Ibuprofen (Intravenous)

Overview

Ibuprofen is a medication commonly used to relieve pain or fever in adults and children. One form of Ibuprofen is provided by injection directly into the patient's vein to provide immediate relief. This form of Ibuprofen can be used either alone, or may be taken with other prescribed medications such as opioid analgesics.

The intravenous form of Ibuprofen is provided in a hospital setting, and administered by a healthcare professional.

Although Ibuprofen is a common medication, as an NSAID, there is a high potential for it to interact with many other medications, including non-prescription medications, as well as herbal supplements. Ibuprofen may cause certain medical conditions to worsen, or may result in common side effects, some of which may be serious. It is important that any patient taking Ibuprofen provide a complete medical history to their doctor, including a complete list of medications, prior to taking Ibuprofen.

Conditions Treated

  • Mild to severe pain or swelling
  • Fever

Type Of Medicine

  • Nonsteroidal anti-inflammatory drug (NSAID)

Side Effects

Ibuprofen has many potential side effects, some more serious than others. In some cases, a doctor may recommend that the patient continue taking Ibuprofen despite the potential for side effects, and he or she may prescribe additional medications or a modified dose of Ibuprofen to counter some of these side effects.

Side effects from taking IPB fall into several general categories. It can irritate the stomach, and can also impact breathing. For large doses, it is also possible that continued or excessive use of Ibuprofen can lead to kidney or liver damage.

Some of the side effects related to the digestive tract and the stomach are indigestion, heartburn, nausea, vomiting, excess gas or air in the intestine or stomach, passing gas, an acid or sour stomach, bloating or feeling full, and belching. Related to this are side effects impacting the intestines, such as constipation, abdominal or stomach pain, or diarrhea.

Ibuprofen can also be the cause or unwanted side effects relating to breathing. Some of these side effects include shortness of breath, wheezing, noisy or rattling breathing, or difficulty breathing either during activity or while resting. This may also include any pain or uncomfortable feelings in the throat, chest or stomach.

Certain side effects may indicate a more severe condition, impacting liver or kidney function. These side effects include cloudy urine, having difficulty urinating or having less volume of urine than usual, and abdominal cramping.

Additionally, some of the more common side effects include swelling in the fingers or hands, face, or legs and feet; having pale or washed-out skin color; itchiness of the skin; or any type of rash or lesions appearing on the skin.

More infrequently, some patients may experience more severe abdominal cramps, or have soreness or feel uncomfortable in the stomach area. These however are less common side effects.

For some of these common side effects, the condition may go away as the patient becomes adjusted to the medication. In other cases, the doctor may be able to prescribe or recommend an additional treatment to help relieve some of the discomfort cause by side effects of Ibuprofen. Patients should seek the advice of their doctor if they find the side effects do not resolve over a few days, or if there are any questions.

In addition to the side effects listed above, there are others that are considered to be rare, and potentially more severe, among patients taking Ibuprofen. Patients should contact their health care professional right away if they experience any of the following:

  • Leg, stomach or back pain
  • Gums that are bleeding
  • Peeling or blistering or loose skin
  • Blood in stools, urine
  • Black, tarry or bloody stools
  • Blurry vision
  • Feeling of burning in chest or stomach
  • Vision changes
  • Pain in the chest
  • Chills
  • Stools that are gray or clay colored
  • Hoarse cough
  • Dark urine
  • Decreased urine output
  • Difficulty breathing
  • Difficulty swallowing
  • Dilated neck veins
  • Dizziness
  • Dry mouth
  • Extreme fatigue
  • Fast, irregular, pounding, or racing heartbeat or pulse
  • Fever with or without chills
  • Frequent urination
  • General body swelling
  • General feeling of tiredness or weakness
  • Hair loss, thinning of hair
  • Headache
  • Hives or welts
  • Hostility
  • Impaired vision
  • High blood pressure
  • Increased volume of pale, dilute urine
  • Joint or muscle pain
  • Light-colored stools
  • Loss of appetite
  • Lower back or side pain
  • Mood changes include irritability, agitation or depression
  • Muscle twitching
  • Nosebleeds
  • Painful or difficult urination
  • Red, irritated eyes
  • Redness of skin
  • Seizures
  • Severe pain in the abdominal area, or other cramping, burning
  • Severe and continuing nausea
  • Sore throat
  • Sores, ulcers, or white spots in mouth or on lips
  • Stiff neck or back
  • Stupor
  • Swollen or painful glands
  • Tenderness in stomach area
  • Thirst
  • Tightness in chest
  • Unpleasant smelling breath
  • Pain on the upper right of the abdominal area
  • Vomiting blood
  • Vomiting a substance similar to coffee grounds
  • Eyes and skin that appear yellow

It is important for patients experiencing any of these rarer side effects to consult their doctor right away, as these side effects may indicate a more severe problem such as liver or kidney damage.

The above list is not intended to be a complete list of side effects. For any unwanted effects a patient may experience that cause usual discomfort or concern, patients should contact their doctor for more information. Patients may also report side effects to the FDA, at 1-800-FDA-1088.

