IBUPROFEN – Risks And Benefits

Discuss the risks and benefits of taking Ibuprofen as an analgesic.

What is Ibuprofen and how does it work?

Ibuprofen is an analgesic non- steroidal anti-inflammatory drug (NSAIDs). Daily dosages above 1200mg does not give any additional relief to pain and can bring about gastrointestinal toxicities and cardiovascular risks (Derry et al.2012).

These types of drugs are normally used to manage mild to moderate pain, fever and inflammation. It can be used to treat easy mild to moderate pain such as the tooth ache, period pain, migraine, back or pain due to arthritis (Nice.org.uk 2017). Ibuprofen works by reducing the hormones that are responsible for the generation of pain and inflammation. Ibuprofen can be used to treat tendonitis and muscle soreness, joint pain, hence is extremely helpful for the runners. It is better to use Ibuprofen in fever rather than using Aspirin.  Ibuprofen has been found to be non addictive and have lesser side effects as compared to other NSAIDs.

Normally ibuprofen bought over the counter comes in capsules or tablets of 200 mg  (Nice.org.uk, 2017).  Adults and children beyond 12 years of age can have one to two tablets every four to six hours if required. In certain cases Ibuprofen can be given in a liquid form intravenously (Derry et al.2012).

For acute pain, dosages as high as 800 mg, can be used. The analgesic ceiling of the drug is only 400- 1200 mg/dose per day. High doses of 2400 mg can be given for inflammation without any additional pain relief ( Derry et al.2012). Daily dosages above 1200mg does not give any additional relief to pain but can bring about gastrointestinal toxicities and cardiovascular risks (Derry et al.2012).

Prostaglandin generated in the body is an important mediator for the sensations like pain fever and inflammation. The antipyretic effect of the prostaglandin is due to the vasodilatation of the hypothalamus and increased peripheral blood flow causing heat dissipation (Derry et al.2012).

Ibuprofen is a non selective inhibitor of the enzyme cyclooxygenase (COX) that is responsible for the generation of prostaglandins by the arachidonic pathway.  COX converts the arachidonic acid of the body to prostaglandin, thus inhibition of COX by Ibuprofen reduces the prostaglandin levels in our body (Rainsford 2016).

Some of the common side effects of Ibuprofen are nausea, vomiting, dizziness, constipation, bloating, rashes and itching, mild hurt burn and cardiovascular risks (Nice.org.uk 2017). People who are about to undergo coronary artery heart bypass graft should not take Ibuprofen at any cost. It is advisable to consult with a  doctor before using Ibuprofen in patients having congestive heart failure, severe anaemia, Systemic lupus erythematous (SLE), bleeding  (Nice.org.uk, 2017). Older persons should be extremely careful while taking up Ibuprofen. NSAIDs available over the counter can cause sleepiness, loss of balance in older adults, which can increase the risk of falls (Derry et al.2012). One is advised not to take alcohol as it may increase the risks of stomach bleeding and may also damage the kidneys (Rainsford 2016).  Some evidences suggest that taking high doses of ibuprofen during the first month of pregnancy increases the chance of miscarriage (Nice.org.uk, 2017).

Ibuprofen has been found to cross react with certain drugs such as apixaban, anti-rheumatic drugs. Ibuprofen has been found to react with a number of blood thinners such as Aspirin, Arixtra, warfarin (Nice.org.uk, 2017). It should also not be administered to patients who are under antidepressant medications such as celexa and paroxetine (Derry et al. 2012). Antidepressants have been found to increase the levels of cytokines in the body, which in turn boosts the level of serotonin in the body by increasing the level of proteins that are required for the generation of the serotonin receptors.  The pain killer interferes with the production of the cytokines (Llorca et al.2008).  Ibuprofen has also been found to interact with beta blockers and some other NSAIDs like celebrex, naprosyn, lodine, toradol (Awa et al.2012).

Although there are several drawbacks of using Ibuprofen, yet the role of the medicine in curing fever and pain cannot be avoided. Correct dosage, under the consultation of the doctor can be really useful in treating pain and inflammations.

References

Awa, K., Satoh, H., Hori, S. and Sawada, Y., 2012. Prediction of time?dependent interaction of aspirin with ibuprofen using a pharmacokinetic/pharmacodynamic model. Journal of clinical pharmacy and therapeutics, 37(4), pp.469-474.

Derry, C.J., Derry, S. and Moore, R.A., 2012. Single dose oral ibuprofen plus paracetamol (acetaminophen) for acute postoperative pain. The Cochrane database of systematic reviews, 6.

Llorca, C.S., Serra, M.P.M. and Donat, F.J.S., 2008. Interactions between ibuprofen and antihypertensive drugs: Incidence and clinical relevance in dental practice. studies, 18, p.19.

Nice.org.uk. (2017). Non-steroidal anti-inflammatory drugs | Guidance and guidelines | NICE. [online] Available at: https://www.nice.org.uk/advice/ktt13 [Accessed 10 Dec. 2017].

Rainsford, K.D. ed., 2016. Aspirin and related drugs. CRC Press.