Indications and dose
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Mild to moderate pain, Pain and inflammation of soft-tissue injuries, Pyrexia with discomfort for ibuprofen
By mouth using immediate-release medicines
- Child 1–2 months
- 5mg/kg 3–4 times a day.
- Child 3–5 months
- 50mg 3 times a day, maximum daily dose to be given in 3–4 divided doses; maximum 30mg/kg per day.
- Child 6–11 months
- 50mg 3–4 times a day, maximum daily dose to be given in 3–4 divided doses; maximum 30mg/kg per day.
- Child 1–3 years
- 100mg 3 times a day, maximum daily dose to be given in 3–4 divided doses; maximum 30mg/kg per day.
- Child 4–6 years
- 150mg 3 times a day, maximum daily dose to be given in 3–4 divided doses; maximum 30mg/kg per day.
- Child 7–9 years
- 200mg 3 times a day, maximum daily dose to be given in 3–4 divided doses; maximum 30mg/kg per day; maximum 2.4g per day.
- Child 10–11 years
- 300mg 3 times a day, maximum daily dose to be given in 3–4 divided doses; maximum 30mg/kg per day; maximum 2.4g per day.
- Child 12–17 years
- Initially 300–400mg 3–4 times a day; maintenance 200–400mg 3 times a day, increased if necessary up to 600mg 4 times a day.
Pain and inflammation for ibuprofen
By mouth using modified-release medicines
- Child 12–17 years
- 1.6g once daily, dose preferably taken in the early evening, increased to 2.4g daily in 2 divided doses, dose to be increased only in severe cases.
Pain and inflammation in rheumatic disease including juvenile idiopathic arthritis for ibuprofen
By mouth using immediate-release medicines
- Child 3 months–17 years
- 30–40mg/kg daily in 3 divided doses (max. per dose 800mg), alternatively 30–40mg/kg daily in 4 divided doses (max. per dose 600mg).
Pain and inflammation in systemic juvenile idiopathic arthritis for ibuprofen
By mouth using immediate-release medicines
- Child 3 months–17 years (body-weight up to 40 kg)
- Up to 60mg/kg daily in 4–6 divided doses.
- Child 3 months–17 years (body-weight 40 kg and above)
- Up to 2.4g daily in 4–6 divided doses.
Post-immunisation pyrexia in infants (on doctor’s advice only) for ibuprofen
By mouth using immediate-release medicines
- Child 2–3 months
- 50mg for 1 dose, followed by 50mg for 1 dose, to be given 6 hours after first dose if required.
Pain and inflammation in rheumatic disease and other musculoskeletal disorders (dose approved for use by community practitioner nurse prescribers), Mild to moderate pain including dysmenorrhoea (dose approved for use by community practitioner nurse prescribers), Migraine (dose approved for use by community practitioner nurse prescribers), Dental pain (dose approved for use by community practitioner nurse prescribers), Headache (dose approved for use by community practitioner nurse prescribers), Fever (dose approved for use by community practitioner nurse prescribers), Symptoms of colds and influenza (dose approved for use by community practitioner nurse prescribers), Neuralgia (dose approved for use by community practitioner nurse prescribers) for ibuprofen
By mouth using immediate-release medicines
- Child 12–17 years
- 200–400mg 3 times a day, if symptoms worsen or persist for more than 3 days refer to doctor.
Mild to moderate pain (dose approved for use by community practitioner nurse prescribers), Pain and inflammation of soft-tissue injuries (dose approved for use by community practitioner nurse prescribers), Pyrexia with discomfort (dose approved for use by community practitioner nurse prescribers) for ibuprofen
By mouth using immediate-release medicines
- Child 3–5 months (body-weight 5 kg and above)
- 20–30mg/kg daily in divided doses, alternatively 50mg 3 times a day for maximum of 24 hours, refer to doctor if symptoms persist for more than 24 hours.
- Child 6–11 months
- 50mg 3–4 times a day, refer to doctor if symptoms persist for more than 3 days.
- Child 1–3 years
- 100mg 3 times a day, refer to doctor if symptoms persist for more than 3 days.
- Child 4–6 years
- 150mg 3 times a day, refer to doctor if symptoms persist for more than 3 days.
- Child 7–9 years
- 200mg 3 times a day, refer to doctor if symptoms persist for more than 3 days.
- Child 10–11 years
- 300mg 3 times a day, refer to doctor if symptoms persist for more than 3 days.
Post-immunisation pyrexia in infants (dose approved for use by community practitioner nurse prescribers) (on doctor’s advice only) for ibuprofen
By mouth using immediate-release medicines
- Child 3 months
- 50mg for 1 dose, followed by 50mg for 1 dose, to be given 6 hours after first dose if required, if pyrexia persists refer to doctor.
Acute moderate pain, Pyrexia for ibuprofen
By intravenous infusion
- Child 6–17 years (body-weight 20–29 kg)
- 200mg 3 times a day as required for maximum 3 days, doses to be given at intervals of at least 6 hours; maximum 600mg per day.
