US FDA The Food and Drug Administration is an agency of the United States Department of Health and Human Services, one of the United States federal executive departments, responsible for protecting and promoting public health through the regulation and supervision of food safety, tobacco products, dietary supplements, prescription and over-the-counter:link

Pregnancy cat. The pregnancy category of a pharmaceutical agent is an assessment of the risk of fetal injury due to the pharmaceutical, if it is used as directed by the mother during pregnancy. It does not include any risks conferred by pharmaceutical agents or their metabolites that are present in breast milk C(AU For at least 40,000 years before European settlement in the late 18th century, Australia was inhabited by indigenous Australians, who belonged to one or more of the roughly 250 language groups. After sporadic visits by fishermen from the immediate north and discovery by Dutch explorers in 1606, Australia's eastern half was claimed by the British) D(US ^ b. English is the de facto language of American government and the sole language spoken at home by 80% of Americans age five and older. Spanish is the second most commonly spoken language) Legal status The regulation of therapeutic goods, that is drugs and therapeutic devices, varies by jurisdiction. In some countries, such as the United States, they are regulated at the national level by a single agency. In other jurisdictions they are regulated at the state level, or at both state and national levels by various bodies, as is the case in Unscheduled (AU For at least 40,000 years before European settlement in the late 18th century, Australia was inhabited by indigenous Australians, who belonged to one or more of the roughly 250 language groups. After sporadic visits by fishermen from the immediate north and discovery by Dutch explorers in 1606, Australia's eastern half was claimed by the British) GSL (UK The United Kingdom of Great Britain and Northern Ireland[note 7] is a sovereign state located off the northwestern coast of continental Europe. It is an island country, spanning an archipelago including Great Britain, the northeastern part of the island of Ireland, and many small islands. Northern Ireland is the only part of the UK with a land) OTC Over-the-counter drugs are medicines that may be sold directly to a consumer without a prescription from a health care professional, as compared to prescription drugs, which may only be sold to consumers possessing a valid prescription. In many countries, OTC drugs are selected by a regulatory agency to ensure that they are ingredients that are (US ^ b. English is the de facto language of American government and the sole language spoken at home by 80% of Americans age five and older. Spanish is the second most commonly spoken language) Routes A route of administration in pharmacology and toxicology is the path by which a drug, fluid, poison, or other substance is brought into contact with the body Oral, rectal, topical, and intravenous Intravenous therapy or IV therapy is the giving of liquid substances directly into a vein. The word intravenous simply means "within a vein". Therapies administered intravenously are often called specialty pharmaceuticals. It is commonly referred to as a drip because many systems of administration employ a drip chamber, which prevents (what is this?) (verify) Coated 200 mg ibuprofen tablets

