Ibuprofen Indications and Dosage
- ankylosing spondylitis †
- arthralgia
- bone pain †
- cystic fibrosis †
- dental pain
- dysmenorrhea
- fever
- gouty arthritis †
- headache
- juvenile rheumatoid arthritis (JRA)
- migraine
- mild pain
- moderate pain
- myalgia
- osteoarthritis
- patent ductus arteriosus (PDA) †
- psoriatic arthritis †
- rheumatoid arthritis
† non-FDA-approved indication
Ibuprofen Indications and Dosage
For the treatment of osteoarthritis; ankylosing spondylitis † ; acute gouty arthritis † ; or psoriatic arthritis † :
Oral dosage:
Adults: 400 - 800 mg PO 3 - 4 times a day. Use the lowest effective dose. Higher doses are usually necessary for rheumatoid arthritis than for osteoarthritis. Doses should not exceed 3200 mg/day.
Children 1 - 12 years: 30 - 40 mg/kg/day PO in 3 - 4 divided doses. Reduce dose to lowest effective dose. Doses exceeding 50 mg/kg/day are not recommended.
For the treatment of rheumatoid arthritis and juvenile rheumatoid arthritis (JRA):
Oral dosage:
Adults: 400 - 800 mg PO 3 - 4 times a day. Use the lowest effective dose. Higher doses are usually necessary for rheumatoid arthritis than for osteoarthritis. Doses should not exceed 3200 mg/day.
Children 1 - 12 years: 30 - 40 mg/kg /day PO in 3 - 4 divided doses. Reduce dose to lowest effective dose. Doses exceeding 50 mg/kg/day are not recommended.
For the treatment of dysmenorrhea:
Oral dosage:
Adults: 400 mg PO every 4 - 6 hours as needed. For self-medication, the usual initial dose is 200 mg PO every 4 - 6 hours; dosage may be increased if needed but should not exceed 1200 mg/day PO unless otherwise directed by a clinician.
For the treatment of mild pain to moderate pain including dental pain, bone pain † , arthralgia, myalgia including minor aches and pains due to colds, flu, and sore throat:
Oral dosage:
Adults and adolescents: 400 mg PO every 4 - 6 hours as needed. Doses greater than 400 mg have not provided greater relief of pain.
Oral dosage:
Adults and adolescents: 200 mg PO every 4 - 6 hours is recommended, and may be increased to 400 mg PO every 4 - 6 hours if needed. However, the total daily dose should not exceed 1200 mg unless directed by a clinician. Self-treatment should not exceed 10 days.
Oral dosage (OTC product - 100 mg caplets or chewable tablets):
NOTE: Self treatment should not exceed 3 days unless directed by a physician. Do not use more than 4 times a day.
Children 6 - 8 years or weighing 48 - 59 lbs: 2 tablets (200 mg) PO every 6 - 8 hours as needed.
Children 9 - 10 years or weighing 60 - 71 lbs: 2.5 tablets (250 mg) PO every 6 - 8 hours as needed.
Children 11 years or weighing 72 - 95 lbs: 3 tablets (300 mg) PO every 6 - 8 hours as needed.
Oral dosage (OTC product - 50 mg chewable tablets or 100 mg/5 ml suspension):
NOTE: Self treatment should not exceed 3 days unless directed by a physician. Do not use more than 4 times a day.
Children 2 - 3 years or weighing 24 - 35 lbs: 1 teaspoonful (5 ml) or 2 chewable tablets (100 mg) PO every 6 - 8 hours as needed.
Children 4 - 5 years or weighing 36 - 47 lbs: 1.5 teaspoonsful (7.5 ml) or 3 chewable tablets (150 mg) PO every 6 - 8 hours as needed.
Children 6 - 8 years or weighing 48 - 59 lbs: 2 teaspoonsful (10 ml) or 4 chewable tablets (200 mg) PO every 6 - 8 hours as needed.
Children 9 - 10 years or weighing 60 - 71 lbs: 2.5 teaspoonsful (12.5 ml) or 5 chewable tablets (250 mg) PO every 6 - 8 hours as needed.
Children 11 years or weighing 72 - 95 lbs: 3 teaspoonsful (15 ml) or 6 chewable tablets (300 mg) PO every 6 - 8 hours as needed.
Oral dosage (OTC product - 40 mg/ml concentrated drops):
NOTE: Self treatment should not exceed 3 days unless directed by a physician. Do not use more than 4 times a day. Only use the dropper provided.
