• Renal impairment: reduced kidney function or acute kidney injury.
• Hypersensitivity reactions: rash, itching, swelling, or anaphylaxis.
• Cardiovascular events: increased risk of thrombotic events such as myocardial infarction.
• Severe skin reactions: Stevens‑Johnson syndrome or toxic epidermal necrolysis.

Before administering ibuprofen injection, consider the following precautions to ensure safe use.

• Renal function: assess baseline kidney function and avoid use in severe renal impairment.
• Gastrointestinal risk: use cautiously in patients with a history of ulcer disease or GI bleeding.
• Cardiovascular status: monitor patients with hypertension, heart failure, or known thrombotic risk.
• Hepatic health: evaluate liver enzymes in patients with existing liver disease.
• Concomitant anticoagulants: exercise caution when combined with warfarin, heparin, or other anticoagulants.
• Store at 2-8°C: keep refrigerated, protect from light, do not freeze or shake.

Ibuprofen can interact with several medicines; awareness of major and moderate interactions helps prevent adverse outcomes.

Major Interactions (Avoid)

• Anticoagulants: increased bleeding risk when combined with warfarin, direct oral anticoagulants, or heparin.
• High‑dose aspirin: additive gastrointestinal toxicity and reduced antiplatelet effect.
• ACE inhibitors/ARBs: may diminish renal protective effects and increase risk of renal dysfunction.
• Lithium: ibuprofen can raise lithium serum levels, risking toxicity.
• Methotrexate: reduced clearance leading to heightened toxicity.

Moderate Interactions (Monitor Closely)

• Diuretics: may potentiate renal impairment, especially in volume‑depleted patients.
• Selective serotonin reuptake inhibitors (SSRIs): modest increase in bleeding tendency.
• Corticosteroids: additive risk of gastrointestinal ulceration.
• Cyclosporine: enhanced nephrotoxicity when used together.
• Antihypertensives: possible attenuation of antihypertensive effect.