Ibuprofen is a medicine which has been available in the UK since 1969; it was discovered by scientists working for the Boots Company in the 1950s when looking for an alternative with fewer side effects than the commonly prescribed aspirin (The Royal Society of Chemistry, 2013). Ibuprofen belongs to a class of drugs known as Non-Steroidal Anti-Inflammatory drugs (NSAIDs) and is available as a Prescription only Medicine (POM), over the counter as a Pharmacy (P) medicine and in retail outlets as a General Sales List Medicine (GSL) (Royal Pharmaceutical Society, 2013). NSAIDs reduce temperature (antipyretic), are painkillers (analgesic) and have anti-inflammatory properties (Joint Formulary Committee, 2013). Figure 1 shows the chemical structure of ibuprofen. There are now twenty-one different NSAIDs available on the market; the drugs differ in their dose, interactions and side effects. This essay will look into many aspects of Ibuprofen to determine if it is the ideal NSAID.
NSAIDs mode of action is to reduce the production of prostaglandins. Prostaglandins are hormones which trigger pain and inflammation in the immediate damaged area. NSAIDs inhibit an enzyme, Cyclo-Oxygenase (COX), which is involved in the first stage of prostaglandin production. There are two variants of this enzyme; COX-1 is responsible for the normal every day production of prostaglandins whereas COX-2 is responsible for production of additional prostaglandins when the body is injured as a natural defensive response. Non-selective NSAIDs, such as Ibuprofen, inhibit both COX-1 and COX-2 whereas selective NSAIDs; Celecoxib and Etoricoxib, inhibit only COX-2 (Society for Endocrinology, 2013; Ogbru, 2009).
Ibuprofen is partially absorbed in the stomach and further absorbed in the small intestine. It is rapidly distributed throughout the body, binding 90-99% to blood plasma proteins (Bushra & Aslam, 2010). Peak plasma levels are reached between 1-2 hours. In pregnancy Ibuprofen is transferred across the placenta and traces can be found in breast milk. Ibuprofen can cause problems for a growing foetus in the first and second trimester (NHS Choices, 2012). Ibuprofen is quickly metabolised in the liver and excreted by the kidneys in the urine and in bile. The half-life of Ibuprofen is 2 hours; hence why Ibuprofen should be taken every 4-6 hours to keep a therapeutic level of the drug in the body (Rang, Dale, Ritter, Flower & Henderson, 2013; Deltapharm1, 2013).
Due to its analgesic, antipyretic and anti-inflammatory nature Ibuprofen is indicated for the treatment of headaches, dental pain, dysmenorrhoea, feverishness, colds, influenza, rheumatic or muscular pain, backache and neuralgia over the counter. As a P medicine it can be sold for non-serious arthritic conditions (Datapharm1, 2013). In addition, as a POM ibuprofen can be prescribed for the treatment of pain and inflammation in several conditions including rheumatic disease, osteoporosis, lower back pain, post-operational pain...