Infants 6 - 11 months or weighing 12 - 17 lbs: 1 dropperful (50 mg/1.25 ml) PO q6 - 8h PRN.
Infants 12 - 23 months or weighing 18 - 23 lbs: 1.5 dropperfuls (75 mg/1.875 ml) PO every 6 - 8 hours as needed.
For the treatment of fever:
Oral dosage:
Adults: 200 - 400 mg PO every 4 - 6 hours. Doses should not exceed 1200 mg/day.
Infants >= 6 months and children (1 - 12 years): The recommended dosage is 5 mg/kg PO if the baseline temperature is < 102.5 degrees F, or 10 mg/kg PO if the baseline temperature is >= 102.5 degrees F. The duration of fever reduction is generally 6 - 8 hours. The recommended maximum dose is 40 mg/kg/day.
Oral dosage (OTC product - 100 mg caplets or chewable tablets):
NOTE: Self treatment should not exceed 3 days unless directed by a physician. Do not use more than 4 times a day.
Children 6 - 8 years or weighing 48 - 59 lbs: 2 tablets (200 mg) PO every 6 - 8 hours as needed.
Children 9 - 10 years or weighing 60 - 71 lbs: 2.5 tablets (250 mg) PO every 6 - 8 hours as needed.
Children 11 years or weighing 72 - 95 lbs: 3 tablets (300 mg) PO every 6 - 8 hours as needed.
Oral dosage (OTC product - 50 mg chewable tablets or 100 mg/5 ml suspension):
NOTE: Self treatment should not exceed 3 days unless directed by a physician. Do not use more than 4 times a day.
Children 2 - 3 years or weighing 24 - 35 lbs: 1 teaspoonful (5 ml) or 2 chewable tablets (100 mg) PO every 6 - 8 hours as needed.
Children 4 - 5 years or weighing 36 - 47 lbs: 1.5 teaspoonsful (7.5 ml) or 3 chewable tablets (150 mg) PO every 6 - 8 hours as needed.
Children 6 - 8 years or weighing 48 - 59 lbs: 2 teaspoonsful (10 ml) or 4 chewable tablets (200 mg) PO every 6 - 8 hours as needed.
Children 9 - 10 years or weighing 60 - 71 lbs: 2.5 teaspoonsful (12.5 ml) or 5 chewable tablets (250 mg) PO every 6 - 8 hours as needed.
Children 11 years or weighing 72 - 95 lbs: 3 teaspoonsful (15 ml) or 6 chewable tablets (300 mg) PO every 6 - 8 hours as needed.
Oral dosage (OTC product - 40 mg/ml concentrated drops):
NOTE: Self treatment should not exceed 3 days unless directed by a physician. Do not use more than 4 times a day. Only use the dropper provided.
Infants 6 - 11 months or weighing 12 - 17 lbs: 1 dropperful (50 mg/1.25 ml) PO q6 - 8h PRN.
Infants 12 - 23 months or weighing 18 - 23 lbs: 1.5 dropperfuls (75 mg/1.875 ml) PO every 6 - 8 hours as needed.
For the treatment of headache:
Oral dosage:
Adults: Doses of 400 - 2400 mg/day PO, in divided doses have been recommended.
Oral dosage (OTC product - 100 mg caplets or chewable tablets):
NOTE: Self treatment should not exceed 3 days unless directed by a physician. Do not use more than 4 times a day.
Children 6 - 8 years or weighing 48 - 59 lbs: 2 tablets (200 mg) PO every 6 - 8 hours as needed.
Children 9 - 10 years or weighing 60 - 71 lbs: 2.5 tablets (250 mg) PO every 6 - 8 hours as needed.
Children 11 years or weighing 72 - 95 lbs: 3 tablets (300 mg) PO every 6 - 8 hours as needed.
Oral dosage (OTC product - 50 mg chewable tablets or 100 mg/5 ml suspension):
NOTE: Self treatment should not exceed 3 days unless directed by a physician. Do not use more than 4 times a day.
Children 2 - 3 years or weighing 24 - 35 lbs: 1 teaspoonful (5 ml) or 2 chewable tablets (100 mg) PO every 6 - 8 hours as needed.
Children 4 - 5 years or weighing 36 - 47 lbs: 1.5 teaspoonsful (7.5 ml) or 3 chewable tablets (150 mg) PO every 6 - 8 hours as needed.
Children 6 - 8 years or weighing 48 - 59 lbs: 2 teaspoonsful (10 ml) or 4 chewable tablets (200 mg) PO every 6 - 8 hours as needed.
