Intravenous ibuprofen: in adults for pain and fever

Ibuprofen is a well established analgesic, anti-inflammatory and antipyretic NSAID. In three double-blind, multicentre trials in postoperative adult patients (n = 185-406), intravenous ibuprofen 800 mg once every 6 hours, as an adjunct to morphine, significantly reduced the consumption of morphine compared with placebo, as an adjunct to morphine, in two of the three trials (primary endpoint in two trials); the between-group difference attained statistical significance in the third trial utilizing a Log-rank transformed analysis. Adjunctive ibuprofen therapy also provided significantly better pain relief during movement than adjunctive placebo for the period from 6 to 24 or 28 hours after the first dose (primary endpoint in one trial). Furthermore, intravenous ibuprofen plus morphine generally provided better pain relief than placebo plus morphine at all time periods evaluated throughout the first 24 or 28 hours, irrespective of whether this was assessed during rest or movement. In three double-blind, single- or multicentre trials (n = 60-120) in febrile hospitalized adult patients with acute malaria or with varying causes of fever, intravenous ibuprofen (100-400 mg every 4 or 6 hours, or 800 mg every 6 hours) reduced fever to a significantly greater extent than placebo (primary endpoint in two trials) and/or significantly more patients achieved a temperature of <38.3°C within 4 hours of the first ibuprofen 400 mg dose than with placebo (primary endpoint in the third trial). Intravenous ibuprofen was generally well tolerated by hospitalized adult patients participating in these clinical trials. The most common adverse event leading to discontinuation of ibuprofen treatment was pruritus (<1% of patients).