Brufen (Ibuprofen)
Also sold as: Brufen, Ibugesic, Combiflam (with paracetamol)
Pregnancy
Cat C
Lactation
Safe
Schedule
OTC
Forms
Tablet 200/400/600mg +2
Indications
- Pain (musculoskeletal, headache, dental)
- Fever (alternative to paracetamol)
- Dysmenorrhea
- Inflammation (arthritis, soft-tissue injury)
Adult Dosing
Pain/fever
400 mg PO every 6-8 hours
Max 1.2g/day OTC, 2.4g Rx
Inflammation/arthritis
600-800 mg PO TDS
Up to 3.2g/day for short periods
Pediatric Dosing
Avoid in dehydration, varicella (Reye risk).
Renal Dose Adjustment
| CrCl / eGFR | Dose Adjustment |
|---|---|
| CrCl > 60 mL/min | Use cautiously |
| CrCl 30-60 mL/min | Avoid if possible — use lowest dose, shortest duration |
| CrCl < 30 mL/min | AVOID — risk of AKI |
Hepatic Adjustment
Avoid in severe hepatic impairment
Pregnancy & Lactation
Pregnancy: Category C
Avoid in 1st and 3rd trimesters (3rd: premature DA closure, oligohydramnios). Brief use in 2nd trimester acceptable.
Lactation: Safe
Top Drug Interactions
| Interacting Drug | Effect | Severity |
|---|---|---|
| Aspirin | Reduces aspirin's cardioprotective effect — separate by 2 hours | Moderate |
| Warfarin | Increased bleeding risk (additive antiplatelet) | Major |
| ACE inhibitors / ARBs / Diuretics | Reduced antihypertensive effect, AKI ("Triple Whammy") | Major |
| Lithium | Increased lithium levels | Moderate |
| Methotrexate | Increased MTX toxicity | Moderate |
| SSRIs | Increased GI bleeding risk | Moderate |
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Side Effects
Common
- Dyspepsia, gastritis
- Nausea
- Headache
- Edema
Serious / Discontinue If
- GI bleeding/perforation
- Acute kidney injury
- MI/stroke (long-term high-dose)
- Heart failure exacerbation
- Hepatotoxicity
- SJS/TEN
Contraindications
- Active GI bleeding/peptic ulcer
- Severe heart failure
- CrCl <30
- Aspirin/NSAID-induced asthma
- 3rd trimester pregnancy
- Coronary artery bypass surgery (perioperative)
Available Indian Brands
| Brand | Manufacturer | Price (approx) |
|---|---|---|
| Brufen 400 | Abbott | 10 tab ₹35 |
| Ibugesic Plus | Cipla | 10 tab ₹40 |
| Combiflam (with paracetamol) | Sanofi | 15 tab ₹45 |
Monitoring Required
- Renal function in elderly, CKD, on diuretics/ACEi
- GI symptoms
- Blood pressure
Patient Counseling Points
- Take with food
- Avoid in dehydration
- Report black stools or coffee-ground vomiting
- Avoid combining with other NSAIDs
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EasyClinic auto-flags Brufen interactions, renal cutoffs, and pregnancy warnings the moment you write the prescription. Built-in safety net for every Indian doctor.
References
- BNF
- Lexicomp Drug Information
- Indian National Formulary
- IAP/RSSDI/CSI Guidelines