Ibuprofen (INN An International Nonproprietary Name is the official non-proprietary or generic name given to a pharmaceutical substance, as designated by the World Health Organization (WHO)[citation needed]. The plethora of named proprietary preparations containing a given substance can lead to confusion about the identity of the active ingredient. INNs) (pronounced /ˈaɪbjuːproʊfɛn/ or /aɪbjuːˈproʊfən/; from the now-outdated nomenclature iso-butyl-propanoic-phenolic acid) is a non-steroidal anti-inflammatory drug Nonsteroidal anti-inflammatory drugs, usually abbreviated to NSAIDs or NAIDs, are drugs with analgesic, antipyretic and, in higher doses, with anti-inflammatory effects (reducing inflammation). The term "nonsteroidal" is used to distinguish these drugs from steroids, which (among a broad range of other effects) have a similar eicosanoid- (NSAID) originally marketed as Brufen, and since then under various other trademarks A trademark or trade mark is a distinctive sign or indicator used by an individual, business organization, or other legal entity to identify that the products or services to consumers with which the trademark appears originate from a unique source, and to distinguish its products or services from those of other entities (see tradenames section), most notably Nurofen Nurofen is the brand name of a range of pain-relief medication made by Reckitt Benckiser. The Nurofen brand was acquired following Reckitt Benckiser's acquisition of Boots Healthcare in 2005. The brand is primarily marketed and sold in the United Kingdom, other parts of Europe, Australia, and New Zealand, Advil Advil is a brand of ibuprofen, a non-steroidal anti-inflammatory drug . Advil is manufactured by Wyeth and has been on the market since 1984, and Motrin. It is used for relief of symptoms of arthritis There are over 100 different forms of arthritis. The most common form, osteoarthritis is a result of trauma to the joint, infection of the joint, or age. Other arthritis forms are rheumatoid arthritis, psoriatic arthritis, and autoimmune diseases in which the body attacks itself. Septic arthritis is caused by joint infection, primary dysmenorrhea Dysmenorrhea is a gynaecological medical condition characterized by severe uterine pain during menstruation. While most women experience minor pain during menstruation, dysmenorrhea is diagnosed when the pain is so severe as to limit normal activities, or require medication, fever Fever is a common medical sign characterized by an elevation of temperature above the normal range of 36.5–37.5 °C (98–100 °F) due to an increase in the body temperature regulatory set-point. This increase in set-point triggers increased muscle tone and shivering, and as an analgesic An analgesic is any member of the group of drugs used to relieve pain (achieve analgesia). The word analgesic derives from Greek an- ("without") and algos ("pain"). Analgesic drugs act in various ways on the peripheral and central nervous systems; they include paracetamol (para-acetylaminophenol, also known in the US as, especially where there is an inflammatory Inflammation is part of the complex biological response of vascular tissues to harmful stimuli, such as pathogens, damaged cells, or irritants. Inflammation is a protective attempt by the organism to remove the injurious stimuli and to initiate the healing process. Inflammation is not a synonym for infection. Even in cases where inflammation is component. Ibuprofen is known to have an antiplatelet An antiplatelet drug is a member of a class of pharmaceuticals that decreases platelet aggregation and inhibits thrombus formation. They are effective in the arterial circulation, where anticoagulants have little effect effect, though it is relatively mild and short-lived when compared with that of aspirin Aspirin , also known as acetylsalicylic acid (pronounced /əˌsɛtəlˌsælɨˈsɪlɨk/ ə-SET-əl-sal-i-SIL-ik, abbreviated ASA), is a salicylate drug, often used as an analgesic to relieve minor aches and pains, as an antipyretic to reduce fever, and as an anti-inflammatory medication or other better-known antiplatelet drugs. Ibuprofen is a core medicine in the World Health Organization The World Health Organization is a specialized agency of the United Nations (UN) that acts as a coordinating authority on international public health. Established on 7 April 1948, and headquartered in Geneva, Switzerland, the agency inherited the mandate and resources of its predecessor, the Health Organization, which had been an agency of the's "Essential Drugs List The List of World Health Organization Essential Medicines is a model list of essential medicines created by the World Health Organization. This list is based on the 15th edition", which is a list of minimum medical needs for a basic health care system.[1]

Contents

History

Ibuprofen was derived from propionic acid Propionic acid is a naturally-occurring carboxylic acid with chemical formula C by the research Research can be defined as the search for knowledge or any systematic investigation to establish facts. The primary purpose for applied research is discovering, interpreting, and the development of methods and systems for the advancement of human knowledge on a wide variety of scientific matters of our world and the universe. Research can use the arm of Boots Group The Boots Company, commercially known as Boots is a leading pharmacy chain in the United Kingdom, with outlets in most high streets throughout the country. Its parent company, Boots Group plc merged with Alliance UniChem plc on 31 July 2006 to become Alliance Boots during the 1960s.[2] It was discovered by Andrew RM Dunlop, with colleagues Stewart Adams, John Nicholson, Jeff Wilson & Colin Burrows and was patented A patent is a set of exclusive rights granted by a state (national government) to an inventor or their assignee for a limited period of time in exchange for a public disclosure of an invention in 1961. The drug was launched as a treatment for rheumatoid arthritis Rheumatoid arthritis is a chronic, systemic inflammatory disorder that may affect many tissues and organs, but principally attacks synovial joints. The process produces an inflammatory response of the synovium (synovitis) secondary to hyperplasia of synovial cells, excess synovial fluid, and the development of pannus in the synovium. The pathology in the United Kingdom in 1969, and in the United States in 1974. Dr. Adams initially tested his drug on a hangover A hangover (veisalgia) or delayed alcohol induced headache describes the sum of unpleasant physiological effects following heavy consumption of alcoholic beverages. The most commonly reported characteristics of a hangover include headache, nausea, sensitivity to light and noise, lethargy, dysphoria, diarrhea and thirst, typically after the. He was subsequently awarded an OBE The Most Excellent Order of the British Empire is an order of chivalry established on 4 June 1917 by George V of the United Kingdom. The Order comprises five classes in civil and military divisions. In decreasing order of seniority, these are: in 1987. Boots was awarded the Queen's Award For Technical Achievement for the development of the drug in 1987.[3]

