Ibuprofen is a specialist in the treatment of pain and inflammation
IBUPROFEN SPECIALIST IN THE TREATMENT OF PAIN AND INFLAMMATION
How does ibuprofen work?
Ibuprofen is an effective and relatively safe painkiller. It has a strong anti-inflammatory and anti-pyretic properties, making it a good treatment for various pains. Koi headaches, teeth, menstrual, relieves symptoms of colds and flu - fever and headaches, muscles, joints, etc.
In medicine, the following applies:
♦ ibuprofen being a racemic mixture of two dextrorotatory and levorotatory optical isomers (enantiomers), the biological activity being mainly dextrorotatory or
♦ dexibuprofen, which is a pure and active dextrorotatory enantiomer, which allows to reduce the dose of the drug compared to ibuprofen
The mechanism of action of ibuprofen
Ibuprofen inhibits the biochemical activity of enzymes that synthesize tissue hormones - prostaglandins. First, it blocks the enzyme - cyclooxygenase constitutive (COX-1) - responsible for the production of prostaglandins that fulfill important physiological functions. Secondly, it also inhibits the so-called inducible cyclooxygenase (COX-2) - responsible for the synthesis of pain-producing pro-inflammatory prostaglandins that cause headache, muscle, etc.
How long does it work in the body?
Ibuprofen is rapidly absorbed from the gastrointestinal tract, partly in the stomach and to a greater extent in the small intestine. It is fully effective therapeutically after less than an hour after administration of the tablet. The analgesic effect occurs after about 30 minutes. and it lasts for 4-6 hours. The medicine is completely eliminated from the blood 24 h after the last dose. The metabolite is excreted in the urine.
Contraindications to the use of ibuprofen
Contraindications to taking ibuprofen are: active or recent peptic ulcer disease of the stomach or duodenum, asthma and allergy to ibuprofen or other components of the preparation.
Safety of useibuprofen - withprecautions
Use with caution in patients with blood clotting disorders. The drug can, like all other agents in this group, increase the effect of oral preparations that reduce blood clotting from the coumarin group. In addition, in hypertensive patients with heart failure and with hepatic or renal impairment, lupus erythematosus, edema, patients treated with diuretics, elderly people and children up to the age of 12. In the elderly, the risk of side effects is bigger.
Chronic use is not recommended
People who receive chronic ibuprofen (and other non-steroidal anti-inflammatory drugs) may experience bleeding, ulceration and perforation of the stomach and intestines. The risk of bleeding increases with increasing the duration of treatment. Long-term use of ibuprofen in people with cardiovascular disease increases the risk of thrombotic events, heart attacks or strokes.
Short-term use - does not threaten cardiac events
Short-term analgesic use of ibuprofen probably does not increase the risk of cardiovascular adverse events, especially if the drug is used at a low dose. However, the use of ibuprofen in the treatment of postoperative pain in patients after coronary artery bypass surgery is not recommended.
Drug interactions of ibuprofen
It may increase the effect of oral anticoagulants.Therefore, do not combine with the administration of oral coumarin anticoagulants - there may be bleeding. The simultaneous use of corticosteroids or other NSAIDs increases the risk of severe gastrointestinal disorders, gastrointestinal bleeding, relapse of peptic ulcer. Ibuprofen increases the toxicity of methotrexate and lithium salts as a result of delayed excretion. It reduces the effect of diuretics, for example furosemide and the effectiveness of drugs that lower blood pressure (hypotensive). If corticosteroids are used in parallel, the risk of side effects in the gastrointestinal tract, including bleeding, increases. Probenecid and sulfinpyrazone prolong the effect of ibuprofen. Antacids containing aluminum hydroxide may interfere with the absorption of ibuprofen and delay the onset of its action; Magnesium hydroxide medicines can accelerate and increase its absorption. Cholestyramine limits the absorption of ibuprofen, this effect was not found in colestipol. Use in parallel with other NSAIDs may cause cross-allergy and increase the risk of side effects. Do not use in conjunction with zidovudine, because it is associated with an increased risk of bleeding.
If you use ibuprofen - do not use acetylsalicylic acid!
