Common conditions such as fever and pain are often managed symptomatically by individuals through over the counter medications. While it may be safe in most circumstances and offer relief, it is essential to be aware of possible undesirable effects. Ibuprofen is one among the more popular OTC formulations available in the market, and has the distinction of being among the first to be approved as an OTC. Belonging to the category of non-steroidal anti-inflammatory medications outside the aspirin class of medications generally used for the above conditions, Ibuprofen has relatively good tolerance. While it is true that major health complications have not been reported the possibility of side effects of ibuprofen exist. The following sections will delve into the circumstances and the best methods to treat the condition.

Properties that make ibuprofen a preferred choice among OTC medications

Ibuprofen contains analgesic properties that make it effective in pain management. In certain instances, when patients suffer acute unbearable pain, treatment options often include a combination of opioids and NSAIDs. For instance, tramadol may sometimes be given along with ibuprofen to alleviate severe pain in patients. This is known to be a relatively safe option with no major interactions. In addition to the analgesic properties, Ibuprofen also comes with unique anti-inflammatory properties.

When administered in lower dosages, Ibuprofen delivers analgesic effects, and when it is delivered in higher dosages, the anti-inflammatory properties of the OTC formulation are experienced. One of the distinct advantages is the relative safety of the medication and its efficacy. While there are stronger medications to handle pain, such as opioids and steroids, there is always the risk of exposure to possible side effects. For instance, bedridden patients on strong pain relief medications may end up with constipation, and fluctuations in blood pressure.

Mechanism of action of the NSAID

Ibuprofen works by inhibiting COX enzymes. This is through a non-selective mode, and this gives it the property to mitigate pain and manage fever effectively. Prostaglandins are lipids at the site of damage to the tissue or infection and are known as mediators for injury and illness. Thromboxane is another group of lipids that are known as vasoconstrictors and hypertensive agents, with a role in platelet aggregation. Ibuprofen helps to control these mediators and this in turn brings down fever, and inflammation, apart from reducing pain.

Enzymes are typically categorized into COX-1 and COX-2 enzymes, with many medications working selectively by regulating a single category of enzymes. Ibuprofen is distinct, in that it non-selectively regulates both enzymes and giving it distinct properties. The body’s natural response in the event of certain stimuli or circumstances involves enzyme release. This causes the prostaglandins and thromboxane to work. The regulation of the enzyme release by Ibuprofen, helps to control the mediators bringing about the desired outcomes. Ibuprofen and other medications that are intended to help treat the symptoms of conditions are usually taken along with other medications to specifically treat the underlying condition that triggers the symptoms.

Conditions managed by Ibuprofen

The conditions or symptoms that can be treated by Ibuprofen include the following:

Different types of presentations or formulations of the NSAID

The NSAID is presently available as OTC medications, and as an active ingredient in other medications that are available as prescription only medications. The various presentations or formulations of the NSAID include:

  • Gel
  • Spray
  • Tablets
  • Syrup

Time taken for Ibuprofen to act

  • Ibuprofen when taken orally typically takes 20 minutes or so for some results
  • When applied as a gel or sprayed, Ibuprofen delivers faster results.

Possibility of side effects of ibuprofen  

Medications, including OTC formulations, are not free from the possibility of undesirable effects. The nature of effects may be experienced differently by different people. For instance, some may feel mild effects, while others may be subject to stronger, adverse effects, while another category of individuals may not experience any kind of effects at all. Similarly, the duration of the effects may also differ among or within categories of users. Most mild effects are known to resolve naturally, without any kind of treatment. Effects classified as stronger are known to be rare in occurrence and may affect only fewer individuals. This may sometimes require some kind of intervention to treat the effects.

Circumstances when probability of adverse outcomes are stronger

Individuals who consume the medication on a long-term basis are exposed to the risk of stronger undesirable effects. The best way to cope with this risk is to take suitable precautions and monitor the patient for possible effects in the initial period of taking or starting the medication. Short term users of the NSAID are highly unlikely to experience effects, with relatively low prevalence rates of undesirable effects.

Other categories of patients at risk of experiencing effects those who consume stronger dosages. For instance, depending on other comorbidities and the medications in use, there is the possibility of patients being exposed to heart attack or stroke as a result of stronger dosage of Ibuprofen. It is necessary to add that this is a possibility among patients diagnosed with conditions that place them at risk of cardiovascular events/stroke.

