Ibuprofen 400 mg Tablet, 40-count
Other active recalls for Ibuprofen (different manufacturers) — 5 · tap to view
🆔 Identity & classification
Where does this data come from?
🏷️ RxNorm drug class
This medicine belongs to the Nonsteroidal Anti-inflammatory Drug class.
Where does this data come from?
🏭 Manufacturer & labeler
Where does this data come from?
🩺 Clinical
Prescription ibuprofen is used to relieve pain, tenderness, swelling, and stiffness caused by osteoarthritis (arthritis caused by a breakdown of the lining of the joints) and rheumatoid arthritis (arthritis caused by swelling of the lining of the joints). It is also used to relieve mild to moderate pain, including menstrual pain (pain that happens before or during a menstrual period). Nonprescription ibuprofen is used to reduce fever and to relieve minor aches and pain from headaches, muscle aches, arthritis, menstrual periods, the common cold, toothaches, and backaches. Ibuprofen is in a clas...
Read the full MedlinePlus article ↗- It does a lot more than just kill pain. Ibuprofen is an anti-inflammatory drug, so it relieves pain, reduces swelling and inflammation, and brings down fever. Over-the-counter prod...
- What's ibuprofen actually used for — is it just a painkiller?
- Yes, it really does help. Ibuprofen can irritate the stomach lining, so taking it with food or a glass of milk significantly reduces the chance of nausea or stomach upset. You don'...
- Should I take ibuprofen with food? Does it really matter?
Patient education
Supplement & herbal interactions
Some supplements/herbs that may interact with Ibuprofen — tap one for details:
Ibuprofen may be associated with lower levels of 1 nutrient — worth a chat with your pharmacist, not a cause for alarm.
Where does this data come from?
Ask a licensed pharmacist directly — free, answered by our team.
💊 What it looks like
Where does this data come from?
🧪 Inactive Ingredients / Excipients
Inactive ingredients, also called excipients, are components of the drug product other than the active ingredient. They may include fillers, dyes, coatings, preservatives, flavors, or other formulation ingredients.
💡 Tap an ingredient (hover on desktop) to see what it is and why it’s used.
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UNII M28OL1HH48
Croscarmellose sodium is a plant-based substance derived from cellulose. It acts as a disintegrant, helping tablets and capsules break down quickly in the digestive system so the medicine can be absorbed.
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UNII 7T9FYH5QMK
A plant-derived powder that serves as a binder and filler in tablets and capsules. It helps hold ingredients together, adds bulk, and aids in smooth tablet disintegration when swallowed.
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UNII G2M7P15E5P
Polyethylene glycol 3350 is a synthetic polymer used as a solvent, humectant, and thickening agent in medicines. It helps dissolve other ingredients, retain moisture in the product, and achieve the desired consistency.
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UNII 532B59J990
Polyvinyl alcohol is a synthetic polymer made from plant-derived materials. It's used as a binder to hold ingredients together, a film-former in coatings, and a thickener in liquid formulations.
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UNII U725QWY32X
Povidone K30 is a synthetic polymer made from petroleum. It acts as a binder to hold tablet ingredients together and as a disintegrant to help the tablet break apart in the stomach so the medicine can be absorbed.
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UNII ETJ7Z6XBU4
Silicon dioxide is a naturally occurring mineral used as a glidant and anti-caking agent. It helps powder ingredients flow smoothly and prevents clumping during manufacturing and storage.
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UNII 4ELV7Z65AP
Stearic acid is a fatty acid derived from plant or animal sources. It acts as a binder and lubricant in tablets and capsules, helping them hold together and flow smoothly during manufacturing.
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UNII 7SEV7J4R1U
A powder made from a naturally occurring mineral. In medicines, talc works as a glidant and anti-caking agent, helping tablets and capsules flow smoothly during manufacturing and preventing clumping.
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UNII 15FIX9V2JP
Titanium dioxide is a bright white mineral powder commonly used as a colorant and opacifying agent. It makes pills and tablets white or lighter in color and helps make coatings non-transparent.
9 inactive ingredients listed in the exact product block matched to this NDC.
Where does this data come from?
ingredient classCode="IACT" elements from the exact product block matched by this NDC. Label-section narrative from DailyMed / the openFDA label index is shown separately when available.Inactive ingredient FAQ
Are inactive ingredients the same for every manufacturer?
Why might an inactive ingredient be missing?
Can inactive ingredients matter?
💲 Pricing
A drug doesn't have one price. Each row is a different public payment system, and none is what you'd pay at the counter — that depends on your insurance. The ⓘ on each row explains what it measures.
| Price system | Per each | Per package |
|---|---|---|
| Retail pharmacies payNADAC · weekly | Not in the retail survey — common for institutional, discontinued, or low-volume packs. | |
| Medicaid paysCMS SDUD · 12 mo | No recent Medicaid claims on file for this NDC — rare and low-volume NDCs are suppressed in the public data. | |
| Medicare drug plans payPart D · Q2 2026 | $0.1334 | $5.34 / 40 tablets |
Where does this data come from?
