Talk:Ibuprofen/Archive 1

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Contents 1 Synthesis 2 Metabolism 3 Dosage 4 History 5 LD 50 6 stereochemistry 6.1 photosensitivity 7 With Food/Drink 8 Expiration 9 Non-Human Uses 10 Acronym? 11 Please add political info 12 Counterindications and Dosage for Children 13 Ibuprofen & Aspirin Interactions 14 NaCl 15 Slang 16 Paracetemol 17 Structural Diagram 18 Measurements 19 Replace Advil with generic ibuprofen? 20 Anticoagulant properties? 21 Human toxicology 22 Over the counter (OTC) availability in the United Kingdom 23 Canada 24 Side Effects of Use for DOMS 25 Interaction with Alcohol 26 Advil 27 creation

Synthesis

Someone should add some synthetic details....

Metabolism

Does anyone know how this is metabolized? I have heard through the stomach making Advil and Tylonol acceptible to use in concert.

Dosage

How about safe dosage limits, and what kind of damage an overdose can do?

• • Excellent Idea Medscin 15:04, 27 December 2005 (UTC)

195.93.21.34 14:38, 28 March 2006 (UTC) I think the safe dose must be very high because if you look at the POM (prescription only medecin) then it says doctors can prescribe 4 times the OTC dose- thats 800mg per tab....

User:Comrade Sephiroth If you look at the directions for over-the-counter use, it says not to exceed 1200 mg in 24 hours unless under medical direction. However, the "prescription dosage" for severe pain, swelling or fever is often as high as 2400 mg, even 3200 mg on occasion. The FDA is deliberately very conservative with over-the-counter dosages to avoid liability, and assumes that some people will fudge the OTC limit a little bit (i.e. 1600 or 1800 mg per day). This also takes into account the alcohol issue, of course. People who are completely sober all the time can push the limit more safely than social drinkers. Today my knee, quads and calf were all quite sore and I took a total of 1600 mg. But please do not take my commentary as a reason to use more than 1200 mg/day; you need to use good judgment and make your own decision on dosage.

Wikipedia does not give instruction to readers, nor is personal experience/opinion permitted in articles (comes under WP:No original research). NSAIDs have their risks (gastric irritation and gastric ulceration, as well as effects on renal functiuon and risk of heart disease), so there are very good safety reasons why limits are placed. If you can find WP:Reliable sources to WP:Verify that it is Ok for people to exceed the stated dosage limits then fine, but no reliable source would... David Ruben ^Talk 11:09, 31 May 2007 (UTC)

I don't know how to give a citation for the topical form of Ibuprofen without violating what I suspect are Wikipedia's commerce policies, but it is called Ibunex Topical Ibuprofen from Core Labs. —Preceding unsigned comment added by 24.180.19.82 (talk) 17:31, 22 May 2008 (UTC)

History

Does anyone know the history of Ibuprofen? How it was discovered, when and by whom?

And, I might add, how somebody came up with such a funny name for the substance. =Axlq 07:03, 6 November 2006 (UTC)

http://www.ibuprofen-foundation.com/what-ibuprofen/story.htm would seem to be a good reference if anybody wants to use/cite it, there's even a copy of the pattent application there --Streaky 00:17, 13 February 2007 (UTC)

it is metabolized through the kidneys.

LD 50

"Ibuprofen: Oral rat LD50: 636 mg/kg; investigated as a mutagen, reproductive effector."

from: http://bulkpharm.mallinckrodt.com/_attachments/msds/IBUPR.htm ~Mike O.

stereochemistry

"Further in vivo testing, however, revealed the existence of an isomerase which converted (R)-ibuprofen to the active (S)-enantiomer. Thus, due to the expense and futility that might be involved in marketing the single-enantiomer, all ibuprofen formulations currently marketed are a racemic mixture of both enantiomers."

According to John McMurry's Organic Chemistry, (S)-ibuprofen is marketed in Europe. Also, although the body converts the R enantiomer into the S, a racemic mixture would take roughly 38 minutes to take effect while the S enantiomer takes a mere 12 minutes. Does anyone have a source for the above paragraph because if not, I'm going to change it.