Typical administration

Low doses of ibuprofen (200 mg, and sometimes 400 mg) are available over the counter Over-the-counter drugs are medicines that may be sold directly to a consumer without a prescription from a health care professional, as compared to prescription drugs, which may only be sold to consumers possessing a valid prescription. In many countries, OTC drugs are selected by a regulatory agency to ensure that they are ingredients that are (OTC) in most countries. Ibuprofen has a dose-dependent duration of action of approximately 4–8 hours, which is longer than suggested by its short half-life The biological half-life or elimination half life of a substance is the time it takes for a substance to lose half of its pharmacologic, physiologic, or radiologic activity, as per the MeSH definition. In a medical context, half-life may also describe the time it takes for the blood plasma concentration of a substance to halve ("plasma half-. The recommended dose varies with body mass and indication. Generally, the oral dose is 200–400 mg (5–10 mg/kg in children) every 4–6 hours, adding up to a usual daily dose of 800–1,200 mg. 1,200 mg is considered the maximum daily dose for over-the-counter use, though under medical direction, the maximum amount of ibuprofen for adults is 800 milligrams per dose or 3200 mg per day (4 maximum doses).

Unlike aspirin, which breaks down in solution, ibuprofen is stable, and thus ibuprofen can be available in topical gel form which is absorbed through the skin, and can be used for sports injuries, with less risk of digestive problems.[4]

Off-label and investigational use

Ibuprofen is sometimes used for the treatment of acne, because of its anti-inflammatory properties,[5] and has been sold in Japan in topical form for adult acne.[6]

As with other NSAIDs Nonsteroidal anti-inflammatory drugs, usually abbreviated to NSAIDs or NAIDs, are drugs with analgesic and antipyretic effects and which have, in higher doses, anti-inflammatory effects (reducing inflammation). The term "nonsteroidal" is used to distinguish these drugs from steroids, which (among a broad range of other effects) have a, ibuprofen may be useful in the treatment of severe orthostatic hypotension Orthostatic hypotension is a form of hypotension in which a person's blood pressure suddenly falls when the person stands up. The decrease is typically greater than 20/10 mm Hg, and may be most pronounced after resting (low blood pressure when standing up).[7]

In some studies, ibuprofen showed superior results compared to a placebo in the prophylaxis Preventive medicine or preventive care refers to measures taken to prevent diseases, rather than curing them or treating their symptoms. The term contrasts in method with curative and palliative medicine, and in scope with public health methods (which work at the level of population health rather than individual health) of Alzheimer's disease Alzheimer's disease , also called Alzheimer disease, Senile Dementia of the Alzheimer Type (SDAT) or simply Alzheimer's, is the most common form of dementia. This incurable, degenerative, and terminal disease was first described by German psychiatrist and neuropathologist Alois Alzheimer in 1906 and was named after him. Generally, it is diagnosed, when given in low doses over a long time.[8] Further studies are needed to confirm the results before ibuprofen can be recommended for this indication.

Ibuprofen has been associated with a lower risk of Parkinson's disease Parkinson's disease is a degenerative disorder of the central nervous system that often impairs the sufferer's motor skills, speech, and other functions, and may delay or prevent it. Aspirin, other NSAIDs, and paracetamol (acetaminophen) US FDA:link had no effect on the risk for Parkinson's.[9] Further research is warranted before recommending ibuprofen for this use.

Ibuprofen lysine

In Europe, Australia, and New Zealand, ibuprofen lysine (the lysine Lysine is an α-amino acid with the chemical formula HO2CCH(NH2)(CH2)4NH2. This amino acid is an essential amino acid, which means that the human body cannot synthesize it. Its codons are AAA and AAG salt of ibuprofen, sometimes called "ibuprofen lysinate" even though the lysine is in cationic An ion is an atom or molecule in which the total number of electrons is not equal to the total number of protons, giving it a net positive or negative electrical charge. An anion , from the Greek word ἀνω (anο), meaning "up", is an ion with more electrons than protons, giving it a net negative charge (since electrons are negatively form) is licensed for treatment of the same conditions as ibuprofen. The lysine salt increases water solubility, allowing the medication to be administered intravenously.[10] Ibuprofen lysine has been shown to have a more rapid onset of action compared to acid ibuprofen.[11]