- Child 6–17 years (body-weight 30–39 kg)
- 200mg 4 times a day as required for maximum 3 days, doses to be given at intervals of at least 6 hours; maximum 800mg per day.
- Child 6–17 years (body-weight 40 kg and above)
- 200–400mg 3 times a day as required for maximum 3 days, doses to be given at intervals of at least 6 hours; maximum 1.2g per day.
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Closure of ductus arteriosus (under expert supervision) for Pedea®
By slow intravenous injection
- Neonate up to 34 weeks corrected gestational age
- Initially 10mg/kg for 1 dose, to be given after the first 6 hours of life, then 5mg/kg every 24hours for 2 doses but see also Monitoring requirements, the course may be repeated after 48 hours if necessary.
Unlicensed use
Unlicensed use For ibuprofen
With oral use:
Not licensed for use in children aged under 3 months or with body-weight under 5kg.
Maximum dose for systemic juvenile idiopathic arthritis is unlicensed.
Important safety information
Important safety information For ibuprofen
MHRA/CHM advice: NSAIDs: potential risks following prolonged use after 20 weeks of pregnancy (June 2023)
With systemic use:
See Non-steroidal anti-inflammatory drugs.
Contra-indications
Contra-indications For ibuprofen
With intravenous use
Active bleeding (especially intracranial or gastro-intestinal); coagulation defects (in neonates); ductal-dependent congenital heart disease (in neonates); known or suspected necrotising enterocolitis (in neonates); life-threatening infection (in neonates); marked unconjugated hyperbilirubinaemia (in neonates); pulmonary hypertension (in neonates); thrombocytopenia
With systemic use
Active gastro-intestinal bleeding; active gastro-intestinal ulceration; history of gastro-intestinal bleeding related to previous NSAID therapy; history of gastro-intestinal perforation related to previous NSAID therapy; history of recurrent gastro-intestinal haemorrhage (two or more distinct episodes); history of recurrent gastro-intestinal ulceration (two or more distinct episodes); severe heart failure; varicella infection
Cautions
Cautions For ibuprofen
With systemic use
Allergic disorders; cardiac impairment (NSAIDs may impair renal function); cerebrovascular disease; coagulation defects; connective-tissue disorders; dehydration (risk of renal impairment); heart failure; history of gastro-intestinal disorders (e.g. ulcerative colitis, Crohn’s disease); ischaemic heart disease; may mask symptoms of infection; peripheral arterial disease; risk factors for cardiovascular events; uncontrolled hypertension
Cautions, further information
High-dose ibuprofen
With oral use:
A small increase in cardiovascular risk, similar to the risk associated with cyclo-oxygenase-2 inhibitors and diclofenac, has been reported with high-dose ibuprofen (≥ 2.4g daily); use should be avoided in patients with established ischaemic heart disease, peripheral arterial disease, cerebrovascular disease, congestive heart failure (New York Heart Association classification II-III), and uncontrolled hypertension.
Masking of symptoms of underlying infections
With systemic use:
Ibuprofen can mask symptoms of infection, which may lead to delayed initiation of appropriate treatment and thereby worsen infection outcome. This has been observed in bacterial community-acquired pneumonia and bacterial complications to varicella. When administered for fever or pain relief in relation to infection, monitoring of infection is advised.
Interactions
View interactions for ibuprofen
Side-effects
Side-effects For ibuprofen
General side-effects:
Common or very common
Constipation; diarrhoea; gastrointestinal discomfort; gastrointestinal disorders; haemorrhage; headache; nausea; skin reactions; vomiting
Uncommon
Asthma; hypersensitivity; oedema
Rare or very rare
Agranulocytosis; anaemia; dyspnoea; heart failure; hypertension; leucopenia; meningitis aseptic (patients with connective-tissue disorders such as systemic lupus erythematosus may be especially susceptible); pancytopenia; renal papillary necrosis; respiratory disorders; severe cutaneous adverse reactions (SCARs); shock; thrombocytopenia (very common in neonates)
Frequency not known
Fluid retention (very common in neonates); increased risk of arterial thromboembolism
Specific side-effects:
Common or very common
With intravenous use
Dizziness; fatigue; inflammatory bowel disease; insomnia; intraventricular haemorrhage (in neonates); neutropenia (in neonates); oral disorders; periventricular leukomalacia (in neonates); vertigo
Uncommon
With intravenous use
Anxiety; irritability; nephritis tubulointerstitial; nephrotic syndrome; renal impairment (very common in neonates); tinnitus; vasculitis; vision disorders
With oral use
Rash (discontinue)
Rare or very rare
With intravenous use
Alopecia; auditory disorder; confusion; depression; hepatic disorders; hypotension; infection exacerbated; myocardial infarction; neck stiffness; palpitations; pancreatitis; photosensitivity reaction; psychotic disorder; systemic lupus erythematosus (SLE)
With oral use
Acute kidney injury; angioedema; liver disorder; oral ulceration
Frequency not known
With oral use
Crohn's disease; fertility decreased female; renal failure (more common in patients with pre-existing renal impairment); respiratory tract reaction
Side-effects, further information
For information about cardiovascular and gastrointestinal side-effects, and a possible exacerbation of symptoms in asthma, see Non-steroidal anti-inflammatory drugs
Overdose
Overdosage with ibuprofen may cause nausea, vomiting, epigastric pain, and tinnitus, but more serious toxicity is very uncommon. Charcoal, activated followed by symptomatic measures are indicated if more than 100 mg/kg has been ingested within the preceding hour.