The paragraph may be true in USA, but globally it is incorrect. In Finland dexibuprofen is widely used even though slightly more expensive. It has brand name Dexit and is marketed by Leiras and produced by Schering. More info (in Finnish) http://www.dexit.fi/. Unfortunately couldn't find info in English.

photosensitivity

I've forgotten my login, so apologize for lack of sign in right now and other unconvenionalities. But I have to say: I cannot see any logical connection between these two statements: "As with other NSAIDs, ibuprofen has been reported to be a photosensitising agent.[6] Ibuprofen, however, has a very weak absorption spectrum which does not reach into the solar spectrum. "

What the molecule does in a test tube and how it affects the physiochemistry of the cells of the body seem like two different things to me. I personally don't know anything about the specifics of photosensitivity in ibuprofen. Haven't read any papers on it. But I know quite a bit of biology, and this makes no sense to me. It's like saying that because sugar releases all its energy at once when burned in a dish, it wouldn't work as a fuel for cells, which need small packets of energy... I hope someone will consider fixing this. I've attempted to fix things at Wikipedia in the past and had them reversed even though I was definitely right, simply because I hadn't been working on the article for months.So I will not bother researching this and fixing it. Best to the authors, science writer in california

What part of that doesn't make sense? The first sentence is a summary statement that it has been reported as a photosensitising agent. The following sentences explain that photosensitivity is not usually clinically significant for ibuprofen and explains why. Admittedly, the reference could be better – I'll fix this. -Techelf 10:34, 5 August 2006 (UTC)

With Food/Drink

Are there any reasons to take Ibuprofen with food or milk etc, or is it better to take it with just water? 69.87.193.34 20:05, 4 June 2006 (UTC)

Found no problems either way personally, and I've used it a lot. 62.241.250.39 05:35, 11 December 2006 (UTC)

I was told to take 300mg twice daily with food for relief of Temporomandibular joint disorder. --NEMT 05:05, 11 July 2007 (UTC)

Expiration

What is the typical time from manufacture to labelled expiration date?

What are the optimum storage conditions?

After expiration, does it just become weaker in proper action, or are harmful compounds formed? If so, what are they, and what effects would they have? 69.87.193.34 20:05, 4 June 2006 (UTC)

Non-Human Uses

Is Ibuprofen useful in non-humans, for example dogs and cats? What are appropriate dosage levels for veterinary uses? 69.87.193.34 20:05, 4 June 2006 (UTC)

Acronym?

Under the Adverse Effects heading:

Ibuprofen appears to have UR MUM at the lowest incidence of gastrointestinal adverse drug reactions (ADRs) of all the non-selective Nigers.

I don't know enough Medicine to know whether 'UR MUM' is some real cryptic acronym or not, sounds suspicious to me. Can someone look into that?

DarkIye 20:34, 26 January 2006 (UTC)

I assume it was vandalism. They replaced NSAIDs with "Nigers" too. Fixed. MasterOfPuppets

Please add political info

Is this available over the counter?

Are there any laws affecting the usage of this drug?

• It's in the article already, as well as the info box. Ibuprofen is OTC for smaller dosages (200mg), and prescription for larger. It is very, very widely used as an OTC drug. Haikupoet 01:46, 10 February 2006 (UTC)

In Finland you can get 400mg over the counter. 62.241.250.39 05:35, 11 December 2006 (UTC)

Blonde2max 21:21, 25 March 2006 (UTC) In the UK your local shop/supermarket can sell 200mg tablets. If you want 400mg then you have to go to a pharmacy. I am not sure if larger doses are ever givin- but I assume they would have to be prescribed.

It's often interesting to note however that 400mg tablets are more than double the price than 200mg: why can't you just double the dose???

Counterindications and Dosage for Children

Does anybody know if / how much is safe for infants and children? The adult dose is listed, but nothing about babies and children, or for that matter the effect on breastfeeding mothers. Just an idea. Blonde2max 21:27, 25 March 2006 (UTC) Heres some info i found in CALPOL

What's the difference? Paracetamol is considered the first choice treatment for easing childhood pain and bringing a temperature down. It is gentle on the tummy, making it suitable from 2 months plus.

Ibuprofen is also an effective pain reliever but should not be given to babies under 6 months. Its anti-inflammatory properties also help to reduce swellings from sprains and strains. However, it can cause tummy upsets and isn't suitable for children with asthma.