Ibuprofen lysine is indicated for closure of a patent ductus arteriosus Patent ductus arteriosus is a congenital heart defect wherein a neonate's ductus arteriosus fails to close after birth. Symptoms are uncommon but in the first year of life include increased work of breathing and poor weight gain. With age, the PDA may lead to congestive heart failure if left uncorrected in premature infants weighing between 500 and 1500 grams, who are no more than 32 weeks gestational age when usual medical management (e.g., fluid restriction, diuretics, respiratory support, etc.) is ineffective.[10] With regard to this indication, ibuprofen lysine is an effective alternative to intravenous indomethacin and may be advantageous in terms of renal function.[12]

Mechanism of action

Main article: Non-steroidal anti-inflammatory drug Nonsteroidal anti-inflammatory drugs, usually abbreviated to NSAIDs or NAIDs, are drugs with analgesic, antipyretic and, in higher doses, with anti-inflammatory effects (reducing inflammation). The term "nonsteroidal" is used to distinguish these drugs from steroids, which (among a broad range of other effects) have a similar eicosanoid- See also: Mechanism of action of aspirin

Non-steroidal anti-inflammatory drugs such as ibuprofen work by inhibiting Enzyme inhibitors are molecules that bind to enzymes and decrease their activity. Since blocking an enzyme's activity can kill a pathogen or correct a metabolic imbalance, many drugs are enzyme inhibitors. They are also used as herbicides and pesticides. Not all molecules that bind to enzymes are inhibitors; enzyme activators bind to enzymes and the enzyme Enzymes are proteins that catalyze chemical reactions. In enzymatic reactions, the molecules at the beginning of the process are called substrates, and the enzyme converts them into different molecules, called the products. Almost all processes in a biological cell need enzymes to occur at significant rates. Since enzymes are selective for their cyclooxygenase Cyclooxygenase is an enzyme (EC 1.14.99.1) that is responsible for formation of important biological mediators called prostanoids, including prostaglandins, prostacyclin and thromboxane. Pharmacological inhibition of COX can provide relief from the symptoms of inflammation and pain. Non-steroidal anti-inflammatory drugs, such as aspirin and (COX), which converts arachidonic acid Arachidonic acid is an omega-6 fatty acid 20:4(ω-6). It is the counterpart to the saturated arachidic acid found in peanut oil, (L. arachis – peanut.) to prostaglandin H2 Prostaglandin H2 is a type of Prostaglandin which is derived from arachidonic acid and is a precursor for many other biologically significant molecules: (PGH2). PGH2, in turn, is converted by other enzymes to several other prostaglandins A prostaglandin is any member of a group of lipid compounds that are derived enzymatically from fatty acids and have important functions in the animal body. Every prostaglandin contains 20 carbon atoms, including a 5-carbon ring. They are mediators and have a variety of strong physiological effects, such as regulating the contraction and (which are mediators of pain, inflammation, and fever) and to thromboxane A2 (which stimulates platelet aggregation, leading to the formation of blood clots).

Like aspirin, indomethacin, and most other NSAIDs, ibuprofen is considered a non-selective COX inhibitor—that is, it inhibits two isoforms of cyclooxygenase, COX-1 and COX-2. The analgesic, antipyretic, and anti-inflammatory activity of NSAIDs appears to be achieved mainly through inhibition of COX-2, whereas inhibition of COX-1 would be responsible for unwanted effects on platelet aggregation and the gastrointestinal tract.[13] However, the role of the individual COX isoforms in the analgesic, anti-inflammatory, and gastric damage effects of NSAIDs is uncertain and different compounds cause different degrees of analgesia and gastric damage.[14] In order to achieve the beneficial effects of ibuprofen and other NSAIDS without gastrointestinal uleceration and bleeding, selective COX-2 inhibitors were developed to inhibit the COX-2 isoform without inhibition of COX-1. [15]

Adverse effects

Main article: Non-steroidal anti-inflammatory drug

Ibuprofen appears to have the lowest incidence of digestive adverse drug reactions (ADRs) of all the non-selective NSAIDs. However, this only holds true at lower doses of ibuprofen, so over-the-counter preparations of ibuprofen are generally labeled to advise a maximum daily dose of 1,200 mg.[16][17]

Common adverse effects include: nausea, dyspepsia, gastrointestinal ulceration/bleeding, raised liver enzymes, diarrhea, constipation, epistaxis, headache, dizziness, priapism, rash, salt and fluid retention, and hypertension.[18]. A study from 2010 has shown that regular use of NSAIDs was associated with an increase in hearing loss.[19]

Infrequent adverse effects include: esophageal ulceration, heart failure, hyperkalemia, renal impairment, confusion, and bronchospasm.[18]

Photosensitivity

As with other NSAIDs, ibuprofen has been reported to be a photosensitising agent.[20][21] However, this only rarely occurs with ibuprofen and it is considered to be a very weak photosensitising agent when compared with other members of the 2-arylpropionic acid class. This is because the ibuprofen molecule contains only a single phenyl moiety and no bond conjugation, resulting in a very weak chromophore system and a very weak absorption spectrum which does not reach into the solar spectrum.

