(more common in patients with pre-existing renal
impairment).respiratory tract reaction
SIDE-EFFECTS, FURTHER INFORMATIONFor information
about cardiovascular and gastrointestinal side-effects, and
a possible exacerbation of symptoms in asthma, see Non-
steroidal anti-inflammatory drugs p. 650.
OverdoseOverdosage with ibuprofen may cause nausea,
vomiting, epigastric pain, and tinnitus, but more serious
toxicity is very uncommon. Charcoal, activated followed by
symptomatic measures are indicated if more than
100 mg/kg has been ingested within the preceding hour.
For details on the management of poisoning, see
Emergency treatment of poisoning p. 832.
lALLERGY AND CROSS-SENSITIVITYContra-indicated in
patients with a history of hypersensitivity to aspirin or any
other NSAID—which includes those in whom attacks of
asthma, angioedema, urticaria or rhinitis have been
precipitated by aspirin or any other NSAID.
lPREGNANCYAvoid unless the potential benefit outweighs
the risk. Avoid during the third trimester (risk of closure of
fetal ductus arteriosusin uteroand possibly persistent
pulmonary hypertension of the newborn); onset of labour
may be delayed and duration may be increased.
lBREAST FEEDINGUse with caution during breast-feeding.
Amount too small to be harmful but some manufacturers
advise avoid.
lHEPATIC IMPAIRMENT
▶With intravenous useIncreased risk of gastro-intestinal
bleeding andfluid retention. Avoid in severe liver disease.
▶With oral useUse with caution; there is an increased risk of
gastro-intestinal bleeding andfluid retention. Avoid in
severe liver disease.
lRENAL IMPAIRMENT
▶With intravenous useAvoid if possible in severe impairment.
▶With oral useAvoid if possible or use with caution. Avoid in
severe impairment.
Dose adjustments▶With intravenous useUse lowest
effective dose.
▶With oral useThe lowest effective dose should be used for
the shortest possible duration.
MonitoringIn renal impairment monitor renal function;
sodium and water retention may occur and renal function
may deteriorate, possibly leading to renal failure.
lMONITORING REQUIREMENTS
▶With intravenous useMonitor for bleeding. Monitor gastro-
intestinal function.
lDIRECTIONS FOR ADMINISTRATIONForslow intravenous
injection, give over 15 minutes, preferably undiluted. May
be diluted with Glucose 5 %orSodium Chloride 0. 9 %.
lPRESCRIBING AND DISPENSING INFORMATIONFlavours of
syrup may include orange.
lPATIENT AND CARER ADVICE
Medicines for Children leaflet: Ibuprofen for pain and
inflammationwww.medicinesforchildren.org.uk/ibuprofen-for-
pain-and-inflammation
lPROFESSION SPECIFIC INFORMATION
Dental practitioners’formulary
Ibuprofen Oral Suspension Sugar-free may be prescribed.
Ibuprofen Tablets may be prescribed.
