Drugs List

Therapeutic Indications

Uses

Fever
Moderate pain: acute treatment

Administration

To be administered as an intravenous infusion for 30 minutes.

Contraindications

Children under 18 years
Varicella
Asthma, urticaria or acute rhinitis associated with NSAIDS
Cerebrovascular haemorrhage
History of angioedema
History of bronchospasm
History of gastrointestinal bleeding
History of peptic ulcer
Severe cardiac failure
Severe dehydration
Severe hepatic impairment
Severe renal impairment
Third trimester of pregnancy
Thrombocytopenia

Precautions and Warnings

Allergic disposition
Elderly
Females attempting to conceive
Restricted sodium intake
Risk factors for cardiovascular disorder
Risk factors for disseminated intravascular coagulation
Surgery
Tobacco smoking
Acute porphyria
Asthma
Breastfeeding
Cerebrovascular disorder
Chronic obstructive pulmonary disease
Congestive cardiac failure
Crohn's disease
Dehydration
Diabetes mellitus
First trimester of pregnancy
Hepatic impairment
History of gastrointestinal disorder
Hyperlipidaemia
Hypertension
Ischaemic heart disease
Occlusive peripheral arterial disease
Renal impairment
Second trimester of pregnancy
Systemic lupus erythematosus
Ulcerative colitis
Uncontrolled hypertension

Contains more than 1 mmol (23 mg) sodium per dose
May mask symptoms or signs of infections
Reduce dose in patients with hepatic impairment
Reduce dose in patients with renal impairment
Advise ability to drive/operate machinery may be affected by side effects
First dose should be given under medical supervision: Risk of anaphylaxis
Maintain adequate hydration during therapy
Discontinue if signs of gastro-intestinal bleeding occur
If rash develops, consider possibility of Stevens-Johnson Syndrome
May inhibit platelet aggregation - observe for signs of bleeding
Monitor coagulation effects in patients undergoing major surgery
Monitor renal, hepatic and haematological parameters
Advise patient to report unexplained nausea,vomiting,abdominal pain
Consider discontinuing treatment if serum transaminase levels rise
May affect results of some laboratory tests
Discontinue if anaphylactoid reaction occurs
Discontinue if any kind of visual disturbance occurs
Discontinue if severe skin reaction occurs
Maintain treatment at the lowest effective dose
Maximum treatment 3 days
Advise patient to avoid alcohol during treatment
May cause impaired fertility

The elderly have an increased frequency of adverse reactions to NSAIDs, these include gastrointestinal bleeding and perforation, which may be fatal.

Caution should be taken when treating patients with ibuprofen if receiving concomitant medications which could increase the risk of ulceration or gastrointestinal bleeding.

Pregnancy and Lactation

Pregnancy

Use ibuprofen with caution during pregnancy.

Use of ibuprofen during the third trimester of pregnancy is contraindicated by the manufacturer due to potential foetal toxicity and inhibition of labour. The manufacturer does not recommend using ibuprofen during the first or second trimester of pregnancy unless clearly necessary. If administered, the dose should be kept as low and the duration as short as possible. Animal studies have shown teratogenic effects. Human data is limited and as such a potential risk cannot be ruled out.

Lactation

Use ibuprofen with caution during breastfeeding.

The manufacturer advises caution if ibuprofen is used when breastfeeding. Ibuprofen and its metabolites can pass in low concentrations into human breast milk. It is recommended to discontinue breastfeeding if using higher doses than 1200mg daily or for longer treatment periods as effects on exposed infants are unknown.