Cardiovascular risk

Along with several other NSAIDs, ibuprofen has been implicated in elevating the risk of myocardial infarction (heart attack), particularly among those chronically using high doses.[22]

Risks in inflammatory bowel disease (IBD)

This section does not cite any references or sources. Please help improve this article by adding citations to reliable sources. Unsourced material may be and removed. (August 2009)

Ibuprofen should not be used regularly in individuals with inflammatory bowel disease due to its ability to cause gastric bleeding and form ulceration in the gastric lining. Pain relievers such as paracetemol/acetaminophen or drugs containing codeine (which slows down bowel activity) are safer methods than ibuprofen for pain relief from IBD. Ibuprofen is also known to cause worsening of IBD during flare-ups, so it should be avoided completely at those times.

Human toxicology

Ibuprofen overdose has become common since it was licensed for over-the-counter use. There are many overdose experiences reported in the medical literature, although the frequency of life-threatening complications from ibuprofen overdose is low.[23] Human response in cases of overdose ranges from absence of symptoms to fatal outcome in spite of intensive care treatment. Most symptoms are an excess of the pharmacological action of ibuprofen and include abdominal pain, nausea, vomiting, drowsiness, dizziness, headache, tinnitus, and nystagmus. Rarely more severe symptoms such as gastrointestinal bleeding, seizures, metabolic acidosis, hyperkalaemia, hypotension, bradycardia, tachycardia, atrial fibrillation, coma, hepatic dysfunction, acute renal failure, cyanosis, respiratory depression, and cardiac arrest have been reported.[24] The severity of symptoms varies with the ingested dose and the time elapsed; however, individual sensitivity also plays an important role. Generally, the symptoms observed with an overdose of ibuprofen are similar to the symptoms caused by overdoses of other NSAIDs.

There is little correlation between severity of symptoms and measured ibuprofen plasma levels. Toxic effects are unlikely at doses below 100 mg/kg but can be severe above 400 mg/kg; (around 150 200mg tablets for an average man)[25] however, large doses do not indicate that the clinical course is likely to be lethal.[26] It is not possible to determine a precise lethal dose, as this may vary with age, weight, and concomitant diseases of the individual patient.

Therapy is largely symptomatic. In cases presenting early, gastric decontamination is recommended. This is achieved using activated charcoal; charcoal absorbs the drug before it can enter the systemic circulation. Gastric lavage is now rarely used, but can be considered if the amount ingested is potentially life threatening and it can be performed within 60 minutes of ingestion. Emesis is not recommended.[27] The majority of ibuprofen ingestions produce only mild effects and the management of overdose is straightforward. Standard measures to maintain normal urine output should be instituted and renal function monitored.[25] Since ibuprofen has acidic properties and is also excreted in the urine, forced alkaline diuresis is theoretically beneficial. However, because ibuprofen is highly protein bound in the blood, there is minimal renal excretion of unchanged drug. Forced alkaline diuresis is therefore of limited benefit.[28] Symptomatic therapy for hypotension, GI bleeding, acidosis, and renal toxicity may be indicated. Occasionally, close monitoring in an intensive care unit for several days is necessary. If a patient survives the acute intoxication, they will usually experience no late sequelae.

Detection in body fluids

Ibuprofen may be quantitated in blood, plasma or serum to demonstrate the presence of the drug in a person who has experienced an anaphylactic reaction, confirm a diagnosis of poisoning in hospitalized patients or to assist in a medicolegal death investigation. A nomogram has been published that relates the ibuprofen plasma concentration, time since ingestion and risk of developing renal toxicity in overdose patients.[29]

Chemistry

Ibuprofen is only very slightly soluble in water. Less than 1 mg of ibuprofen dissolves in 1 ml water (< 1 mg/mL).[30] However, it is much more soluble in alcohol/water mixtures.