Not everyone knows that ibuprofen reduce the effectiveness of acetylsalicylic acid or "aspirin" - as a drug "thinning" blood and preventing the formation of blood clots, and thus heart attacks and strokes. Ibuprofen blocks the antiplatelet effect of aspirin, which inhibits their "sticking", i.e. aggregation that causes clots. Inverse interaction is also unfavorable - because acetylsalicylic acid reduces the anti-inflammatory effect of ibuprofen and, to a greater extent than other drugs in this group, increases the risk of gastrointestinal bleeding.
Interactions with alcohol
Ibuprofen does not affect the concentration of alcohol in the blood; alcohol intake during treatment with ibuprofen slightly increases the risk of damage to the gastrointestinal mucosa.
Possible side effects of ibuprofen
Indigestion, epigastric pain, flatulence, nausea, lack of appetite, less frequent gastric or duodenal ulcer, gastrointestinal bleeding. In allergic people allergic to ibuprofen and other non-steroidal anti-inflammatory drugs - allergic reactions: cutaneous allergic reactions, erythema, edema, rash, urticaria, rhinitis, bronchial asthma; at high doses, headache and dizziness, impaired hearing, weakness, fatigue, fluid retention, blurred vision, drowsiness, impaired renal and hepatic function; rarely, haemolytic anemia, granulocytopenia and thrombocytopenia may occur in long-term treatment. When dexibuprofen is used, it is possible to reduce the incidence of certain side effects.
Pregnancy and lactation
In the I and II trimesters of pregnancy, use only if absolutely necessary. Do not use in the third trimester of pregnancy. During breastfeeding, it can be used for a short time.
Oral dosage
Adults and children over 12 years of age: analgesic and antipyretic 200-400 mg - once or 3-4 times a day; in rheumatoid arthritis, osteoarthritis: 1200-3200 mg in 3-4 doses; in juvenile rheumatoid arthritis: 30-40 mg / kg m.c. in 3-4 doses. The maximum daily dose is 3200 mg. Children up to 12 years of age: 5 mg / kg m.c. If the temperature is below 39 ° C or 10 mg / kg m.c. if the temperature is higher than 39 ° C. The maximum daily dose is 40 mg / kg m.c. The preparation is taken during or after a meal.
The drug is well tolerated by the body
Although ibuprofen, like any preparation from the group of non-steroidal anti-inflammatory drugs, can cause stomach and duodenum ulceration - the risk is much lower than when using acetylsalicylic acid. Ibuprofen is one of the best-tolerated non-steroidal anti-inflammatory drugs.
Drug progress in improving the "construction" of the tablet
An interesting variation of drug progression are controlled-time tablets and the drug release site. An example is the gradually released ibuprofen microgranules, etc.
Support for pain management
To support painkillers, in addition:
- sedatives,
- betamimetics, direct sprays and calcium channel blockers.
- less frequently used alternative treatments for headaches and other types of pain include acupuncture, acupressure, hypnosis and psychotherapy.
ed. Edward Ozga Michalski, MA
internal medicine consultation med. Ewa Pakuła internist
neurological consultation med. Tomasz Rosochowicz
Literature
1. "Menstrual pain and ways to fight it"; Dr Marek Marcyniak, gynecologist-obstetrician; II Chair and Clinic of Gynecology and Obstetrics at the Medical Academy in Warsaw, publ. Internet http://www.mediweb.pl/womens.
2. 30 years after the discovery of John Vane: what we know about the mechanisms of action of non-steroidal anti-inflammatory drugs
3. Drugs used in rheumatology and cardiovascular system - PhD. Biol., Lek. med. Ryszard Międzybrodzki1, med. Jerzy Świerkot, prof. dr hab. ed. Jacek Szechiński - Institute of Immunology and Experimental Therapy of the Polish Academy of Sciences in Wrocław; REUMATOLOGY - Trapia - MARCH 2005
4. "Oncology" - a textbook for students and physicians edited by Radzisław Kordek, Jacek Jassema, Maciej Krzakowski and Arkadiusz Jeziorski, Medical Press, Gdańsk, 2003
5. Encyclopedia of Practical Medicine ONLINE, PHARMINDEX
