Medicine

How does Ibuprofen work?

This post originally appeared on Medical News Bulletin.

Ibuprofen is a drug that is used to treat pain and reduce inflammation – how does it work?

Non-steroidal anti-inflammatory drugs (NSAIDs) are a class of drugs that are used for pain relief. There are currently several NSAIDs available to treat pain. These pain relievers include ibuprofen, aspirin, and naproxen – find out more about how they work.

Ibuprofen is the most widely used non-steroidal anti-inflammatory drug around the world. A 2003 review, published in the International Journal of Clinical Practice, suggests that Ibuprofen taken at low doses is found to be as effective as aspirin and acetaminophen for symptoms or medical conditions usually treated with over the counter drugs.

Ibuprofen helps relieve pain as well as reduce inflammation and fever. The drug is generally used to manage pain associated with headaches, menstruation, migraine, dental surgery, joint aches, muscle strains, and sprains. The drug is commonly prescribed to treat inflammatory disorders such as osteoarthritis and rheumatoid arthritis. It is also used to treat pericarditis (inflammation of the pericardium), gout attacks and Patent Ductus arteriosus (PDA) – a condition affecting premature infants in which the fetal blood vessel connecting the aorta and the pulmonary artery does not close after birth.

How does Ibuprofen work?

Ibuprofen works by preventing the production of hormones called prostaglandins, which are responsible for causing pain, inflammation, or fever in the body. This is done by inhibiting the cyclooxygenase (COX) enzymes, particularly the COX-1 and COX-2 enzymes. The COX enzymes help convert arachidonic acid to prostaglandins as part of the body’s response to injury or infection.

The enzyme, COX-1 is responsible for activating platelets, regulating kidney function and protecting the gastrointestinal lining. The COX-2 enzyme is primarily produced due to tissue damage or the presence of pathogens in the body. According to some studies, ibuprofen blocks the COX-1 enzyme more effectively than COX-2. These studies suggest that larger doses of the drug may be needed to induce stronger anti-inflammatory effects, likely because the COX-2 enzyme plays a more active role in inflammation.

How long does it take for Ibuprofen to work?

Patients can generally expect to feel the effects of ibuprofen within twenty minutes after taking the medication. However, the time taken to experience the effects of the drug depends on each individual. The medication can generally achieve peak concentrations in the blood between one and two hours.

The effects can usually last between four and six hours, however it takes about twenty-four hours to completely get rid of the drug from the body.

Taking Ibuprofen

Ibuprofen is generally administered orally or through the intravenous (IV) route. It is available in the form of capsules, tablets, oral suspension, gel or IV solution. The tablets come in different sizes ranging between 200 mg and 800 mg.

The medication is recommended to be taken with food or liquids for both adults and children.

The dosage of the drug depends on the person’s age or medical condition – always take as directed by your physician. Persons with mild or moderate pain, muscle aches, menstrual cramps or fever usually take the drug at doses around 200 mg or 400 mg. Patients with arthritis or other chronic medical conditions can be prescribed a dosage between 300 mg and 800 mg taken daily at around three or four times. Children between the ages of six months and twelve years are generally treated for pain and fever with a dosage between five and ten mg/kg taken once every six to eight hours.

Parents should seek medical advice from the doctor before providing ibuprofen to their children under six months of age.

Side effects of Ibuprofen

Ibuprofen can potentially cause serious side effects affecting the gastrointestinal tract and these include gastrointestinal bleeding as well as the formation of ulcers. Patients who are elderly or using the drug long-term may be at an increased risk of developing these side effects. Patient may be at an increased risk of heart attacks or kidney failure from using Ibuprofen at high doses or for long-term. Ibuprofen is not recommended for individuals with gastrointestinal disorders, heart problems, impaired kidney or renal function.

Other side effects of Ibuprofen include rash, constipation, diarrhea, nausea, nervousness, bloating, ringing in the ears, headaches, dizziness, and fever.

Persons allergic to aspirin or other NSAID medications may not take Ibuprofen and should immediately see a doctor if they develop an allergic reaction to the drug. Individuals may be at an elevated risk of developing an ulcer from taking Ibuprofen with aspirin.

It is recommended to not drink large amounts of alcohol while taking the drug as it elevates the risk of gastrointestinal bleeding or liver damage.

Ibuprofen can worsen the symptoms of asthma so persons with asthma are not recommended to use the drug.

Ibuprofen can cause blood thinning. Patients taking coagulants or blood thinners such as warfarin are recommended to not take the drug.

Written by Ranjani Sabarinathan, MSc                                                                                      

References

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Moore N. Forty years of ibuprofen use. Int J Clin Pract Suppl. 2003 Apr;(135):28-31. PMID: 12723744.

Ngo VTH, Bajaj T. Ibuprofen. [Updated 2020 May 30]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2020 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK542299/

Schwier N, Tran N. Non-Steroidal Anti-Inflammatory Drugs and Aspirin Therapy for the Treatment of Acute and Recurrent Idiopathic Pericarditis. Pharmaceuticals (Basel). 2016;9(2):17. Published 2016 Mar 23. doi:10.3390/ph9020017

Patent Ductus Arteriosus (PDA). Retrieved from https://www.stanfordchildrens.org/en/topic/default?id=patent-ductus-arteriosus-pda-90-P01811

Ricciotti E, FitzGerald GA. Prostaglandins and inflammation. Arterioscler Thromb Vasc Biol. 2011;31(5):986-1000. doi:10.1161/ATVBAHA.110.207449

Wright JM. The double-edged sword of COX-2 selective NSAIDs. CMAJ. 2002;167(10):1131-1137.

ibuprofen (Advil, Motrin, Nuprin). Retrieved from https://www.medicinenet.com/ibuprofen/article.htm#what_is_ibuprofen_advil_motrin_nuprin_and_how_does_it_work

Ibuprofen Use in Young Children. Retrieved from https://www.healthlinkbc.ca/health-topics/sid7727

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This post originally appeared on Medical News Bulletin.

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