Stereochemistry

Ibuprofen, like other 2-arylpropionate derivatives (including ketoprofen, flurbiprofen, naproxen, etc), contains a stereocenter in the α-position of the propionate moiety. As such, there are two possible enantiomers of ibuprofen, with the potential for different biological effects and metabolism for each enantiomer.

Indeed it was found that (S)-(+)-ibuprofen (dexibuprofen) was the active form both in vitro and in vivo.

It was logical, then, that there was the potential for improving the selectivity and potency of ibuprofen formulations by marketing ibuprofen as a single-enantiomer product (as occurs with naproxen, another NSAID).

Further in vivo testing, however, revealed the existence of an isomerase (2-arylpropionyl-CoA epimerase) which converted (R)-ibuprofen to the active (S)-enantiomer.[31][32][33] Due to the expense and probable futility of making pure (S)-(+)-ibuprofen, most ibuprofen formulations currently marketed are racemic mixtures.

(R)-ibuprofen (S)-ibuprofen

Synthesis

The synthesis of this compound is a popular case study in green chemistry. The original Boots synthesis of ibuprofen consisted of six steps, started with the Friedel-Crafts acetylation of isobutylbenzene. Reaction with ethyl chloroacetate (Darzens reaction) gave the α,β-epoxy ester, which was decarboxylated and hydrolyzed to the aldehyde. Reaction with hydroxylamine gave the oxime, converted to the nitrile, then hydrolyzed to the desired acid:[34]

An improved synthesis by BHC required only three steps. This improved synthesis won the Presidential Green Chemistry Challenge Greener Synthetic Pathways Award in 1997.[35] After a similar acetylation, hydrogenation with Raney nickel gave the alcohol, which underwent palladium-catalyzed carbonylation:[34]

Availability

See also: List of ibuprofen brand names A bottle of generic ibuprofen

Ibuprofen was made available under prescription in the United Kingdom in 1969, and in the United States in 1974. In the years since, the good tolerability profile along with extensive experience in the population, as well as in so-called Phase IV trials (post-approval studies), has resulted in the availability of small packages of ibuprofen over the counter in pharmacies worldwide, as well as in supermarkets and other general retailers.

North America

In the United States, the Food and Drug Administration approved ibuprofen in 200mg doses for over the counter use in 1984, and is commonly available. Higher doses are only available in North America by prescription.

In 2009, the first injectable formulation of ibuprofen was approved in the United States, under the trade name Caldolor. Ibuprofen thus became the only parenteral for both pain and fever available in the country.[36]

Europe

For some time, there has been a limit on the amount that can be bought over the counter in a single transaction in the UK. Behind the counter in pharmacies this is one pack of 96 × 200 mg or 400 mg, the latter being far less common for over the counter sales. In UK non-pharmacy outlets only 200 mg tablets are allowed and they are restricted to a maximum pack of 16 tablets.

In Germany, 600 mg and 800 mg per pill packages have to be prescribed, whereas 400 mg is available over the counter in pharmacies. In Italy, Belgium and the Netherlands, 200 mg and 400 mg pills are available with no prescription.

In other countries, higher dosages of 600 mg are available.