Discontinuation of Ibuprofen or other NSAIDs

There are special circumstances, when it may be necessary to discontinue Ibuprofen or other NSAIDs. Symptoms that warrant discontinuation or careful monitoring include:

  • Fainting
  • Visible traces of blood in stools, vomit
  • Extended pain
  • Change in color of skin or irritation when applied topically

Most moderate effects will not make it necessary to discontinue or stop the medication, while the above conditions need to be monitored and assessed quickly and wherever necessary, the medication is to be stopped.  Another condition that needs to be borne in mind is that Ibuprofen is intended to help manage fever. When fever is not controlled with the medication, it may be necessary to look at different medications, with special emphasis on treating the underlying condition with greater urgency.

Commonly occurring side effects of the NSAID

Some undesirable effects attributed to the use of NSAIDs are sometimes relatively common in occurrence. Here is a compilation of some of the frequently occurring or reported undesirable outcomes of the medication. It is necessary to add that this is not exhaustive in nature, but is intended to help give an overview of the effects or the types of effects.

  • Nausea – known to occur frequently
  • Vomiting – typically accompanies nausea
  • Pain – mild or moderate in nature
  • Diarrhea – among certain users
  • Bloated feeling/flatulence – typically associated with diarrhea
  • Dyspepsia – symptoms include upper abdominal pain
  • Indigestion – relatively common
  • Edema – retention of fluid in hands/legs and tissues
  • Dizziness – common effect
  • Nervousness, anxiety
  • Headache – throbbing pain
  • Mild rashes – needs to be managed quickly
  • Tinnitus – mild in nature, mostly resolves naturally

Simple measures to manage the side effects of ibuprofen  

Undesirable outcomes of the medication, as mentioned above are a possibility and it is virtually impossible to prevent the same in totality. However, simple measures help to tone down the severity of the effects and also helps to quickly resolve the condition. This is necessary as the possibility of effects are not just direct in nature, but could also result in indirect effects. For instance, dizziness/fainting are possible effects and this could have a serious effect on individuals at the workplace. Similarly, the impact on reflexes may also have an indirect effect on the ability of the individual to drive safely, without endangering the lives of others on the roads.

Patients preparing to undergo heart surgeries need to choose different medications, as all NSAIDs are likely to cause adverse outcomes. This applies to all patients and all NSAIDs, due to the mechanism of action of the medication and the impact during the surgical procedure, or the period immediately after the procedure.

Patients with history of allergies to be extra cautious or avoid NSAIDs

Ibuprofen could trigger allergies in patients with past allergic reactions to ingredients in the medications. The best option is to choose a medication that does not trigger an allergy, but whenever, it is imperative or the individual is left with no other choice, it is necessary to seek the advice of the consultant. It would also help to take the medication under supervision or with quick access to a healthcare facility in the event of allergic reactions.

Unsuitability of Ibuprofen for certain categories of individuals

While this NSAID is relatively safe with a good tolerance and efficacy, it cannot be used by all patients. Individuals with certain conditions or on specific type medications are not to take Ibuprofen. Here is a short compilation of some of the categories of individuals unsuitable for taking this NSAID.

Patients with:

  • Abdominal pain
  • Heartburn
  • Stomach ulcers
  • Internal bleeding
  • Hypertension
  • Cardiovascular health issues
  • Kidney disease
  • Shingles
  • Chicken pox
  • Ulcerative colitis
  • Crohn’s disease
  • Liver disease

Patients on:

  • Diuretics
  • Other medications belonging to NSAIDs category
  • Anticoagulants

Tips to manage symptoms that are indicative of undesirable effects

It is important to seek medication intervention in the event of certain symptoms that are indicative of serious or adverse effects. This includes:

  • Pain/uneasy feeling in the chest
  • Breathing difficulty
  • Speech that is slurred
  • Weakness experienced on one side

Symptoms that indicate allergies to Ibuprofen

Specific symptoms indicate that the individual is experiencing an allergy to Ibuprofen. The following symptoms need to be monitored and managed/treated at the earlier to prevent aggravation:

The last symptom on the above list is serious and could endanger the life of the patient. It is important to seek urgent treatment and prevent fatalities or serious conditions.

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