In addition to diclofenac and acetylsalicylic acid, ibuprofen is one of the most commonly used so-called "acidic" analgesics. Thanks to its acidic nature, ibuprofen, in contrast to substances such as acetaminophen or metamizole, not only works against pain but also against inflammation, as these active ingredients do not penetrate so well into the inflamed and thus acidified tissue.
Effect of ibuprofen
Ibuprofen is used to quell mild to moderate pain and to stop inflammation - for example, in rheumatic diseases, which are manifested by painful joint inflammation. In addition, ibuprofen reduces fever, but is hardly used therapeutically for this purpose.
Ibuprofen belongs to the class of non-steroidal anti-inflammatory drugs (NSAIDs), as opposed to, for example, cortisone. The active ingredient Ibuprofen is also a representative of the nonopioid analgesics, thus belongs to the group of (other than opioids) non-addictive and widely used worldwide cyclooxygenase inhibitors.
The effect of ibuprofen is based on inhibiting cyclooxygenase. Therefore, the so-called prostaglandins, which are pro-inflammatory, pain-inducing and fever-increasing, only reduced imitated.
Applications of ibuprofen
Ibuprofen is often used in the following cases:
- Ibuprofen has been used and developed especially often for the treatment of rheumatic joint diseases. It relieves inflammation, swelling and pain in arthrosis, rheumatoid arthritis and gout.
- In a lower dose Ibuprofen also helps against headaches and migraines as well as toothache or menstrual pain.
- Ibuprofen is also used for muscle pain and sports injuries such as strains and torn ligaments; alternatively diclofenac helps here.
- Other areas of application are pain relief in acute otitis media, tonsillitis or sunburn.
Ibuprofen is sold in a variety of dosage forms. It is available as a tablet, capsule, suppository, juice, granules or ointment. The drug is available in different dosages, the low ones are available at the pharmacy. Ibuprofen in doses over 400 mg are prescription.
The spectrum of the effect of ibuprofen depends on the dose: Lower doses of between 200 and 800 mg in adults have an analgesic and antipyretic effect . Only at higher dosages up to 2, 400 mg daily, the anti-inflammatory effect comes into play.
The ingested funds remain in the same concentration in the blood for about two to three hours, after which the effect decreases. For the most part, the degradation products are excreted via the kidney, sometimes also via the liver.
In contrast to the related acetylsalicylic acid, ibuprofen can also be used in children after consultation with a doctor. A reason for treatment is, for example, in premature babies. In order to support their immature heart, it helps to close the often persistent ductus arteriosus botalli, a connection between the venous and arterial system, with the help of ibuprofen.
Ibuprofen: side effects
Often, ibuprofen causes side effects such as stomach pain, nausea and diarrhea. Dizziness, headache and reversible visual acuity rarely occur.
As with the related cyclooxygenase inhibitors acetylsalicylic acid and diclofenac, the frequent use of ibuprofen may also lead to gastric bleeding or even gastric puffing. The inhibition of cyclooxygenase not only reduces the production of unwanted pro-inflammatory prostaglandins. Also, the prostaglandins, which normally protect the stomach, fall out, which makes the stomach very sensitive to the digestive enzymes and its own stomach acid.
Because of this, prolonged ibuprofen therapy should only be used in combination with gastric protection. Recommended drugs for this purpose are drugs that reduce the production of stomach acid, for example proton pump inhibitors such as omeprazole or pantoprazole. In addition, it helps to protect the stomach, if you do not take these drugs sober .
Parallel therapy with steroidal painkillers such as cortisone is not recommended because it would further increase the risk of bleeding. Caution should also be exercised in patients with known inflammatory gastrointestinal disorders such as ulcerative colitis or Crohn's disease, as taking ibuprofen may cause an acute episode of these diseases.
In addition, ibuprofen has an inhibitory effect on platelet aggregation, similar to the effect of acetylsalicylic acid. Therefore, there is an increased risk of bleeding. The concomitant use of other anticoagulants such as Marcumar® can therefore be questionable.
Paradoxically, however, the effect of other platelet inhibitors such as acetylsalicylic acid is reduced when taken by competition at the same receptor. This can lead to increased thrombi and emboli. Because of the difficult to assess the effect on your own blood clotting you should inform the attending physician prior to surgery necessarily on the previous intake of painkillers.
Ibuprofen in pregnancy
Also, problems with unwanted prolongation of pregnancy in the context of prostaglandin intake is reported: Some prostaglandins promote contractions. If these are formed diminished, then the contractions also set in late.
According to the theory, the treatment of rheumatoid arthritis, in a low dosage up to 600 mg daily, seems safe even during pregnancy and lactation. Other doctors see pregnancy as a clear contraindication for ibuprofen therapy. In the individual case, it is therefore strongly advised to consult the treating physician again.
Rarely does it come to the so-called "aspirin asthma", which can also occur when taking the painkillers ibuprofen and diclofenac. By reducing prostaglandins, the body converts the parent compound into leukotrienes. These cause coughing and narrow the lungs.
Also, patients who have a contaminated kidney must be careful when taking ibuprofen and other cyclooxygenase inhibitors, as the renal vessels also contract when fewer prostaglandins are formed. This can further reduce already low kidney function and in the worst case lead to dialysis. The use of Ibuprofen in existing kidney disease must therefore be carefully monitored.
The same applies to liver diseases, as part of the drug is metabolised via the liver. Therefore, it is not recommended to consume alcohol during the treatment because it puts additional strain on the liver. Regular monitoring of kidney and liver values with longer-term use of ibuprofen is therefore important.
With simultaneous lithium therapy, one must control the plasma level of this antidepressant particularly carefully, since the lithium excretion in the kidney is reduced by the ibuprofen intake. The same applies to a therapy with the antiepileptic drug phenytoin, which is degraded in the presence of ibuprofen slowed down.
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