Special patient groups
The active ingredient content of 400mg/tablet is too high for children and adolescents under 15 years of age, which is why ibuprofen 400 is not indicated at this age. For the age group under 15 years there are lower ibuprofen preparations on the market. In particular, side effects such as bleeding and gastric or intestinal rupture are frequently observed in older patients under treatment with non-steroidal anti-inflammatory drugs such as ibuprofen.
These side effects can be life-threatening and therefore careful and regular monitoring is necessary, especially in elderly patients, when medication with non-steroidal anti-inflammatory drugs is administered. In the first and second trimester of pregnancy ibuprofen may also be used in pregnant women, in the last trimester of pregnancy it should be avoided urgently due to study results on the increased risk for child development! During the breastfeeding period, however, no increased risk for mother or child has been determined to date if ibuprofen is taken. However, it should generally be considered that a longer intake of medication is not harmless even during the breastfeeding period and then weaning should be considered.
Contraindications
Ibuprofen should not be taken if you are allergic to any of the tablet’s components. Other contraindications for ibuprofen are:
- Unexplained blood formation disorders
- Previous or existing stomach ulcers
- Previous or existing ulcers of the duodenum
- Gastrointestinal bleeding
- Gastrointestinal perforation in connection with painkillers
- Cerebral hemorrhages
- Active bleeding
- Severe liver dysfunction
- Severe kidney dysfunction
- Severe heart muscle weakness (heart failure)
- In the last third of pregnancy
Interactions
Before taking ibuprofen, you should rule out taking any of the following other medications, as they may interact If ibuprofen and digoxin, phenytoin, lithium are taken at the same time, the effect of these medications may be increased, which is why regular monitoring of serum lithium levels is necessary, especially in the case of lithium. A control of serum digoxin and serum phenytoin levels is also recommended when taking ibuprofen at the same time.If dehydrating and blood pressure-lowering drugs (diuretics and antihypertensives) are taken at the same time as ibuprofen, ibuprofen can weaken their effect. Ibuprofen also weakens the effect of ACE inhibitors and, in this combination, also increases the risk of kidney dysfunction.
If a potassium-saving dehydration drug (diuretic) is taken in parallel with ibuprofen, this leads to an increase in the potassium level in the blood, which can cause serious side effects (cardiovascular system!). The risk of gastrointestinal ulcers and bleeding is increased if other anti-inflammatory and painkilling drugs from the group of non-steroidal anti-inflammatory drugs or glucocorticoids are taken at the same time as ibuprofen. Acetylsalicylic acid and certain antidepressants (selective serotonin reuptake inhibitors/SSRIs) together with ibuprofen may also increase the risk of gastrointestinal bleeding.
The antiplatelet aggregation inhibitory effect of ASA, however, is reduced by ibuprofen. If ibuprofen is taken within 24 hours before or after methotrexane, this leads to an increased concentration of methotrexate in the blood, which in turn may increase the likelihood of its adverse effects occurring. If ibuprofen is taken together with ciclospoprine A, there may be an increased probability of its kidney-damaging effect.
The excretion of ibuprofen is delayed by simultaneous intake of drugs with the ingredients probenecid or sulfinpyrazone (against gout). This leads to an increase in the effectiveness of ibuprofen, but also to an increase in the probability of the adverse drug effects of ibuprofen (side effects). Taking ibuprofen can increase the inhibition of blood clotting by drugs such as warfarin, phenprocoumon and heparin.
Likewise, there may be interactions between sulfonylureas and ibuprofen, so regular checks should be carried out here. If Ibuprofen is taken together with Tacrolimus, there may be an increased risk of kidney damage. Zidovudine and ibuprofen in combination cause an increased risk of joint bleeding and bruising in HIV-positive hemophilia patients (hemophiliacs).