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External links

Wikimedia Commons has media related to: Ibuprofen
Non-steroidal anti-inflammatory drug (NSAID) products (primarily M01A and M02A, also N02BA)
Salicylates Aspirin (acetylsalicylic acid) · Aloxiprin · Benorylate · Diflunisal · Ethenzamide · Magnesium salicylate · Methyl salicylate · Salsalate · Salicin · Salicylamide · Sodium salicylate
Arylalkanoic acids Diclofenac · Aceclofenac · Acemetacin · Alclofenac · Bromfenac · Etodolac · Indometacin · Indometacin farnesil · Nabumetone · Oxametacin · Proglumetacin · Sulindac · Tolmetin
2-Arylpropionic acids (profens) Ibuprofen · Alminoprofen · Benoxaprofen · Carprofen · Dexibuprofen · Dexketoprofen · Fenbufen · Fenoprofen · Flunoxaprofen · Flurbiprofen · Ibuproxam · Indoprofen† · Ketoprofen · Ketorolac · Loxoprofen · Miroprofen · Naproxen · Oxaprozin · Pirprofen · Suprofen · Tarenflurbil · Tiaprofenic acid
N-Arylanthranilic acids (fenamic acids) Mefenamic acid · Flufenamic acid · Meclofenamic acid · Tolfenamic acid
Pyrazolidine derivatives Phenylbutazone · Ampyrone · Azapropazone · Clofezone · Kebuzone · Metamizole · Mofebutazone · Oxyphenbutazone · Phenazone · Sulfinpyrazone
Oxicams Piroxicam · Droxicam · Lornoxicam · Meloxicam · Tenoxicam · Ampiroxicam
COX -2 inhibitors Celecoxib · Deracoxib‡ · Etoricoxib · Firocoxib‡ · Lumiracoxib† · Parecoxib · Rofecoxib† · Valdecoxib†
Sulfonanilides Nimesulide
Topically used products Bendazac · Diclofenac · Etofenamate · Felbinac · Flurbiprofen · Ibuprofen · Indometacin · Ketoprofen · Naproxen · Piroxicam · Suprofen
COX-inhibiting nitric oxide donators Naproxcinod
Others Fluproquazone
Items listed in bold indicate initially developed compounds of specific groups. †Withdrawn drugs. ‡Veterinary use medications.
Anti-inflammatory products (M01A)
Pyrazolidine/Butylpyrazolidines Ampyrone · Clofezone · Kebuzone · Metamizole · Mofebutazone · Oxyphenbutazone Phenazone · Phenylbutazone · Sulfinpyrazone · Feprazone ·
Acetic acid derivatives and related substances Aceclofenac · Acemetacin · Alclofenac · Bromfenac · Bumadizone · Bufexamac · Diclofenac · Difenpiramide · Etodolac · Fentiazac · Indometacin · Ketorolac · Lonazolac · Oxametacin · Proglumetacin · Sulindac · Tolmetin · Zomepirac · Amfenac
Oxicams Ampiroxicam · Droxicam · Lornoxicam · Meloxicam · Piroxicam · Tenoxicam
Propionic acid derivatives Alminoprofen · Benoxaprofen · Dexibuprofen · Dexketoprofen · Fenbufen · Fenoprofen · Flunoxaprofen · Flurbiprofen · Ibuprofen · Ibuproxam · Indoprofen · Ketoprofen · Naproxen · Oxaprozin · Pirprofen · Suprofen · Tiaprofenic acid
Fenamates Flufenamic acid · Meclofenamic acid · Mefenamic acid · Tolfenamic acid · Niflumic acid · Morniflumate · Azapropazone ·
Coxibs Celecoxib · Etoricoxib · Lumiracoxib · Parecoxib · Rofecoxib · Valdecoxib
Other Nabumetone · Glucosamine · Benzydamine · Glycosaminoglycan · Magnesium salicylate · Proquazone · Superoxide dismutase/Orgotein · Nimesulide · Diacerein · Tenidap · Oxaceprol · Chondroitin sulfate

: MUS, DF+DRCT

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noco(, , )/()/, /,

, drug (/)
Topical products for joint and muscular pain (M02)
Anti-inflammatory preparations, non-steroids
Butylpyrazolidines Phenylbutazone • Mofebutazone • Clofezone • Oxyphenbutazone
Acetic acid derivatives Tolmetin • Diclofenac • Fentiazac
Other Benzydamine • Etofenamate • Piroxicam • Felbinac • Bufexamac • Ketoprofen • Bendazac • Naproxen • Ibuprofen • Feprazone • Niflumic acid • Meclofenamic acid • Flurbiprofen • Suxibuzone • Indometacin • Nifenazone
Capsaicin derivatives Zucapsaicin
Other Tolazoline • Dimethyl sulfoxide
Analgesics (N02A, N02B)
Opioids See also:
Opium & alkaloids thereof

Codeine · Morphine · Opium · Laudanum · Paregoric
Semi-synthetic opium derivatives

Acetyldihydrocodeine · Benzylmorphine · Buprenorphine · Desomorphine · Dihydrocodeine · Dihydromorphine · Ethylmorphine · Diamorphine · Hydrocodone · Hydromorphinol · Hydromorphone · Nicocodeine · Nicodicodeine · Nicomorphine · Oxycodone · Oxymorphone
Synthetic opioids

