Ibuprofen

Ibuprofen is a non-steroidal anti-inflammatory drug (NSAID) originally marketed as Nurofen and since then under various other trademarks. It is used for relief of symptoms of arthritis, primary dysmenorrhea, fever, and as an analgesic, especially where there is an inflammatory component. Ibuprofen is know to have an antiplatelet (blood-thinning) effect.

Mechanism of action

Ibuprofen is an NSAID which is believed to work through inhibition of cyclooxygenase (COX), thus inhibiting prostaglandin synthesis. There are at least 2 variants of cyclooxygenase (COX-1 and COX-2). Ibuprofen inhibits both COX-1 and COX-2. It appears that its analgesic, antipyretic, and anti-inflammatory activity are achieved principally through COX-1 inhibition; whereas COX-2 inhibition is responsible for its unwanted effects on platelet aggregation and the GI mucosa.

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Adverse effects

Ibuprofen appears to have the lowest incidence of gastrointestinal adverse drug reactions (ADRs) of all the non-selective NSAIDs.However, this only holds true at lower doses of ibuprofen, so over-the-counter preparations of ibuprofen are generally labeled to advise a maximum daily dose of 1,200 mg.

Common adverse effects include: nausea, dyspepsia, gastrointestinal ulceration/bleeding, raised liver enzymes, diarrhea, epistaxis, headache, dizziness, unexplained rash, salt and fluid retention, and hypertension.

Infrequent adverse effects include: oesophageal ulceration, heart failure, hyperkalaemia, renal impairment, confusion, bronchospasm, and rash.

Very infrequent adverse effects include Stevens-Johnson syndrome.

Tradenames

Dorival, Espidifen (Spain), Herron Blue, Panafen, Motrin,Ibusal and Ibumax (Finland), Ipren or Ibumetin (Denmark and Sweden), Ibuprom (Poland),  Bupuren (South Korea), Nurofen (Turkey) and Eve (Japan)