Blonde2max 21:46, 25 March 2006 (UTC) Age Safe dose Under 6 months 0 mg 6 months - 1 year 50 mg every 6 hours (not exceeding 150mg a day) 1 Year - 2 years 50 mg every 4 hours (not exceeding 200mg a day) 3 years - 7 years 100 mg every 4 hours (not exceeding 400mg a day) 7 years - 12 years 200 mg every 4 hours (not exceeding 800mg a day)

Someone changed the children's dosage information to remove the /kg from "5–10 mg/kg in children". I added the /kg back in. Dosage in children is determined based on the child's weight, so it's 5-10 mg of ibuprofen for each kg that the child weighs. The wording in the article may be somewhat confusing, although I'm unsure how to make it less so. I found a dosage chart that uses the child's weight rather than age, that seems to correspond with 5-10 mg/kg, although it uses pounds rather than kg. http://www.lpch.org/HealthLibrary/ParentCareTopics/DrugDosageTables/Ibuprofenforfeverandpain.html Brokenchairs 14:23, 20 May 2007 (UTC)

Ibuprofen & Aspirin Interactions

I was told by a doctor that Ibuprofen and Aspirin can cancel each others' effects when taken simultaneously. Since this came from a well-educated medical professional I assume that it is true but I am having some trouble finding a reliable source online to confirm. Perhaps someone can look into this and make any necessary changes or additions to the article. Mrestko 02:13, 3 May 2006 (UTC)

There is some evidence to suggest that ibuprofen can decrease the antiplatelet action of aspirin (MacDonald & Wei, 2003; PMID 12598144). Concurrent use does not "cancel" the anti-inflammatory effect of aspirin and ibuprofen, however there won't be any added benefit (because they work the same way) and the risk of adverse effects is increased. -Techelf 09:31, 3 May 2006 (UTC)

NaCl

Apparently some NSAIDS have NaCl. Does anyone know if Ibuprofen has NaCl and if so how much? KPM M.D.

You are mistaken. Perhaps a preparation of a particular NSAID contains sodium chloride (NaCl), in which case the best place to look is the Appproved Product Information/Prescribing Information document. On the other hand, if you're talking about sodium content, then yes some NSAIDs are marketed as the sodium salt (e.g. diclofenac sodium), in which case the sodium content depends on the NSAID in question. -Techelf 08:50, 24 May 2006 (UTC)

Slang

Added a somewhat half-assed link to "Vitamin I." The only other reference I know is from personal experience as a Morris dancer where the term was much in vogue. However, I'm painfully aware that I don't count as an acceptable reference... Septegram 20:30, 29 June 2006 (UTC)

Paracetemol

Is it safe to take 2 Paracetemols and 2 Ibruprofens together. I am told by my mother this is safe, is it?

Note: This is not personal advice I class it as Dosage

Ibuprofen should be enough, if you feel you need Pracetemol on top of it I would suggest you consult your GP JayKeaton 16:05, 27 November 2006 (UTC)

I'd really suggest you list the dosage in milligrams instead of just saying the number of pills - but I've taken paracetamol (400mg) and ibuprofen (600mg) simultaneously, and it should be safe at least occasionally.

I know this probably seems facetious, but I think it is worth pointing out that this section title is misspelt - the correct name for this medication is "paracetamol", which is the INN. Sorry. :-p Leevclarke 02:18, 9 July 2007 (UTC)

Re: the dosage, the recommended maximum dosage limits are (unofficially) well below what most people could safely take, at least occasionally. Ibuprofen is a painkiller and an anti-inflammatory (inflammation may well be a cause for generalised pain), whereas paracetamol is only a painkiller.

My advice would be to take one or the other, in increased doses if you really feel it's necessary. Ibuprofen is available generically at no real cost difference compared with paracetamol (at least here in the UK), so I tend to go for ibuprofen in the first instance. Either is a lot safer than the old days of aspirin as a general painkiller. ;-) Leevclarke 02:19, 9 July 2007 (UTC)

The answer to this question is yes. I have had multiple doctors tell me that both medications can be taken together. It is generally safe. However, the risk of stomach irritation increases when both are taken together. ALWAYS talk to your doctor first before taking both together as only your doctor knows your medical history. —Preceding unsigned comment added by 156.80.234.108 (talk) 01:54, 23 April 2008 (UTC)