Children 9 - 10 years or weighing 60 - 71 lbs: 2.5 teaspoonsful (12.5 ml) or 5 chewable tablets (250 mg) PO every 6 - 8 hours as needed.
Children 11 years or weighing 72 - 95 lbs: 3 teaspoonsful (15 ml) or 6 chewable tablets (300 mg) PO every 6 - 8 hours as needed.
Oral dosage (OTC product - 40 mg/ml concentrated drops):
NOTE: Self treatment should not exceed 3 days unless directed by a physician. Do not use more than 4 times a day. Only use the dropper provided.
Infants 6 - 11 months or weighing 12 - 17 lbs: 1 dropperful (50 mg/1.25 ml) PO q6 - 8h PRN.
Infants 12 - 23 months or weighing 18 - 23 lbs: 1.5 dropperfuls (75 mg/1.875 ml) PO every 6 - 8 hours as needed.
- for the treatment of pain due to acute migraine:
Oral dosage (OTC product -
Motrin® Migraine Pain or Advil® Migraine)
Adults and adolescents † : 1 - 2 tablets or capsules (200 - 400 mg) PO at the beginning of migraine pain. The smallest effective dose should be taken. Do not take more than 400 mg for migraine pain within 24 hours unless directed by a health care provider.
Children >= 4 years † : In one trial, single doses of 10 mg/kg PO were three times as effective as placebo in reducing severe or moderate migraine headache pain within 2 hours.
For patients with cystic fibrosis † to slow the rate of decline in lung function:
Oral dosage:
Adults and children: Eighty-four patients with cystic fibrosis who had not received corticosteroids or NSAIDs during the previous 2 years or inhaled cromolyn during the previous 6 months were randomized to receive oral ibuprofen or placebo for 4 years. Ibuprofen was adjusted to maintain a serum concentration of 50 - 100 mcg/ml. Most patients required a dose of 20 - 30 mg/kg PO twice daily. The maximum daily dose administered was 3200 mg/day. At the end of the study, patients who received ibuprofen and were compliant had a significantly slower rate of decline in FEV1 than patients who received placebo.
For treatment of a hemodynamically significant patent ductus arteriosus (PDA) † in premature infants:
NOTE: Intravenous ibuprofen has been designated an orphan drug by the FDA for this indication.
Intravenous dosage (not available in the US) † :
Premature neonates < 32 weeks gestation: Premature neonates of postnatal age of 2 - 4 days were randomly assigned to receive ibuprofen 10 mg/kg IV over 15 minutes, followed by 2 doses of 5 mg/kg IV at 24 and 48 hours after the initial dose or indomethacin. The rate of ductal closure was similar with the two treatments (70% vs. 66%, respectively). There was a decreased incidence of oliguria in neonates treated with ibuprofen.
Maximum Dosage Limits:
- Adults: 3200 mg/day PO for Rx-only products; 1200 mg/day PO for non-prescription use.
- Elderly: 3200 mg/day PO for Rx-only products; 1200 mg/day PO for non-prescription use.
- Adolescents: 3200 mg/day PO for Rx-only products; 1200 mg/day PO for non-prescription use.
- Children: 50 mg/kg/day PO or 2400 mg/day PO for Rx-only products; 30 mg/kg/day PO for non-prescription use.
Patients with hepatic impairment:
Dosage reduction or initiation of ibuprofen therapy at the lower end of the usual dosage range is prudent in patients with moderate to severe hepatic impairment. Ibuprofen is extensively metabolized in the liver and its elimination half-life is significantly prolonged in patients with moderate to severe cirrhosis.
Patients with renal impairment:
No dosage adjustment needed.
Intermittent hemodialysis:
No supplemental dosage is needed following dialysis.
† non-FDA-approved indication
[ Last revised: 5/5/2003 11:54:00 AM ]
References
. Schulman EA, Silberstein SD. Symptomatic and prophylactic treatment of migraine and tension-type headache. Neurology 1992;42(suppl 2):16 - 21.
. Konstan MW, Byard PJ, Hoppel CL et al. Effect of high-dose ibuprofen in patients with cystic fibrosis. N Engl J Med 1995;332:848 - 54.
. Hamalainen ML, Hoppu K, Vlakeila E, et al. Ibuprofen or acetaminophen for the acute treatment of migraine in children: a double-blind, randomized, placebo-controlled, crossover study. Neurology 1997;48:103 - 7.
. Van Overmeire B, Smets K, Lecoutere D, et al. A comparison of ibuprofen and indomethacin for closure of patent ductus arteriosus. N Engl J Med 2000;343:674 - 81.
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