IBUMEX SUSPENSION

Indications

• Mild to moderate pain
• Fever
• Inflammation
• Arthritis
• Musculoskeletal disorders
• Menstrual cramps

Dosage

Children: Refer to the BNF for Children for appropriate dosing based on age and weight.

Adults: Refer to specific dosing guidelines based on clinical scenario and patient factors.

Mechanism of action

Ibuprofen exerts its effects primarily through the inhibition of cyclooxygenase (COX) enzymes, COX-1 and COX-2. This inhibition leads to a decrease in the synthesis of prostaglandins, which are mediators of pain, inflammation, and fever. By reducing prostaglandin levels, ibuprofen effectively alleviates pain and inflammation.

Pharmacodynamics

The analgesic effects of ibuprofen typically begin within 30 minutes to 1 hour after oral administration, peaking in effect within 1 to 2 hours. The anti-inflammatory effects may take longer to manifest, often requiring several days of treatment to achieve optimal results. Ibuprofen's antipyretic effects are also due to its action on the hypothalamic heat-regulating center, leading to a reduction in fever.

Pharmacokinetics

Ibuprofen is rapidly absorbed from the gastrointestinal tract, with peak plasma concentrations occurring approximately 1 to 2 hours after oral intake. It is highly protein-bound, primarily to albumin. The drug is metabolized mainly in the liver through cytochrome P450 enzymes, and its metabolites are excreted primarily via the kidneys. The elimination half-life of ibuprofen ranges from 1.8 to 2 hours, depending on individual patient factors such as age and renal function.

Contra-indications

• Hypersensitivity to ibuprofen or any components of the formulation
• Active or history of recurrent peptic ulcer/haemorrhage
• Severe heart failure
• Severe hepatic impairment
• Severe renal impairment
• Third trimester of pregnancy

Adverse effects

• Gastrointestinal discomfort
• Nausea
• Vomiting
• Diarrhea
• Constipation
• Dizziness
• Headache
• Rash
• Increased blood pressure
• Risk of cardiovascular events
• Renal toxicity

Interactions

• Anticoagulants (e.g., warfarin) may increase the risk of bleeding
• Other NSAIDs may increase the risk of gastrointestinal side effects
• ACE inhibitors and diuretics may have reduced efficacy
• Lithium levels may increase, leading to toxicity
• Methotrexate may have increased toxicity

Precautions

• Use with caution in patients with cardiovascular disease
• Monitor renal function in patients with renal impairment
• Assess gastrointestinal history before use
• Caution in patients with asthma, as NSAIDs may exacerbate symptoms
• Avoid in the elderly unless supervised

Pregnancy

Use is contraindicated during the third trimester. In the first and second trimesters, use only if clearly needed and after careful evaluation of risks and benefits.

Breast-feeding

Ibuprofen is generally considered safe for use during breastfeeding, but should be used with caution and for the shortest duration necessary.

Storage

Store in a cool, dry place, away from direct sunlight. Keep out of reach of children.

Formulations

• Tablets
• Capsules
• Oral suspension
• Topical gel