Alphaprodine · Anileridine · Butorphanol · Dextromoramide · Dextropropoxyphene · Dezocine · Fentanyl · Ketobemidone · Levorphanol · Methadone · Meptazinol · Nalbuphine · Pentazocine · Propoxyphene · Propiram · Pethidine · Phenazocine · Piminodine · Piritramide · Tapentadol · Tilidine · Tramadol
Pyrazolones Ampyrone/Aminophenazone · Metamizole · Phenazone · Propyphenazone
Cannabinoids Ajulemic acid · AM404 · Cannabidiol · Cannabis · Nabilone · Nabiximols · Tetrahydrocannabinol
Anilides Paracetamol (acetaminophen) · Phenacetin · Propacetamol
Non-steroidal anti-inflammatories See also:
Propionic acid class

Fenoprofen · Flurbiprofen · Ibuprofen · Ketoprofen · Naproxen · Oxaprozin
Oxicam class

Meloxicam · Piroxicam
Acetic acid class

Diclofenac · Indometacin · Ketorolac · Nabumetone · Sulindac · Tolmetin
COX-2 inhibitors

Celecoxib · Rofecoxib · Valdecoxib · Parecoxib · Lumiracoxib
Anthranilic acid (fenamate) class

Meclofenamate · Mefenamic acid
Salicylates

Aspirin (Acetylsalicylic acid) · Benorylate · Diflunisal · Ethenzamide · Magnesium salicylate · Salicin · Salicylamide · Salsalate · Trisalate · Wintergreen (Methyl salicylate)
Atypical, adjunct and potentiators, miscellaneous Amitryptiline · Befiradol · Bicifadine · Carisoprodol · Camphor · Clonidine · Cyclobenzaprine · Duloxetine · Esreboxetine · Flupirtine · Gabapentin · Glafenine · Hydroxyzine · Ketamine · Menthol · Nefopam · Orphenadrine · Pregabalin · Scopolamine · Tebanicline · Trazodone · Ziconotide

: CNS

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,drug(////////)
Acne-treating agents (D10)
Antibacterial Azelaic acid · Benzoyl peroxide · Blue light therapy · Tea tree oil
Keratolytic Glycolic acid · Salicylic acid · Sulfur · Benzoyl peroxide
Anti-inflammatory Aspirin · Ibuprofen · Red light therapy
Antibiotics Clindamycin · Dapsone · Erythromycin · Sulfacetamide · Minocycline · Tetracyclines
Hormonal Antiandrogens · Contraceptives
Retinoids Adapalene · Isotretinoin · Tazarotene · Tretinoin
Combinations ZIANA · Duac · BenzaClin · PLEXION · Epiduo

: SKA

//

//, /

, drug()
Prolactin inhibitors and anti-inflammatory products for vaginal administration (G02CB-G02CC)
Prolactin inhibitors Bromocriptine · Lisuride · Cabergoline · Quinagolide · Metergoline · Terguride
Anti-inflammatory products for vaginal administration Ibuprofen · Naproxen · Benzydamine · Flunoxaprofen

Categories: Non-steroidal anti-inflammatory drugs | World Health Organization essential medicines | Carboxylic acids

 

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'Ibuprofen' News
Eco-ergonomics: Reducing Strain on Your Budget - Consumerism Commentary (blog)
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Eco-ergonomics: Reducing Strain on Your Budget - Consumerism Commentary (blog)
Wed, 30 Jun 2010 12:05:39 GMT+00:00
Consumerism Commentary (blog) Maybe you really need that ibuprofen . But maybe you just need a change of scenery, especially if you're stuck in Cubicle Land with a bunch of other ...
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'Ibuprofen' Blogs
Ibuprofen - Chronic Pain - Health Tips
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Ibuprofen - Chronic Pain - Health Tips

unknown

Mon, 26 Jul 2010 16:56:55 GM

Plus . ibuprofen. and acetominaphin have to be filtered out of your body by your liver. your liver has no way of telling you if it is not functioning properly so If it is damaged you may have bigger problems. Make sure with any medication ...

Google Blogs Search: ibuprofen,
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'Ibuprofen' Answers
How much ibuprofen can a person take in a day before it becomes dangerous?
Q. I have chronic pain due to sports injuries. I take a lot of ibuprofen.
Asked by mark l - Wed Apr 29 22:14:27 2009 - - 3 Answers - 0 Comments

A. The maximum amount of ibuprofen for adults is 800 milligrams per dose or 3200 mg per day (4 maximum doses). My husband was having chronic pain and our doctor wrote a prescription for 600mg of ibuprofen that he could take up to 4 times a day. Try that dosage and see if that helps at all.
Answered by Josie826 - Wed Apr 29 22:26:44 2009

Yahoo Answers Search: ibuprofen,
Wed Jul 14 07:32:53 2010
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