Dosage

Dosage For Adults

For pain symptoms, the usual adult dose of Ibuprofen applied intravenously is 400 to 800 milligrams (mg) via an intravenous injection, given every 6 hours, as needed. The maximum dosage recommended for patients should not exceed 3600 mg per day.

For fever in an adult, the initial dose of Ibuprofen applied intravenously is 400 mg supplied once via an intravenous injection. Following this initial dose, additional doses of 100mg, 200mg or 400 mg may be supplied intravenously every 4 to 6 hours, as needed, as recommended by the physician. The maximum dose is 3200 mg per day.

Dosage For Children

To treat pain in a child between 6 months of age, up to 12 years old, 10 mg per kg of weight may be supplied intravenously, every 4 to 6 hours as needed, with the maximum recommended daily dose being the lesser of 40 mg/kg or 2400 mg per day. For children between 12 years and 17 years of age, 400 mg may be given intravenously every 4 to 6 hours as needed, up to 2400 mg per day.

To treat fever in a child between 6 months of age, up to 12 years old, 10 mg per kg of weight may be supplied intravenously, every 4 to 6 hours as needed, with the maximum recommended daily dose being the lesser of 40 mg/kg or 2400 mg per day. For children between 12 years and 17 years of age, 400 mg may be given intravenously every 4 to 6 hours as needed, up to 2400 mg per day.

Major Drug Interactions:

All medications have the potential to interact with other pharmaceuticals which a patient may be taking. It is important that, prior to taking Ibuprofen, patients inform their doctor about all medications, both prescription and non-prescription (over the counter) which they may be taking. A complete list of medications should include dosages and frequency.

Use of Ibuprofen is not recommended if the patient is also taking the drug Ketorolac. The physician may decide not to treat with Ibuprofen in this case, or may modify the patient's prescription.

For the following list of medications, it is not in most cases recommended to take Ibuprofen with any of these, except with under the direction of the doctor. The doctor may determine that the patient can safely take either or both medications, and may recommend a change to the patient's dosage or frequency of either or both. Patients should inform their doctor if they are taking any of the following prior to taking Ibuprofen injections:

  • Acalabrutinib
  • Acetaminophen / aluminum hydroxide / aspirin / caffeine / magnesium hydroxide
  • Acetaminophen / aspirin
  • Acetaminophen / aspirin / caffeine
  • Acetaminophen / aspirin / caffeine / salicylamide
  • Acetaminophen / aspirin / diphenhydramine
  • Acetaminophen / aspirin / phenylpropanolamine
  • Adefovir
  • Aluminum hydroxide / aspirin / calcium carbonate / magnesium hydroxide
  • Anisindione
  • Apixaban
  • Ardeparin
  • Aspirin
  • Betrixaban
  • Bisacodyl / sodium biphosphate / sodium phosphate
  • Botulism immune globulin
  • Cabozantinib
  • Cidofovir
  • Cytomegalovirus immune globulin
  • Dabigatran
  • Dalteparin
  • Danaparoid
  • Dasatinib
  • Deferasirox
  • Desirudin
  • Diatrizoate
  • Diatrizoate / iodipamide
  • Dicumarol
  • Drotrecogin alfa
  • Edoxaban
  • Efavirenz / emtricitabine / tenofovir
  • Emtricitabine / lopinavir / ritonavir / tenofovir
  • Emtricitabine / nelfinavir / tenofovir
  • Enoxaparin
  • Fondaparinux
  • Hyoscyamine / methenamine / methylene blue / phenyl salicylate / sodium biphosphate
  • Hyoscyamine / methenamine / methylene blue / sodium biphosphate
  • Ibritumomab
  • Ibrutinib
  • Immune globulin intravenous
  • Immune globulin intravenous and subcutaneous
  • Iodamide
  • Iodine i 131 tositumomab
  • Iodipamide
  • Iodixanol
  • Iohexol
  • Iopamidol
  • Iopromide
  • Iothalamate
  • Ioversol
  • Ioxaglate
  • Ioxilan
  • Ketorolac
  • Leflunomide
  • Lithium
  • Lomitapide
  • Methenamine / sodium biphosphate
  • Methotrexate
  • Metrizamide
  • Mipomersen
  • Omacetaxine
  • Panobinostat
  • Ponatinib
  • Prasugrel
  • Ramucirumab
  • Regorafenib
  • Respiratory syncytial virus immune globulin
  • Rivaroxaban
  • Sirolimus
  • Sodium biphosphate / sodium phosphate
  • Tacrolimus
  • Teriflunomide
  • Tinzaparin
  • Tositumomab
  • Vorapaxar
  • Warfarin

Patients taking Ibuprofen should also inform their doctor if they are using alcohol or tobacco, as either of these taken with Ibuprofen may result in additional unwanted side effects. The doctor may make certain recommendations regarding the patient's use of these, as well as food recommendations.

