Ibuprofen

Ibuprofen is a medication in the nonsteroidal anti-inflammatory drug (NSAID) class that is used for treating pain, fever, and inflammation. This includes painful menstrual periods, migraines, and rheumatoid arthritis. It may also be used to close a patent ductus arteriosus in a premature baby. It can be used by mouth or intravenously. It typically begins working within an hour. Common side effects include heartburn and a rash. Compared to other NSAIDs, it may have fewer side effects such as gastrointestinal bleeding. It increases the risk of heart failure, kidney failure, and liver failure. At low doses, it does not appear to increase the risk of heart attack; however, at higher doses it may. Ibuprofen can also worsen asthma. While it is unclear if it is safe in early pregnancy, it appears to be harmful in later pregnancy and therefore is not recommended. Like other NSAIDs, it works by inhibiting the production of prostaglandins by decreasing the activity of the enzyme cyclooxygenase. Ibuprofen is a weaker anti-inflammatory agent than other NSAIDs. Ibuprofen was discovered in 1961 by Stewart Adams and initially marketed as Brufen. It is available under a number of trade names, including Advil and Motrin. It was first marketed in 1969 in the United Kingdom and in the United States in 1974. It is on the World Health Organization's List of Essential Medicines, which lists the safest and most effective medicines needed in a health system. It is available as a generic medication. The wholesale cost in the developing world is between US$0.01 and US$0.04 per dose. In the United States, it costs about US$0.05 per dose. In 2016, it was the 35th most prescribed medication in the United States, with more than 21 million prescriptions. Ibuprofen is used primarily to treat fever (including post-vaccination fever), mild to moderate pain (including pain relief after surgery), painful menstruation, osteoarthritis, dental pain, headaches, and pain from kidney stones. About 60% of people respond to any NSAID; those who do not respond well to a particular one may respond to another. It is used for inflammatory diseases such as juvenile idiopathic arthritis and rheumatoid arthritis. It is also used for pericarditis and patent ductus arteriosus. In some countries, ibuprofen lysine (the lysine salt of ibuprofen, sometimes called 'ibuprofen lysinate') is licensed for treatment of the same conditions as ibuprofen; the lysine salt is used because it is more water-soluble. In 2006, ibuprofen lysine was approved in the US by the Food and Drug Administration (FDA) for closure of patent ductus arteriosus in premature infants weighing between 500 and 1,500 grams (1 and 3 lb), who are no more than 32 weeks gestational age when usual medical management (such as fluid restriction, diuretics, and respiratory support) is not effective. Adverse effects include nausea, dyspepsia, diarrhea, constipation, gastrointestinal ulceration/bleeding, headache, dizziness, rash, salt and fluid retention, and high blood pressure. Infrequent adverse effects include esophageal ulceration, heart failure, high blood levels of potassium, kidney impairment, confusion, and bronchospasm. Ibuprofen can exacerbate asthma, sometimes fatally.