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Ibuprofen (Motrin®, Advil®, etc.)

By: Dr. Nicholas Dodman

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Overview

  • Ibuprofen is a substituted phenylalkanoic acid with potent analgesic, anti-inflammatory, and antipyretic activity.
  • It inhibits prostaglandin synthesis by blocking the conversion of arachidonic acid to prostaglandins.
  • Ibuprofen belongs to a general class of drugs known as [[rol||non-steroidal anti-inflammatory drugs |A group of drugs, roughly related to aspirin and ibuprofen, which work by inhibiting the formation of particular chemicals in the body (prostaglandins). The NSAID's are effective in reducing pain, inflammation, and fever, but carry the risk of causing stomach (gastric) ulcers, liver injury, and kidney damage in animals.]](NSAID). Other related drugs in this class include naproxen and ketoprofen.
  • Clinically, ibuprofen is most often used to treat arthritis and musculoskeletal pain.
  • Following oral administration it is rapidly absorbed. Its bioavailability in dogs is 60 to 86% and it reaches peak serum concentrations in about 2 hours. Ibuprofen is transported 96% bound to plasma protein and has a half-life in dogs of approximately 5 hours.
  • Ibuprofen is a non-prescription drug but should ONLY be used under the guidance of a veterinarian. Used improperly, ibuprofen can be highly toxic. Veterinarians may not recommend its use, as there are alternative veterinary drugs approved for the use in animals.
  • Ibuprofen is NOT recommended for use in cats
  • This drug is not approved for use in animals by the Food and Drug Administration.
  • Ibuprofen is available over the counter but should not be administered unless under the supervision of a veterinarian.

    Brand Names and Other Names

  • This drug is registered for use in humans only.
  • Human formulations: Motrin® (McNeil), Advil® (Whitehall-Robins), Haltran® (Lee Pharmaceutical), Midol® (Bayer), Menadol® (Rugby), PediaCare (Pharmacia & Upjohn), and various generic forms of ibuprofen.
  • Veterinary formulations: None

    Uses of Ibuprofen

  • Ibuprofen is used in dogs for analgesia, to reduce swelling or reduction of a fever. It is not recommended for use in cats.

    Precautions and Side Effects

  • Ibuprofen should not be used unless recommended by your veterinarian.
  • Ibuprofen has a narrow therapeutic index in domestic small animals and very small changes in the dosage level can lead to toxicity.
  • Ibuprofen should not be used in animals with known hypersensitivity or allergy to the drug, its components, or other NSAIDs.
  • Hepatopathy, renal failure, and GI ulceration/perforation have been reported in dogs and cats treated with ibuprofen. Cats are estimated to be twice as sensitive to the toxic effects of ibuprofen because of their limited ability to form glucuronides.
  • Signs of impending toxicity include reduced appetite, vomiting (+/- blood), black tarry stools, abdominal pain, dehydration, weakness, and lethargy. Blood loss from GI ulcers may cause anemia. Treatment of toxicity may involve intravenous fluids, activated charcoal (if given within 2 hours of ingestion), and blood transfusion if anemia is severe. Medications such as misoprotol (Ctotec®), sucralfate (Carafate®), cimetidine (Tagamet®) or famotidine (Pepcid®) can be given to treat gastric ulcers. Blood work is often necessary to evaluate hepatic and renal function before and after treatment of toxicity.

    Drug Interactions

    Ibuprofen may interact with several medications. If your veterinarian recommends ibuprofen for you pet, make sure you discuss all other medications they are on. Interactions may include:

  • Cholestyramine may decrease the effects of NSAIDs.
  • Phenobarbital may reduce ibuprofen's half-life by inducing liver enzymes. Dose adjustment may thus be necessary.
  • Probenecid may increase the plasma concentration and toxicity of ibuprofen.
  • Plasma concentrations of NSAIDs may be decreased by salicylates.
  • NSAIDs may decrease the antihypertensive effect of ACE inhibitors and beat blockers.
  • Coadministration of NSAIDs and anticoagulants may prolong the prothrombin time.
  • The nephrotoxicity of both agents is increased when NSAIDs and cyclosporine are used concomitantly.
  • The effects of diuretics may be decreased when administered with ibuprofen.
  • NSAIDs tend to increase plasma phenytoin levels, increasing its pharmacologic effect and toxicity.
  • NSAIDs increase the risk of methotrexate toxicity.
  • NSAIDs may increase plasma theophylline levels.

    How Ibuprofen is Supplied

  • Tablets: 100 mg, 400 mg, 600 mg, and 800 mg
  • Chewable tablets: 50 mg, and 100 mg
  • Capsules: 200 mg
  • Suspension: 100 mg/5 mL
  • Oral drops: 40 mg/mL

    Dosing Information

  • Medication should never be administered without first consulting your veterinarian.
  • The usual dose in dogs is 2.5 to 4 mg per pound (5 to 8 mg/kg) every 12 hours.
  • It is NOT recommended for use in cats.



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