Side Effects

Abdominal pain
Aggravation of existing asthma
Agranulocytosis
Alopecia
Amblyopia
Anaemia
Anaphylactic shock
Anxiety
Aseptic meningitis
Bleeding skin
Bronchospasm
Burning (injection site)
Cardiac failure
Confusion
Constipation
Depression
Diarrhoea
Disorientation
Dizziness
Drug rash with eosinophilia and systemic symptoms (DRESS)
Dyspepsia
Dyspnoea
Erythema multiforme
Exacerbation of colitis or Crohn's proctocolitis
Fatigue
Fever
Flatulence
Gastritis
Gastro-intestinal perforation
Gastrointestinal bleeding
Haematemesis
Haematoma (injection site)
Headache
Hearing disturbances
Hepatic damage
Hepatitis
Hypersensitivity reactions
Hypertension
Hypotension
Increased uric acid level
Influenza-like symptoms
Infusion related reaction
Irritability
Itchy skin nodules
Jaundice
Lassitude
Leucopenia
Local pain (injection site)
Melaena
Minor bleeding (injection site)
Myocardial infarction
Nausea
Neck stiffness
Non-specific haemorrhagic colitis
Nose bleeds
Oedema
Oesophagitis
Palpitations
Pancreatitis
Pancytopenia
Peptic ulceration
Photosensitivity
Psychotic reactions
Renal damage
Respiratory disorders
Restlessness
Skin infection
Sleeplessness
Sore throat
Stevens-Johnson syndrome
Swelling (injection site)
Systemic lupus erythematosus
Thrombocytopenia
Tinnitus
Tongue swelling
Toxic epidermal necrolysis
Ulcerative stomatitis
Urine abnormality
Vasculitis (allergic)
Vertigo
Visual disturbances
Vomiting

Presentation

Infusions of ibuprofen.

Drugs List

Therapeutic Indications

Uses

Fever
Moderate pain: acute treatment

Dosage

Adults

Patients with Renal Impairment

Patients with Hepatic Impairment

Administration

To be administered as an intravenous infusion for 30 minutes.

Contraindications

Children under 18 years
Varicella
Asthma, urticaria or acute rhinitis associated with NSAIDS
Cerebrovascular haemorrhage
History of angioedema
History of bronchospasm
History of gastrointestinal bleeding
History of peptic ulcer
Severe cardiac failure
Severe dehydration
Severe hepatic impairment
Severe renal impairment
Third trimester of pregnancy
Thrombocytopenia

Precautions and Warnings

Allergic disposition
Elderly
Females attempting to conceive
Restricted sodium intake
Risk factors for cardiovascular disorder
Risk factors for disseminated intravascular coagulation
Surgery
Tobacco smoking
Acute porphyria
Asthma
Breastfeeding
Cerebrovascular disorder
Chronic obstructive pulmonary disease
Congestive cardiac failure
Crohn's disease
Dehydration
Diabetes mellitus
First trimester of pregnancy
Hepatic impairment
History of gastrointestinal disorder
Hyperlipidaemia
Hypertension
Ischaemic heart disease
Occlusive peripheral arterial disease
Renal impairment
Second trimester of pregnancy
Systemic lupus erythematosus
Ulcerative colitis
Uncontrolled hypertension

Contains more than 1 mmol (23 mg) sodium per dose
May mask symptoms or signs of infections
Reduce dose in patients with hepatic impairment
Reduce dose in patients with renal impairment
Advise ability to drive/operate machinery may be affected by side effects
First dose should be given under medical supervision: Risk of anaphylaxis
Maintain adequate hydration during therapy
Discontinue if signs of gastro-intestinal bleeding occur
If rash develops, consider possibility of Stevens-Johnson Syndrome
May inhibit platelet aggregation - observe for signs of bleeding
Monitor coagulation effects in patients undergoing major surgery
Monitor renal, hepatic and haematological parameters
Advise patient to report unexplained nausea,vomiting,abdominal pain
Consider discontinuing treatment if serum transaminase levels rise
May affect results of some laboratory tests
Discontinue if anaphylactoid reaction occurs
Discontinue if any kind of visual disturbance occurs
Discontinue if severe skin reaction occurs
Maintain treatment at the lowest effective dose
Maximum treatment 3 days
Advise patient to avoid alcohol during treatment
May cause impaired fertility

The elderly have an increased frequency of adverse reactions to NSAIDs, these include gastrointestinal bleeding and perforation, which may be fatal.