🔁 Therapeutic equivalents
| Product | Labeler | Pack | NADAC/unit | TE | Status | Price vs. this |
|---|---|---|---|---|---|---|
| Ibuprofen 400 mg 00904-5853-40 | Major | 500 tablets | $0.039 | AB | Availability likely | — |
| Ibuprofen 400 mg 00904-7587-40 | Major | 500 tablets | $0.039 | AB | Availability likely | — |
| Ibuprofen 400 mg 42543-0966-07 | Strides | 500 tablets | $0.039 | AB | Discontinued | — |
| Ibuprofen 400 mg 49483-0602-01 | TIME | 100 tablets | $0.039 | AB | Availability likely | — |
| Ibuprofen 400 mg 55111-0682-01 | Dr. | 100 tablets | $0.039 | — | Availability likely | — |
| Ibuprofen 400 mg 59651-0360-01 | Aurobindo | 100 tablets | $0.039 | AB | Availability likely | — |
| Ibuprofen 400 mg 60687-0446-01 | American | 100 tablets | $0.039 | AB | Availability likely | — |
| Ibuprofen 400 mg 62135-0400-12 | Chartwell | 120 tablets | $0.039 | — | Availability likely | — |
| Ibuprofen 400 mg 64380-0809-06 | Strides | 100 tablets | $0.039 | AB | Availability likely | — |
| Ibuprofen 400 mg 67877-0319-01 | Ascend | 100 tablets | $0.039 | AB | Availability likely | — |
| Ibuprofen 400 mg 69367-0394-01 | Westminster | 100 tablets | $0.039 | — | Availability likely | — |
| Ibuprofen 400 mg 70010-0066-01 | Granules | 100 tablets | $0.039 | — | Availability likely | — |
| Ibuprofen 400 mg 76282-0712-10 | EXELAN | 100 tablets | $0.039 | AB | Availability likely | — |
| Ibuprofen 400 mg 69238-1101-05 | Amneal | 500 tablets | $0.048 | AB | FDA listed | — |
| Ibuprofen 400 mg 71921-0180-01 | Florida | 100 tablets | $0.049 | AB | FDA listed | — |
| Ibuprofen 400 mg 00615-8309-39 | NCS | 30 tablets | — | AB | FDA listed | — |
| Ibuprofen 400 mg 11788-0008-00 | AiPing | 34000 tablets | — | — | Discontinued | — |
| Ibuprofen 400 mg 25000-0121-03 | MARKSANS | 30 tablets | — | AB | FDA listed | — |
| Ibuprofen 400 mg 43063-0872-06 | PD-Rx | 6 tablets | — | AB | FDA listed | — |
| Ibuprofen 400 mg 50090-2996-00 | A-S | 16 tablets | — | AB | Discontinued | — |
| Ibuprofen 400 mg 50090-3007-00 | A-S | 90 tablets | — | AB | FDA listed | — |
| Ibuprofen 400 mg 50090-5818-00 | A-S | 90 tablets | — | AB | FDA listed | — |
| Ibuprofen 400 mg 50090-5819-00 | A-S | 16 tablets | — | AB | FDA listed | — |
| Ibuprofen 400 mg 50090-6676-00 | A-S | 16 tablets | — | AB | FDA listed | — |
| Ibuprofen 400 mg 50090-6677-00 | A-S | 90 tablets | — | AB | FDA listed | — |
| Ibuprofen 400 mg 50090-7788-00 | A-S | 90 tablets | — | — | FDA listed | — |
| Ibuprofen 400 mg 50090-7789-00 | A-S | 16 tablets | — | — | FDA listed | — |
| Ibu 400 mg 51407-0369-05 | Golden | 500 tablets | — | AB | FDA listed | — |
| Ibuprofen 400 mg 51407-0839-01 | Golden | 100 tablets | — | AB | FDA listed | — |
| Ibuprofen 400 mg 51655-0048-26 | Northwind | 90 tablets | — | AB | FDA listed | — |
| Ibuprofen 400 mg 51655-0759-52 | Northwind | 30 tablets | — | AB | FDA listed | — |
| Ibuprofen 400 mg 53746-0131-01 | Amneal | 100 tablets | — | AB | FDA listed | — |
| Ibuprofen 400 mg 53746-0464-01 | Amneal | 100 tablets | — | AB | FDA listed | — |
| Ibuprofen 400 mg 54348-0835-00 | PharmPak, | 1 tablet | — | AB | FDA listed | — |
| Ibuprofen 400 mg 55154-1380-00 | Cardinal | 1 tablet | — | AB | FDA listed | — |
| Ibuprofen 400 mg 62207-0354-42 | Granules | 50 tablets | — | AB | FDA listed | — |
| Ibuprofen 400 mg 63187-0489-20 | Proficient | 20 tablets | — | AB | FDA listed | — |
