Ibuprofen is a non-steroidal anti-inflammatory drug (NSAID) classified as propionic acid derivative. Other drugs of this group are naproxen, dexibuprofen, ketoprofen, dexketoprofen, fenoprofen, flurbiprofen, loxoprofen and oxaprozin. The name describes the chemical composition of this drug i.e. Isobutylpropanoicphenolic acid. Like many other NSAIDs, Ibuprofen is also a non-selective cyclooxygenase (COX) inhibitor. It inhibits both the isoforms of enzyme cyclooxygenase (COX-1 and COX-2). Ibuprofen exerts its analgesic, anti pyretic and anti-inflammatory effect by the inhibition of above-mentioned enzymes resulting in decreased production of prostaglandins and thromboxane A2. The primary beneficial effects of the drug are mediated by the inhibition of COX-2 whereas side effects such as gastric disturbance come due to inhibition of COX-1. Ibuprofen is marketed all over the world with different brand or trade names like Brufen, Nurofen, and Nuprin.
What is Ibuprofen used for?
Ibuprofen is commonly used for:
- Fever – ibuprofen is an effective antipyretic agent and is most commonly used in children for this purpose. It mediates its antipyretic effect by inhibiting the production of prostaglandins
- Pain –ibuprofen has a very strong analgesic effect.
- Rheumatoid arthritis – it is used in the symptomatic treatment of rheumatoid arthritis because of its strong anti-inflammatory effects
- Pericarditis – it is inflammation of the outer covering (pericardium) of the heart. As it is an anti-inflammatory drug, so it is used for the management of this condition
- Patent ductus arteriosus – in infants soon after the birth the ductus arteriosus closes and ligamentum arteriosum is formed. However, in few odd cases the ductus arteriosus remains patent and is closed by using Ibuprofen
Common side effects of Ibuprofen
Common adverse effects associated with Ibuprofen use are:
- Gastrointestinal intolerance – Ibuprofen use may be associated with nausea, vomiting, diarrhea, bloating, flatulence and sometimes even constipation
- Dyspepsia – mild to severe dyspepsia may occur with long term Ibuprofen use
- Gastrointestinal ulceration or bleeding – usually upper gastrointestinal tract bleeding occurs with the use of this drug, which may present as hematemesis or dark colored stools. Ocassionaly espophageal ulceration may occur due to its use
- Hepatitis – mild drug induced hepatitis is seen in some individuals using Ibuprofen. In such cases liver function tests are impaired
- Bleeding from nose (epistaxis)
- Pain in the penis while errection (Priapism)
- Errectile dysfunction with chronic Ibuprofen use
- Skin rash – Ibuprofen can cause some serious skin disorders rarely. One of them is Steven Johnson’s Syndrome in which there is blistering and loss of hair and nails all over the body. This condition may even lead to death. Ibuprofen can also cause photosensitivity in some individuals
- Hearing loss – numerous studies have shown that increased NSAID use is associated with increased hearing loss and Ibuprofen is one of the main culprits
- Cardiovascular side effects – chronic use of Ibuprofen causes salt and water retention that may lead to the development of hypertension in healthy individuals. Moreover, it also increases the risk of myocardial infarction and heart failure in healthy individuals
- Renal cell carcinoma – renal cell carcinoma is the most common type of kidney cancer and its risk is increased with the long term use of Ibuprofen
- Renal impairment – kidney functions are impaired which may cause increased levels of potassium in the blood (hyperkalemia)
- Asthma – Ibuprofen can cause severe bronchspasm and respiratory difficulty in genetically prone individuals
Ibuprofen side effects on children
In children and adolescents the most common side effect of Ibuprofen is gastrointestinal intolerance that may appear in the form of stomach cramps, dyspepsia, ulceration or bleeding. If you observe blood in the vomitus or black colored stools of the child, Ibuprofen must be stopped there and then.
Ibuprofen side effects on men
Although all the side effects of Ibuprofen can bother men, however, two most common side effects are:
- Priapism – it is painful and prolonged erection of the penis or clitoris even after removal of physical or psychological sexual stimuli
- Some studies on chronic use of Ibuprofen revealed that Ibuprofen use for three months or more may lead to erectile dysfunction and delayed ejaculation
Ibuprofen side effects on women
One of the common side effects of Ibuprofen in women is the hearing loss. A study revealed that women taking Ibuprofen for more than two days per week have higher chances of developing hearing loss as compared to the other. This study also showed that women who take Aspirin in place of Ibuprofen have less chances of hearing loss.
Ibuprofen side effects on pregnant women
Ibuprofen is an NSAID and it must be avoided if you are planning to conceive or already conceived. Although during the first two trimesters, Ibuprofen can be used cautiously after consulting with the health care provider: however, during third week of pregnancy it must not be used. Paracetamol is a better alternative to be used in pregnancy. Adverse effects of Ibuprofen on fetus or mother are given according to the trimester:
- First trimester – ibuprofen use in the first trimester increases the risk of miscarriage or abortion. Moreover, it may cause congenital heart defects, defects of abdominal wall, cleft lip and cleft palate
- Third trimester – ibuprofen use in third trimester increases the chances of pulmonary hypertension in the new born, delays the labor and causes oligohydramnios (decreased amount of amniotic fluid).
Ibuprofen may pass to the breast fed baby but the amount is so less that it is not harmful for the baby. So, it can be used by the breast-feeding mothers but after consultation with the healthcare provider.
Ibuprofen side effects on elderly
One of the main side effects of Ibuprofen in the elderly patients is increased systolic blood pressure. It occurs in hypertensive elderly individuals being treated with Thiazide diuretics (hydrochlorthiazide). Moreover, chronic use of Ibuprofen increases the risk of heart failure and heart attacks in elderly men.