lEXCEPTIONS TO LEGAL CATEGORYOral preparations can be
sold to the public in certain circumstances.lMEDICINAL FORMS
There can be variation in the licensing of different medicines
containing the same drug. Forms available from special-order
manufacturers include: oral suspension
Effervescent granules
CAUTIONARY AND ADVISORY LABELS13, 21
ELECTROLYTES:May contain Sodium
▶Brufen(Mylan)
Ibuprofen 600 mgBrufen 600 mg effervescent granules sachets|
20 sachetP£ 6. 80 DT = £ 6. 80
Modified-release tablet
CAUTIONARY AND ADVISORY LABELS25, 27
▶Brufen Retard(Mylan)
Ibuprofen 800 mgBrufen Retard 800 mg tablets| 56 tabletP
£ 7. 74 DT = £ 7. 74
Tablet
CAUTIONARY AND ADVISORY LABELS 21
▶Ibuprofen (Non-proprietary)
Ibuprofen 200 mgIbuprofen 200 mg tablets| 16 tabletp£ 0. 25 |
24 tabletp£ 0. 91 DT = £ 0. 66 | 48 tabletp£ 0. 80 – £ 1. 47 |
84 tabletp£ 3. 29 DT = £ 2. 31 | 96 tabletp£ 1. 69
Ibuprofen 200 mg caplets| 16 tabletp£ 0. 25 | 24 tabletpsDT =
£ 0. 66
Ibuprofen 400 mgIbuprofen 400 mg tablets| 250 tabletP
£ 10. 54
Ibuprofen 600 mgIbuprofen 600 mg tablets| 84 tabletP£ 6. 95
DT = £ 3. 60
Ibuprofen 600 mg tablets film coated| 84 tabletP£ 3. 60 DT =
£ 3. 60
▶Brufen(Mylan)
Ibuprofen 400 mgBrufen 400 mg tablets| 60 tabletP£ 4. 90
Ibuprofen 600 mgBrufen 600 mg tablets| 60 tabletP£ 7. 34
▶Ibucalm(Aspar Pharmaceuticals Ltd)
Ibuprofen 200 mgIbucalm 200 mg tablets| 24 tabletp£ 0. 77 DT =
£ 0. 66 | 48 tabletp£ 1. 43 | 96 tabletp£ 2. 43
Ibuprofen 400 mgIbucalm 400 mg tablets| 16 tabletp£ 0. 88 |
24 tabletp£ 1. 36 DT = £ 1. 01 | 48 tabletp£ 2. 44 | 96 tabletp
£ 4. 19
▶Nurofen(Reckitt Benckiser Healthcare (UK) Ltd)
Ibuprofen 200 mgNurofen 200 mg caplets| 24 tabletp£ 2. 49 DT =
£ 0. 66
Nurofen 200 mg tablets| 24 tabletp£ 2. 38 DT = £ 0. 66 |
48 tabletp£ 4. 36 | 96 tabletp£ 7. 20
Ibuprofen (as Ibuprofen lysine) 400 mgNurofen Maximum
Strength Migraine Pain 684 mg caplets| 12 tabletp£ 3. 49
Oral suspension
CAUTIONARY AND ADVISORY LABELS 21
▶Ibuprofen (Non-proprietary)
Ibuprofen 20 mg per 1 mlIbuprofen 100 mg/ 5 ml oral suspension|
500 mlP£ 6. 45
▶Brufen(Mylan)
Ibuprofen 20 mg per 1 mlBrufen 100 mg/ 5 ml syrup| 500 mlP
£ 8. 88 DT = £ 8. 88
Modified-release capsule
▶Nurofen Back Pain SR(Reckitt Benckiser Healthcare (UK) Ltd)
Ibuprofen 300 mgNurofen Back Pain SR 300 mg capsules|
24 capsulep£ 4. 20 DT = £ 4. 20
Solution for infusion
▶Pedea(Orphan Europe (UK) Ltd)
Ibuprofen 5 mg per 1 mlPedea 10 mg/ 2 ml solution for infusion
ampoules| 4 ampouleP£ 288. 00 (Hospital only)
Chewable capsule
▶Nurofen(Reckitt Benckiser Healthcare (UK) Ltd)
Ibuprofen 100 mgNurofen for Children 100 mg chewable capsules|
12 capsulep£ 3. 23
Capsule
▶Ibuprofen (Non-proprietary)
Ibuprofen 200 mgIbuprofen 200 mg capsules| 30 capsulepsDT
=£ 4. 39
Ibuprofen 400 mgIbuprofen 400 mg capsules| 20 capsulepsDT
=£ 5. 82
▶Flarin(infirst Healthcare Ltd)
Ibuprofen 200 mgFlarin 200 mg capsules| 30 capsulep£ 6. 85 DT
=£ 4. 39
▶Nurofen Express(Reckitt Benckiser Healthcare (UK) Ltd)
Ibuprofen 200 mgNurofen Express 200 mg liquid capsules|
30 capsulep£ 4. 39 DT = £ 4. 39656 Pain and inflammation in musculoskeletal disorders BNFC 2018 – 2019
Musculoskeletal system10