Structural Diagram

I was somewhat confused by the squiggly line someone put in the structural diagram. I asked a chemistry teacher and she said the squiggly line should simply a straight line, which seemed right as it is a (single?) bond with CH3. Am I right, or simply unlearned in the matter? --DoomsElf 00:45, 20 January 2007 (UTC)

The squiggly line is meant to show that the drug is a racemic mixture of two different enantiomers. If only one enantiomer was given, you would see the wedge shaped bond indicating the group is sticking out of the page or the dashed wedge indicating it being slightly behind the page. The main article currently discusses the chirality. 206.111.112.99 21:31, 29 June 2007 (UTC) Anonymouse

Measurements

in the section detailing overdose the phrase "As little as 4 tablets" occurs. this is hardly scientific, can somone get a minimum reported dosage for an overdose, or I might be tempter to get rid of that part.

The phrase "As little as 4 tablets" is actually in the side effects section, rather than the overdose section, which would imply that these effects are possible from taking the recommended dose. This phrase (4 tablets) seems rather dubious. I have expirienced nausea (one of the side effects mentioned) from taking 200 mg, which is only one tablet. Brokenchairs 01:33, 10 May 2007 (UTC)

Ok, so I went ahead and removed the bit about "4 tablets". If anyone thinks it really needs to be there, hopefully you'll use a more quantitative way to describe the amount needed for those side effects, and back it up with a reference. Brokenchairs 01:38, 10 May 2007 (UTC)

Replace Advil with generic ibuprofen?

Two out of four of the pictures here are of advil, and the two others are just chemical structures. Should we replace it with something more generic so the article doesn't seem to be endorsing any particular brand? Klosterdev 03:11, 27 February 2007 (UTC)

There seems to be no point in having any pictures of containers of ibuprofen apart from providing free advertisements SilasW 09:14, 17 April 2007 (UTC)

Anticoagulant properties?

I'm currently suffering from oral surgery pain, and I've been avoiding ibuprofen and naproxen in preference to prescription painkillers because I distinctly recalled that even non-aspirin NSAIDs cause a drop in platelet count. In the process of attempting to confirm this for a friend's edification a few moments ago, I wound up visiting the articles for ibuprofen, cyclooxygenase, and platelets before confirming to my satisfaction that I had the right idea... part of the confusion is that the statement about COX-2 inhibition is highly ambiguous - on first reading, the sentence appears to state that COX-2 inhibition occurs at levels below those needed to obtain reduced platelet counts.

Bottom line: confusing as hell, disclaimers notwithstanding. Persist1 06:59, 13 March 2007 (UTC)

Human toxicology

"There is little correlation between severity of symptoms and measured ibuprofen plasma levels. Toxic effects are unlikely at doses below 100 mg/kg but can be severe above 400 mg/kg;[11] ....."

Total dosage/kg per day, per week, per microsecond? What exactly? Geez, no wonder people get poisoned in hospitals. Everyone is so blithe and casual with dropping figures minus context. Assume per day. I weigh 82kg => @100mg/kg/day = 8200mg/day. So toxic effects are unlikely if I stay below 7 times the 1200mg limit for 24 hrs recommended on my bottle here? LOL!!!

Please sign your comments. Thank you. As for the doses, for me it's quite clear, that the figures are ment for a single dose p.o. and in a toxicological context. So, if your BM = 82 kg, than, a single ingestion of up to 8.2 g ibuprofen is rather unlikely to be too severe or even fatal, though it certainly would be a medical emergency, requiring examination and assesment by a physician right then, right there (in a hospital); if you'd ingest doses of more than 10 g, the poisoning resulting can be expected to be severe or even fatal, requiring hospitalisation and intensive care, possibly.

If you read the article carefully, you certainly shouldn't have problems to find the suggestion to follow dosage instruction in package insert of the medication, or advice your pharmacist/physician gave you. Still laughing out loud? Cheers.--84.163.127.140 (talk) 02:11, 28 January 2008 (UTC)

Over the counter (OTC) availability in the United Kingdom

It is not true that OTC sales are limited to 16 * 200mg in the United Kingdom. You can in fact purchase 96 x 200mg and also 400mg packets OTC (as I did myself the other day); they are just not available in general retailers, only from pharmacy counters. However this is still OTC - the definition being you do not need a prescription.

Could we discuss/confirm then update the "availability" section appropriately please?