For details on the management of poisoning, see Emergency treatment of poisoning.
Allergy and cross-sensitivity
Allergy and cross-sensitivity For ibuprofen
Contraindicated in patients with a history of hypersensitivity to aspirin or any other NSAID—which includes those in whom attacks of asthma, angioedema, urticaria or rhinitis have been precipitated by aspirin or any other NSAID. M
Conception and contraception
Conception and contraception For ibuprofen
With systemic use:
Caution—long-term use of some NSAIDs is associated with reduced female fertility, which is reversible on stopping treatment. M
Pregnancy
Pregnancy For ibuprofen
With systemic use:
Avoid use in first and second trimesters unless essential; the MHRA advises additional antenatal monitoring may be required if treatment is considered necessary by a doctor from week 20 of pregnancy onwards.
Avoid use in third trimester.
See NSAIDs in Pregnancy in Non-steroidal anti-inflammatory drugs for further details.
Breast feeding
Breast feeding For ibuprofen
Specialist sources indicate suitable for use in breast-feeding—negligible amounts present in milk.
Hepatic impairment
Hepatic impairment For ibuprofen
With systemic use for indications relating to Pain or Pyrexia:
Caution in mild to moderate impairment; avoid in severe impairment. M
Dose adjustments
With systemic use for indications relating to Pain or Pyrexia:
The lowest effective dose should be used for the shortest possible duration. M
Renal impairment
Renal impairment For ibuprofen
With systemic use for indications relating to Pain or Pyrexia:
In general, for NSAIDs the MHRA advises to avoid where possible; if necessary, use with caution (risk of fluid retention and further renal impairment, including renal failure).
For ibuprofen, avoid in severe impairment. M
With intravenous use in neonates:
Caution in mild to moderate impairment; avoid if possible in severe impairment. M
Dose adjustments
With systemic use for indications relating to Pain or Pyrexia:
The lowest effective dose should be used for the shortest possible duration. M
Monitoring requirements
Monitoring requirements For ibuprofen
Monitoring of patient parameters For ibuprofen
With intravenous use in neonates
Monitor for bleeding.
Monitor gastro-intestinal function.
Monitor renal function—withhold next dose until urine output returns to normal if anuria or manifest oliguria occurs after the first or second dose.
Directions for administration
Directions for administration For ibuprofen
With intravenous use:
For intravenous infusion, give over 30 minutes.
Directions for administration For Pedea®
With intravenous use in neonates:
For slow intravenous injection, give over 15 minutes, preferably undiluted. May be diluted with Glucose 5% or Sodium Chloride 0.9%.
Prescribing and dispensing information
Prescribing and dispensing information For ibuprofen
With oral use:
Flavours of syrup may include orange.
With topical use:
Caution—topical preparations not generally suitable for children.
Patient and carer advice
Patient and carer advice For ibuprofen
Medicines for Children leaflet: Ibuprofen for pain and inflammation
https://www.medicinesforchildren.org.uk/medicines/ibuprofen-for-pain-and-inflammation/
Profession specific information
Profession specific information For ibuprofen
Dental practitioners' formulary
With oral use:
Ibuprofen Oral Suspension Sugar-free may be prescribed.
Ibuprofen Tablets may be prescribed.
Exceptions to legal category
Exceptions to legal category For ibuprofen
With oral use:
Oral preparations can be sold to the public in certain circ*mstances.
Medicinal forms
There can be variation in the licensing of different medicines containing the same drug.
Forms available from special-order manufacturers include: oral suspension.
View all medicinal forms and pricinginformation
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- Oral tablet
- Orodispersible tablet
- Modified-release tablet
- Oral capsule
- Chewable capsule
- Modified-release capsule
- Effervescent granules
- Oral suspension
- Solution for infusion
- Anal fissure
- Analgesics
- Cerebral palsy and spasticity
- Drugs affecting the ductus arteriosus
- Ear
- Fever
- Herpesvirus infections
- Migraine
- Non-steroidal anti-inflammatory drugs
- Peri-operative analgesia
- Poisoning, emergency treatment
- Sinusitis (acute)
- Soft-tissue disorders
Other drugs in class
Other drugs in classNon-steroidal anti-inflammatory drugs
- Aspirin
- Benzydamine hydrochloride
- Diclofenac potassium
- Diclofenac sodium
- Etoricoxib
- Flurbiprofen
- Indometacin
- Ketorolac trometamol
- Mefenamic acid
- Meloxicam
- Naproxen
- Phenazone with lidocaine
- Piroxicam