Ibuprofen Dosing in Divided Doses
For pain and inflammation management, ibuprofen should be administered in 3-4 divided doses daily, with a total daily dose of 1200-3200 mg, using the lowest effective dose for the shortest duration necessary. 1
General Dosing Guidelines
- For most pain conditions, ibuprofen should be started at 400 mg every 4-6 hours as needed for pain relief 1
- For rheumatoid arthritis and osteoarthritis, including flare-ups of chronic disease, the recommended dosage is 1200-3200 mg daily divided into 3-4 doses (400 mg, 600 mg, or 800 mg three or four times daily) 1
- The maximum daily dose should not exceed 3200 mg 1
- For migraine headache treatment, 400-800 mg can be given every six hours, with a maximum daily dose of 2400 mg 2
Optimizing Divided Dosing
- Administer ibuprofen with meals or milk if gastrointestinal complaints occur 1
- For moderate pain, 400 mg every 4-6 hours provides effective relief 1, 3
- For dysmenorrhea, begin with 400 mg at the earliest onset of pain and continue with 400 mg every 4 hours as needed 1
- Higher doses (600-800 mg) do not necessarily provide greater analgesic efficacy than 400 mg for acute pain management 4
Duration of Action and Dosing Intervals
- Ibuprofen 400 mg has a duration of action of at least 6 hours compared with 4-6 hours for ibuprofen 200 mg 3
- A therapeutic response to ibuprofen in chronic conditions is sometimes seen within a few days to a week, but most often is observed by two weeks 1
- After achieving a satisfactory response, the patient's dose should be reviewed and adjusted as required 1
Safety Considerations
- Use the lowest effective dose for the shortest duration consistent with treatment goals 1
- Patients at high risk (over 60 years, history of peptic ulcer, significant alcohol consumption) should be monitored for gastrointestinal risks 5
- Caution is advised in patients with renal problems, compromised hydration status, or interstitial nephritis 5
- Discontinue ibuprofen if urea or creatinine doubles, if hypertension develops or worsens, or if gastrointestinal bleeding occurs 5, 2
- Patients with cardiovascular disease should be treated with caution 5
Special Populations
- In children, the recommended dose is 10 mg/kg every 8 hours 5
- For patients with cancer, ibuprofen can be used at doses of 400 mg every 4-6 hours (maximum 3200 mg/day) 5
By following these dosing guidelines, ibuprofen can provide effective pain and inflammation management while minimizing the risk of adverse effects. The key is to use the lowest effective dose for the shortest duration necessary to achieve therapeutic goals.