Dosage & Administration
In the US, the recommended dosage of intravenous ibuprofen for the treatment of pain is 400 or 800 mg every 6 hours as required; in febrile patients, the initial dose of ibuprofen is 400 mg, followed by 400 mg every 4 to 6 hours as required or 100–200 mg every 4 hours as required. intravenous ibuprofen. is given as a 30-minute infusion; patients must be well hydrated prior to the infusion of ibuprofen.
Ibuprofen is contraindicated in patients with asthma, urticaria or allergic-type reactions after taking aspirin or any other NSAIDs. It is also contraindicated during the perioperative period of CABG surgery. Ibuprofen should be used with caution in patients with a prior history of ulcer disease or gastrointestinal bleeding. Since hypertension may occur during NSAID treatment, BP should be monitored during treatment. Discontinue treatment immediately if abnormal liver tests persist or worsen. Since long-term treatment with NSAIDs may result in renal papillary necrosis and other renal injury, ibuprofen should be used with caution in patients at risk of such events (e.g. the elderly, those with renal impairment, heart failure or hepatic impairment, and patients taking diuretics or ACE inhibitors). Local prescribing information should be consulted for details on any other warnings, precautions and potential drug interactions.
The lowest effective dose should be used for the shortest duration consistent with individual patient treatment goals. The maximum daily dose is 3200 mg. Patients should be hydrated prior to administration of intravenous ibuprofen to reduce the risk of renal adverse reactions. For analgesia, 400 mg to 800 mg should be administered intravenously every 6 hours as necessary. For fever 400 mg intravenously followed by 400 mg every 4 to 6 hours or 100 to 200 mg every 4 hours should be administered as necessary. According to the product labeling, the minimum infusion time for intravenous ibuprofen is 30 minutes. A randomized, cross-over, placebo controlled study, examined the safety and tolerability of a single 800-mg 39 dose given via rapid infusion over 5 to 7 minutes in 12 healthy volunteers, and 4 of 12 subjects reported infusion-related site pain.34 Rapid infusion, when tolerated, may be pragmatic in the post-operative or intensive care unit setting resulting in rapid achievement of Cmax, also aiding in administration decisions at the patient’s bedside. Intravenous ibuprofen. is available as a 400 mg/4 mL single-dose vial and 800 mg/8 mL single-dose vial. The stopper in the intravenous ibuprofen vial does not contain natural rubber latex, drug natural rubber, or blends of natural rubber.
For the treatment of pain in adults, the recommended dose of intravenous ibuprofen is 400 to 800 mg every 6 hours.
For fever, 400 mg is initially infused and 400 mg every 4 to 6 hours or 100 to 200 mg every 4 hours as required.
Ibuprofen is soluble in agents such as acetone and ethanol, but only slightly soluble in water (< 1 mg/mL). To prevent serious phlebitis during administration, the final concentration during admixture must be resulting in a final solution of no less than 100 ml (400 mg) or 200 ml (800 mg).
Intravenous ibuprofen is stable when 0.9% sodium chloride injection USP (normal saline), 5% dextrose injection USP (D5W), or lactated Ringer’s solution is used as the diluent. The infusion time must be at a minimum of 30 minutes.
Once diluted, intravenous ibuprofen remains stable for 7 days at room temperature in standard lighting.