|| Do not exceed the recommended dosage.
- If nervousness, restlessness or sleeplessness occurs, reduce dosage.
- Sympathomimetic amines should be used with caution in patients with cardiovascular disease
such as ischemic heart disease, arrhythmia or tacchycardia, occlusive vascular disorders
including arteriosclerosis, hypertension, or aneurysms.
- Anginal pain may be precipitated in patients with angina pectoris.
- Care is required when sympathomimetic agents are given to patients with diabetes mellitus or
- May cause excitability, especially in children.
- Elderly persons (approximately 60 years of age and older) are more likely ot have adverse
reactions to sympathomimetic amines.
- Persistent and severe pain or for fever for more than 3 days, could be signs of a serious condition
that needs investigation and additional treatment.
- Do not take this product for persistent or chronic cough such as occurs with smoking, asthma,
emphysema, or if cough is accompanied by excessive phlegm (mucus).
- Alcohol Warning: There is increased overall relative risk of upper gastrointestinal bleeding with
regular use of Ibuprofen among varying amounts of alcohol consumption.
# General Precautions:
- Ibuprofen should be given with care to patients with a history of gastrointestinal disease.
- Caution is required if ibuprofen is administered to patients suffering from or with a previous
history of bronchial asthma since ibuprofen has been reported to cause bronchospasm in
- Caution is required in patients with renal, hepatic or cardiac impairment since the use of NSAIDs
may result in deterioration of renal function.
- The dose should be kept as low as possible and renal function should be monitored in these
- Ibuprofen should be given with care to patients with a history of heart failure or hypertension
since edema has been reported in association with ibuprofen administration.
- As with other NSAIDs, ibuprofen may msk the signs of infection.
- Caution should be used when initiating treatment with ibuprofen in patients with considerable dehydration.
- As with other NSAIDs, long-term administration of ibuprofen has resulted in renal papillary necrosis and
other renal pathologic changes.
- Renal toxicity has also been seen in patients in whom renal prostaglandins have a compensatory
role in the maintenance of renal perfusion. In these patients, administration of a NSAID may cause
a dose-dependent reduction in prostaglindin formation and, secondarily, in renal blood flow, which
may precipitate overt renal decompensation.
- Patients at greatest risk of this reaction are those with impaired renal function, heart failure, liver
dysfunction, those taking diuretics and ACE inhibitors and the elderly.
- Discontinuation of NSAID therapy is usually followed by recovery to the pretreatment state.
# Hematological Effects:
Ibuprofen, like other NSAIDs, can inhibit platelet aggregation and has been shown to prolong bleeding
time in normal subjects.
# Aseptic Meningitis:
- Although meningitis has been observed on rare occasions in patients on ibuprofen therapy.
- Although it is probably more likely to occur in patients with systemic lupus erythematosus and
related connective tissue diseases, it has been reported in patients who do not have an underlying
* Pregnancy: Safety for use during pregnancy has not been established. The use of ibuprofen during
pregnancy should, if possible, be avoided. In view of the known effects of NSAIDs on the fetal
cardiovasular system (closure of ductus arteriosus), use in late pregnancy should be avoided.
* Labor and Delivery:
Administration of ibuprofen is not recommended during labor and delivery.
* Nursing Mothers:
In the limited studies so far available, ibuprofen appears in the breast milk in very low concentrations.
Ibuprofen is not recommended for use in nursing mothers.