Warnings

Patients taking Ibuprofen who also have pre-existing medical conditions may experience unwanted side effects or may risk their condition becoming worse. Prior to taking Ibuprofen intravenously, patients should inform their doctor if they have any of the following medical conditions or have a history of any of the following:

  • Anemia
  • Aspirin sensitivity
  • Asthma
  • Bleeding problems
  • Edema (fluid retention)
  • Heart conditions, including congestive heart failure or heart attack
  • Renal Toxicities
  • Thrombosis
  • Hepatotoxicity
  • Hyperkalemia (high levels of potassium in the blood)
  • Hypertension (high blood pressure)
  • Hypovolemia (low blood volume)
  • Kidney disease
  • Liver disease
  • Stomach ulcers or bleeding
  • Stroke'use of Ibuprofen may make this condition worse
  • Systemic lupus erythematosus (SLE'use of Ibuprofen may make this condition worse
  • Platelet Aggregation Inhibition

When being given Ibuprofen intravenously, it is important that the patient be well hydrated prior to being given this medication, in order to avoid any negative side effects regarding kidney function.

During treatment, the doctor will review the patient's progress and may administer blood or urine tests in order to determine if it is working as needed.

Ibuprofen intravenous may increase the risk of the patient having a stroke or heart attack. This risk is higher in patients with a history of heart disease. In addition, patients who take Ibuprofen for long periods of time may also have an increased risk. Patients should inform the doctor immediately if they experience any side effects such as chest pain that spreads to arms, neck, jaw or back, or if the patient experiences any difficulty breathing, slurred speech, unusual or excessive sweating, or feeling faint or dizzy.

Ibuprofen may increase the possibility of bleeding, especially in the stomach or intestines. This risk is higher in patients who have a history of ulcers, who drink alcohol or smoke, are more than 60 years old, are not in good health, or are using medications such as steroid or blood thinners. This side effect may occur without warning or obvious symptoms.

Ibuprofen may lead to liver problems. Patients should contact their doctor immediately if they experience any of the following symptoms: dark stools or urine; abdominal pain or soreness; stomach pain or soreness; headache; fever; nausea; vomiting; reduced appetite; swelling in the feet or legs; unusual lethargy or weakness; or yellowish skin or eyes.

Use of Ibuprofen can also lead to the body retaining fluids, which appears as rapid weight gain; difficulty breathing or shortness of breath; having chest pain; feeling excessively tired; or unusual or extreme swelling of hands, feet, ankles or wrists. Patients should contact their doctor immediately if these symptoms appear.

Use of Ibuprofen may also result in kidney damage. Symptoms of kidney problems include feeling confused or dizzy; having a headache; sudden weight gain; swelling in the face, hands or ankles; and feeling unusually tired or weak. Patients should contact their doctor immediately if they experience any of these symptoms.

It is possible that hyperkalemia (high potassium levels in the blood) may occur while taking Ibuprofen. Patients should contact their doctor immediately if they experience confusion, a feeling of being tired or weak, an irregular heartbeat, difficulty breathing, or any tingling or numbness of lips, hands, or feet.

Some patients taking Ibuprofen may experience a severe allergic reaction, which may include anaphylaxis, a potentially deadly reaction needing emergency medical attention. Patients should inform their doctor immediately if, following an injection, they experience any difficulty breathing, difficulty speaking or swallowing, a rash or itching, or any swelling of the face, hands or mouth.

Ibuprofen may cause a reaction on the skin as a side effect, such as peeling or blistering, any kind of rash or lesion, unusual acne, surface ulcers or sores, or chills or fever. Patients should inform their doctor right away if they experience any of these symptoms.

Use of Ibuprofen is not recommended for pregnant women, as it may harm the unborn child. Women should inform their doctor if they believe they may be pregnant while taking this medication.

Ibuprofen has been known to impact a serious condition known as aseptic meningitis syndrome (AMS). Patients should inform their doctor right away in the event of symptoms such as feeling tired or drowsy, having fever, severe headache, nausea, vomiting, or sudden sensitivity to light or painful eye movements.

Due to the possibility of Ibuprofen interacting with other medications, patients should not take this medication without providing a complete list of other medications to the doctor, including over the counter medications, supplements and herbal remedies.

Storage

This medication is administered in the course of surgery by a doctor, and storage by the patient is not needed. This drug will be normally kept in a cool, dry and secure place in a hospital setting.

Summary

Ibuprofen intravenous route is a nonsteroidal anti-inflammatory drug, prescribed to relieve pain or fever in adults and children. Ibuprofen may be taken alone, or it may be prescribed in combination with other medications such as opioid analgesics.

Ibuprofen intravenous route is provided by prescription only, and is administered to patients in a hospital setting by a healthcare professional.

Ibuprofen has the potential to interact with many other drugs, including over the counter medications and supplements. Patients with some medical conditions may be unable to take Ibuprofen due to the potential impact on their condition or due to side effects. All patients taking Ibuprofen must provide a complete medical history to their doctor prior to taking Ibuprofen.