Caution should be taken when treating patients with ibuprofen if receiving concomitant medications which could increase the risk of ulceration or gastrointestinal bleeding.

Pregnancy and Lactation

Pregnancy

Use ibuprofen with caution during pregnancy.

Use of ibuprofen during the third trimester of pregnancy is contraindicated by the manufacturer due to potential foetal toxicity and inhibition of labour. The manufacturer does not recommend using ibuprofen during the first or second trimester of pregnancy unless clearly necessary. If administered, the dose should be kept as low and the duration as short as possible. Animal studies have shown teratogenic effects. Human data is limited and as such a potential risk cannot be ruled out.

Lactation

Use ibuprofen with caution during breastfeeding.

The manufacturer advises caution if ibuprofen is used when breastfeeding. Ibuprofen and its metabolites can pass in low concentrations into human breast milk. It is recommended to discontinue breastfeeding if using higher doses than 1200mg daily or for longer treatment periods as effects on exposed infants are unknown.

Side Effects

Abdominal pain
Aggravation of existing asthma
Agranulocytosis
Alopecia
Amblyopia
Anaemia
Anaphylactic shock
Anxiety
Aseptic meningitis
Bleeding skin
Bronchospasm
Burning (injection site)
Cardiac failure
Confusion
Constipation
Depression
Diarrhoea
Disorientation
Dizziness
Drug rash with eosinophilia and systemic symptoms (DRESS)
Dyspepsia
Dyspnoea
Erythema multiforme
Exacerbation of colitis or Crohn's proctocolitis
Fatigue
Fever
Flatulence
Gastritis
Gastro-intestinal perforation
Gastrointestinal bleeding
Haematemesis
Haematoma (injection site)
Headache
Hearing disturbances
Hepatic damage
Hepatitis
Hypersensitivity reactions
Hypertension
Hypotension
Increased uric acid level
Influenza-like symptoms
Infusion related reaction
Irritability
Itchy skin nodules
Jaundice
Lassitude
Leucopenia
Local pain (injection site)
Melaena
Minor bleeding (injection site)
Myocardial infarction
Nausea
Neck stiffness
Non-specific haemorrhagic colitis
Nose bleeds
Oedema
Oesophagitis
Palpitations
Pancreatitis
Pancytopenia
Peptic ulceration
Photosensitivity
Psychotic reactions
Renal damage
Respiratory disorders
Restlessness
Skin infection
Sleeplessness
Sore throat
Stevens-Johnson syndrome
Swelling (injection site)
Systemic lupus erythematosus
Thrombocytopenia
Tinnitus
Tongue swelling
Toxic epidermal necrolysis
Ulcerative stomatitis
Urine abnormality
Vasculitis (allergic)
Vertigo
Visual disturbances
Vomiting

Effects on Laboratory Tests

Ibuprofen treatment may interfere with analytical tests such as:
Bleeding time (can be prolonged during 1 day after withdrawn the treatment)
Blood glucose concentration (may decrease)
Creatinine clearance (may decrease)
Haematocrit or haemoglobin (may decrease)
Blood concentrations of ureic nitrogen and seric concentrations of creatinine and potassium (may increase)
Hepatic function tests: increase in transaminases values.

Overdosage

It is strongly recommended that the UK National Poisons Information Service be consulted on cases of suspected or actual overdose where there is doubt over the degree of risk or about appropriate management.

The following number will direct the caller to the relevant local centre (0844) 892 0111

Information may be obtained if you have access to ToxBase the primary clinical toxicology database of the National Poisons Information Service. This is available via password on the internet ( www.toxbase.org ) or if this is unavailable at the backup site ( www.toxbasebackup.org ).

Further Information

Last Full Review Date: April 2021

Reference Sources

Summary of Product Characteristics: Ibuprofen 400mg solution for infusion. Dr Reddy's Laboratories (UK) Ltd. Revised September 2019.