Ibuprofen (Nurofen, Caldolor)

Last updated 05/12/19

Definition

• Non-selective COX inhibitor non-steroidal anti-inflammatory drugs (NSAID)

Features

• Reduces opiate requirements

Mechanism

• Prostaglandin synthetase inhibition
• Analgesic
• Anti-inflammatory
• Antipyretic

Indications

• Pain
• Headache
• Osteoarthritis (OA)
• Juvenile idiopathic arthritis
• Rheumatoid arthritis (RA)
• Fever
• Closure of patent ductus arteriosus
• Menorrhagia or dysmenorrhoea
• IV
• Mild to moderate post operative pain
• Fever reduction

Dose

• PO, topical, IV
• Tablets: 100mg, 200mg, 400mg (Advil, Nurofen, Brufen)
• Combinations
• Codeine 12.8mg + Ibuprofen 200mg (Neurofen Plus, Panafen Plus)
• Paracetamol 500mg + Ibuprofen 150mg or 200mg (Nuromol, etc.)
• Oral liquid (Advil, Nurofen, Brufen)
• 20mg/ml in 50ml or 100ml
• 40mg/ml in 40ml or 100ml
• Gel: 5% in 30h, 50g, 100g (Nurofen Gel)
• Ampules
• 100mg/ml in 8ml (Caldolor)
• 5mg/ml in 2ml (Peda)
• Clear colorless to slightly yellow solution
• Must be diluted: saline 0.9% or Dextrose 5%
• Maximum concentration 4mg/ml
• 400mg dose = 100ml minimum total volume for dilution
• 800mg dose = 200ml minimum total volume for dilution
• If not diluted may cause haemolysis
• PO
• Adult: 200-400mg PO Q6-8h
• Max: 800mg PO Q6h
• Paeds (6 months to 11yrs): 10mg/kg PO Q6-8h
• IV
• Infuse over 30 minutes
• Adult: 400-800mg Q6h IV
• Max: 3200mg/day for 2 days
• Not indicated for children <18yrs

Side Effects/Precautions/Contraindications

• Side Effects
• Nausea, vomiting
• Headache, dizziness
• Hypertension
• Anaphylaxis
• Gastrointstinal bleed
• Precautions
• Ischaemic heart disease (IHD): may increase risk of event
• Congestive cardiac failure (CCF)
• Contraindications
• Severe hepatic impairment
• Asthma sensitive to NSAIDs
• IV
• Coronary artery bypass graft (CABG) post operative pain
• Active gastrointestinal bleeding
• Spinal cord injuries
• Pregnancy: C

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References

1. AMH: Ibuprofen. July 2019
2. BioCSL: Caldolor Product Information