Ibuprofen

In addition to diclofenac and acetylsalicylic acid, ibuprofen is one of the most commonly used so-called "acidic" analgesics. Thanks to its acidic nature, unlike substances such as acetaminophen or metamizole, ibuprofen not only works against pain but also against inflammation, as these active ingredients do not penetrate so well into the inflamed and thus acidified tissue.

Effect of ibuprofen

Ibuprofen is used to quell mild to moderate pain and to stop inflammation - for example, in rheumatic diseases, which are characterized by painful joint inflammation. In addition, ibuprofen reduces fever, but is hardly used therapeutically for this purpose.

Ibuprofen belongs to the class of non-steroidal anti-inflammatory drugs (NSAIDs), as opposed to, for example, cortisone. The active ingredient Ibuprofen is also a representative of nonopioid analgesics, thus belongs to the group of (other than opioids) non-addictive and used worldwide cyclooxygenase inhibitors.

The effect of ibuprofen is due to the fact that the cyclooxygenase is hindered. Therefore, the so-called prostaglandins, which promote inflammation, pain-inducing and fever-increasing, only reduced imitated.

Applications of ibuprofen

Ibuprofen is often used in the following cases:

  • Ibuprofen has been used and developed especially often for the treatment of rheumatic joint diseases. It relieves inflammation, swelling and pain in arthrosis, rheumatoid arthritis and gout.
  • In a lower dose Ibuprofen also helps against headaches and migraines, as well as toothache or menstrual pain.
  • Ibuprofen is also used for muscle pain and sports injuries such as strains and torn ligaments, alternatively diclofenac helps here.
  • Other areas of application are pain relief in acute otitis media, tonsillitis or sunburn.

Ibuprofen: dosage

Ibuprofen is sold in a variety of dosage forms. It is available as a tablet, capsule, suppository, juice, granules or ointment. The drug is available in different dosages, the low ones are available at the pharmacy. Ibuprofen in Doses over 400 mg are prescription.

The spectrum of action of ibuprofen depends on the dose: lower doses of between 200 and 800 mg in adults are particularly effective analgesic and antipyretic. Only at higher doses up to 2,400 mg daily comes the anti-inflammatory effect to carry.

The ingested funds remain in the same concentration in the blood for about two to three hours, after which the effect decreases. For the most part, the degradation products are excreted via the kidney, sometimes also via the liver.

Unlike related acetylsalicylic acid, after consultation with a doctor Ibuprofen also in children be applied. A reason for treatment exists, for example, in premature babies. In order to support their immature heart, it is possible to close off the often persistent ductus arteriosus botalli, a connection between the venous and arterial system, by means of ibuprofen.

Ibuprofen: side effects

Often ibuprofen causes side effects such as stomach pain, nausea and diarrhea. Dizziness, headache and reversible visual acuity rarely occur.

As with the related cyclooxygenase inhibitors acetylsalicylic acid and diclofenac, the frequent use of ibuprofen may also lead to gastric bleeding or even gastric puffing. The inhibition of cyclooxygenase not only reduces the production of unwanted pro-inflammatory prostaglandins. The prostaglandins, which normally protect the stomach, also fail, which makes the stomach very sensitive to the digestive enzymes and stomach acid it contains.

Because of this, prolonged ibuprofen therapy should only be used in Combination with a stomach protector be performed. Recommended drugs are drugs that reduce the production of stomach acid, for example proton pump inhibitors such as omeprazole or pantoprazole. It also helps to protect the stomach when taking these medications not sober occupies.

Parallel therapy with steroidal painkillers such as cortisone is not recommended because it would further increase the risk of bleeding. Caution should also be exercised in patients with known inflammatory gastrointestinal diseases such as ulcerative colitis or Crohn's disease, as the intake of ibuprofen may cause an acute episode of these diseases.

5 facts about ibuprofen - © istockphoto, diego_cervo

Ibuprofen: interactions

In addition, ibuprofen has an inhibitory effect on platelet aggregation, similar to the action of acetylsalicylic acid. Therefore there is one increased risk of bleeding. The concomitant use of other anticoagulants such as Marcumar® may therefore be of concern.

Paradoxically, however, the effect of other platelet inhibitors such as acetylsalicylic acid is reduced when taken by competition at the same receptor. This can lead to increased thrombi and emboli. Because of the difficult to assess effect on your own blood clotting you should inform the attending physician prior to surgery necessarily on the previous intake of painkillers.

Ibuprofen in pregnancy

Also, problems with unwanted prolongation of pregnancy in the context of prostaglandin intake is reported: Some prostaglandins promote contractions. If these are formed diminished, then the contractions set in late, too.

According to the opinion, the treatment of rheumatoid arthritis, in a low dosage up to 600 mg daily, seems safe even during pregnancy and lactation. Other doctors see pregnancy as a clear contraindication for ibuprofen therapy. In each individual case, it is therefore strongly advised to consult the treating physician again.

Ibuprofen: Contraindications

Rarely does it come to the so-called "aspirin asthma", which can also occur when taking the painkillers ibuprofen and diclofenac. By reducing prostaglandins, the body converts the parent compound into leukotrienes. These cause coughing and narrow the lungs.

Also, patients who have a burdened kidney have caution when taking ibuprofen and other cyclooxygenase inhibitors as the renal arteries also contract when fewer prostaglandins are produced. This can further reduce a already low kidney function and, at worst, lead to dialysis. The use of ibuprofen in existing kidney disease must therefore be carefully monitored.

The same applies to Liver disease, because some of the drug is metabolised via the liver. Therefore, it is not recommended to consume alcohol during the treatment, as this puts additional strain on the liver. Regular monitoring of renal and hepatic values ​​with longer-term use of ibuprofen is therefore important.

With simultaneous lithium therapy, one must control the plasma level of this antidepressant particularly carefully, since the lithium excretion in the kidney is reduced by the ibuprofen intake. The same applies to a therapy with the antiepileptic drug phenytoin, which is degraded in the presence of ibuprofen slowed down.

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