What is this medicine?
IBUPROFEN (eye BYOO proe fen) is a non-steroidal anti-inflammatory drug (NSAID). It is used for dental pain, fever, headaches or migraines, osteoarthritis, rheumatoid arthritis, or painful monthly periods. It can also relieve minor aches and pains caused by a cold, flu, or sore throat.

This medicine may be used for other purposes; ask your health care provider or pharmacist if you have questions.

What is the price of this medication and similar alternatives?

This pricing information is subject to change at the sole discretion of DS Pharmacy. This pricing information was updated 09/2009. For the most current and up-to-date pricing information, please visit www.drugstore.com. Actual costs to patients will vary depending on the use of specific retail or mail-order locations and health insurance copays.

What side effects may I notice from receiving this medicine?
Side effects that you should report to your doctor or health care professional as soon as possible:

• allergic reactions like skin rash, itching or hives, swelling of the face, lips, or tongue
• black or bloody stools, blood in the urine or in vomit
• breathing problems
• changes in vision
• chest pain
• general ill feeling or flu-like symptoms
• nausea or vomiting
• redness, blistering, peeling or loosening of the skin, including inside the mouth
• slurred speech or weakness on one side of the body
• stomach pain
• unexplained weight gain or swelling
• unusually weak or tired
• yellowing of eyes or skin

Side effects that usually do not require medical attention (report to your doctor or health care professional if they continue or are bothersome):

• constipation or diarrhea
• dizziness
• gas or heartburn
• stomach upset

How should I use this medicine?
Take this medicine by mouth with a glass of water. Follow the directions on the prescription label. Take this medicine with food if your stomach gets upset. Try to not lie down for at least 10 minutes after you take the medicine. Take your medicine at regular intervals. Do not take your medicine more often than directed.

A special MedGuide will be given to you by the pharmacist with each prescription and refill. Be sure to read this information carefully each time.

Talk to your pediatrician regarding the use of this medicine in children. Special care may be needed.

What if I miss a dose?
If you miss a dose, take it as soon as you can. If it is almost time for your next dose, take only that dose. Do not take double or extra doses.

What may interact with this medicine?
Do not take this medicine with any of the following medications:

• cidofovir
• ketorolac
• methotrexate
• pemetrexed

This medicine may also interact with the following medications:

• alcohol
• aspirin
• diuretics
• lithium
• other drugs for inflammation like prednisone
• warfarin

Who should NOT use this medication?

• Known hypersensitivity to ibuprofen or any ingredient in the formulation.
• History of asthma, urticaria, or other sensitivity reaction precipitated by aspirin or other NSAIAs.
• Treatment of perioperative pain in the setting of CABG surgery.
• When used for PDA, known or suspected untreated infection.

IV Therapy for PDA
• Known or suspected untreated infection.
• Bleeding, especially active intracranial hemorrhage or GI bleeding; thrombocytopenia; coagulation defects.
• Known or suspected necrotizing enterocolitis.
• Substantial renal impairment.
• Congenital heart disease if patency of the ductus arteriosus is necessary for pulmonary or systemic blood flow (e.g., pulmonary atresia, severe tetralogy of Fallot, severe coarctation of the aorta).

What should I watch for while using this medicine?
Tell your doctor or healthcare professional if your symptoms do not start to get better or if they get worse.

This medicine does not prevent heart attack or stroke. In fact, this medicine may increase the chance of a heart attack or stroke. The chance may increase with longer use of this medicine and in people who have heart disease. If you take aspirin to prevent heart attack or stroke, talk with your doctor or health care professional.

Do not take medicines such as ibuprofen and naproxen with this medicine. Side effects such as stomach upset, nausea, or ulcers may be more likely to occur. Many medicines available without a prescription should not be taken with this medicine.

This medicine can cause ulcers and bleeding in the stomach and intestines at any time during treatment. Ulcers and bleeding can happen without warning symptoms and can cause death. To reduce your risk, do not smoke cigarettes or drink alcohol while you are taking this medicine.

You may get drowsy or dizzy. Do not drive, use machinery, or do anything that needs mental alertness until you know how this medicine affects you. Do not stand or sit up quickly, especially if you are an older patient. This reduces the risk of dizzy or fainting spells.

This medicine can cause you to bleed more easily. Try to avoid damage to your teeth and gums when you brush or floss your teeth.

What should I tell my health care provider before I take this medicine?
They need to know if you have any of these conditions:

• asthma
• cigarette smoker
• drink more than 3 alcohol containing drinks a day
• heart disease or circulation problems such as heart failure or leg edema (fluid retention)
• high blood pressure
• kidney disease
• liver disease
• stomach bleeding or ulcers
• an unusual or allergic reaction to ibuprofen, aspirin, other NSAIDS, other medicines, foods, dyes, or preservatives
• pregnant or trying to get pregnant
• breast-feeding

Can I stop taking the medication if I feel better?
If you are taking an analgesic for pain and you are no longer experiencing the pain you may stop using the medication. In general, pain medications are to be used on an “as needed” basis.

I am on so many medications; do I have to take them all?
This is called polypharmacy—many different medications being used at the same time by one person. Sometimes, being on multiple medications is acceptable and appropriate but at other times it may be problematic. If you are receiving your medications from multiple physicians you need to ensure that they all know what medications you are taking. The best way to do this is to make a list of all the medications you are currently using, including all nutritional supplements, homeopathic remedies, vitamins and over-the-counter drugs (if possible, also include all the diseases you have been diagnosed with). Give a copy to every doctor who takes care of you so they have it on file, this way they can avoid duplicating medications and perhaps even try to consolidate some. After every doctor's visit remember to update the list accordingly. Also, as much as you possibly can, try to use the same pharmacy to fill all your prescriptions, this way any potential drug interactions can be caught and averted.