Canada

Is it available over the counter in Canada? I heard that it was not, but that might not be recent information. -- Beland 23:35, 27 July 2007 (UTC).Ibuprofen is available over the counter in Canada.

Side Effects of Use for DOMS

Still a new user to Wikipedia, I noticed a citation is needed for the current statement that use of Ibuprofen for delayed onset muscle soreness (DOMS) may suppress muscle growth for athletes/bodybuilders. I've found an article by researchers at the Democritus University of Thrace showing a decreased level of creatine kinase of the ibuprofen group compared to the control group at 48 hours (Tokmakidis, S.P., Kokkinidis, F.A., Smilios, I., & Douda, H.(2003). The effects of ibuprofen on delayed muscle soreness and muscular performance after eccentric exercise. The Journal of Strength and Conditioning Research, 17(1), 53-59.) I found this to be related with the claim that Ibuprofen can result in decreased muscle growth. Anyone with confident editing skills and some experience with the drug is welcome to use this citation to add to or replace the DOMS section of Side Effects. Article was found on Google Scholar. Nathan.pepper 03:47, 27 August 2007 (UTC) Nathan.pepper

The entire section related to DOMS should be removed. I'm not in favour of sweeping statements being added with a request for a citation. Anything contentious which requires a citation as supporting evidence should not be included until one is provided. Otherwise it is simply an assertion.

The Journal of Strength and Conditioning Research 'The effects of Ibuprofen on delayed muscle soreness and muscular performance after eccentric exercise' Vol 17 (1) 53-59 details quite clearly that

Despite a decrease in the perception of pain and reduced levels of the markers associated with muscle damage, the research team were unable to establish any performance benefits resulting from the administration of Ibuprofen. Muscular performance of the hamstrings (maximal strength, knee flexion ROM and vertical jump performance) decreased following the eccentric-exercise session. Ibuprofen administration had no effect on the level of decline. The reduction in performance post-exercise was similar for both groups. http://www.sportsinjurybulletin.com/archive/Ibuprofen-muscle-soreness.html

--Antipodean 03:27, 6 September 2007 (UTC)

i was treated withthis after being hit by a bus. Just wondering if it can stone you or make you high? started tripping out when i was listening to Pink Floyd —Preceding unsigned comment added by 24.255.51.222 (talk) 09:17, 23 September 2007 (UTC)

Interaction with Alcohol

Well, the main article does not even mention alcohol. I've also read the packaging on many ibuprofen products and none of those mention alcohol either. So from that I am assuming that it is safe to use Ibuprofen if you have consumed alcohol, unlike paracetamol (tylanol)? It's an important issue with any drug to know how it interacts with alcohol seeing as so many people do drink. So for that reason may I request that someone who knows, make the inclusion? 80.176.233.50 (talk) 21:11, 27 January 2008 (UTC)

Concomitant use of Ibuprofen or other NSAIDs and alcohol should be generally avoided, since it may enhance gastrointestinal (stomach, intestines) and renal (kidneys) toxicities of the drugs. For reference, you can read one of the full prescribing informations available online for Ibuprofen containing medications. Generally, it is wise to assume, that none medication should be combined with alcohol, unless your physician tells you it can. This can be particularly complicated because many people take OTC NSAIDs like Ibuprofen as a "standard" hangover-associated headache remedy, but...it isn't wise to do so often.--84.163.127.140 (talk) 02:30, 28 January 2008 (UTC)

Advil

To be consistent with other similar articles, I put back into the summary the best-known brand that contains this ingredient. For the same reason that it's done in the other articles. --Psm (talk) 18:29, 21 April 2008 (UTC)

creation

does anyone know how to make ibuprofen?-

You go to walgreens and you buy a jar of 100 200mg tablets for $1.08

http://www.chm.bris.ac.uk/motm/ibuprofen/synthesisc.htm lists two synthesis pathways, the Boot process, and the more efficient Hoechst process. "Most of these routes to ibuprofen begin with isobutylbenzene and use Friedel-Crafts acylation. The Boot process requires six steps, while the Hoechst process, with the assistance of catalysts, is completed in only three steps."

Don't try it. You'll destroy yourself.

Just mix equal parts Ibu with Profen. You can't go wrong. —Preceding unsigned comment added by 80.192.119.210 (talk) 10:19, 1 May 2008 (UTC)