| Ibuprofen 400 mg 63187-0967-15 | Proficient | 15 tablets | — | AB | FDA listed | — |
| Ibuprofen 400 mg 63629-1468-01 | Bryant | 20 tablets | — | AB | FDA listed | — |
| Ibuprofen 400 mg 65162-0464-03 | Amneal | 30 tablets | — | AB | FDA listed | — |
| Ibuprofen 400 mg 67296-2184-02 | Redpharm | 20 tablets | — | — | FDA listed | — |
| Ibuprofen 400 mg 68071-2939-04 | NuCare | 4 tablets | — | AB | FDA listed | — |
| Ibuprofen 400 mg 68071-3442-03 | NuCare | 30 tablets | — | AB | FDA listed | — |
| Ibuprofen 400 mg 68071-3507-06 | NuCare | 6 tablets | — | AB | FDA listed | — |
| Ibuprofen 400 mg 68071-4952-04 | NuCare | 40 tablets | — | AB | FDA listed | — |
| Ibuprofen 400 mg 68071-5126-03 | NuCare | 30 tablets | — | AB | FDA listed | — |
| Ibuprofen 400 mg 68071-5134-06 | NuCare | 6 tablets | — | AB | FDA listed | — |
| Ibuprofen 400 mg 68071-5228-06 | NuCare | 6 tablets | — | AB | FDA listed | — |
| Ibuprofen 400 mg 68788-4039-01 | Preferred | 100 tablets | — | — | FDA listed | — |
| Ibuprofen 400 mg 68788-8438-01 | Preferred | 100 tablets | — | AB | FDA listed | — |
| Ibuprofen 400 mg 68788-9110-01 | Preferred | 100 tablets | — | AB | FDA listed | — |
| Ibuprofen 400 mg 69367-0447-01 | Westminster | 100 tablets | — | AB | FDA listed | — |
| Ibuprofen 400 mg 70518-1051-00 | REMEDYREPACK | 30 tablets | — | AB | FDA listed | — |
| Ibuprofen 400 mg 70518-2432-01 | REMEDYREPACK | 30 tablets | — | AB | FDA listed | — |
| Ibuprofen 400 mg 70518-3861-00 | REMEDYREPACK | 30 tablets | — | AB | Discontinued | — |
| Ibuprofen 400 mg 71205-0464-15 | Proficient | 15 tablets | — | AB | FDA listed | — |
| Ibu 400 mg 71205-0604-15 | Proficient | 15 tablets | — | AB | FDA listed | — |
| Ibuprofen 400 mg 71335-0690-01 | Bryant | 20 tablets | — | AB | FDA listed | — |
| Ibuprofen 400 mg 71335-1270-01 | Bryant | 20 tablets | — | AB | Discontinued | — |
| Ibuprofen 400 mg 71335-1517-01 | Bryant | 20 tablets | — | AB | FDA listed | — |
| Ibuprofen 400 mgthis 71335-2682-03 | Bryant | 40 tablets | — | AB | FDA listed | — |
| Ibuprofen 400 mg 71610-0916-60 | Aphena | 90 tablets | — | — | FDA listed | — |
| Ibuprofen 400 mg 71610-0969-60 | Aphena | 90 tablets | — | AB | FDA listed | — |
| Ibuprofen 400 mg 72189-0324-30 | Direct | 30 tablets | — | AB | FDA listed | — |
| Ibuprofen 400 mg 72189-0564-30 | Direct_rx | 30 tablets | — | AB | FDA listed | — |
| Ibuprofen 400 mg 72789-0185-20 | PD-Rx | 20 tablets | — | AB | FDA listed | — |
| Ibuprofen 400 mg 72789-0201-06 | PD-Rx | 6 tablets | — | AB | FDA listed | — |
| ibuprofen 400 mg 73086-0210-01 | SKYA | 100 tablets | — | AB | FDA listed | — |
| Ibuprofen 400 mg 75907-0331-94 | Dr. | 4000 tablets | — | — | FDA listed | — |
| Ibuprofen 400 mg 76420-0575-01 | Asclemed | 100 tablets | — | AB | FDA listed | — |
| Ibuprofen 400 mg 76420-0846-01 | Asclemed | 100 tablets | — | — | FDA listed | — |
| Ibuprofen 400 mg 82804-0137-15 | Proficient | 15 tablets | — | — | FDA listed | — |
| Ibuprofen 400 mg 83209-0464-09 | Boswell | 9 tablets | — | AB | FDA listed | — |
| Ibuprofen 400 mg 85534-0011-00 | HAWAII | 30 tablets | — | AB | FDA listed | — |
| Ibuprofen 400 mg 85766-0218-01 | Sportpharm | 100 tablets | — | AB | FDA listed | — |
| Ibuprofen 400 mg 63629-7676-01 | Bryant | 20 tablets | — | AB | FDA listed | — |
| Ibuprofen 400 mg 55154-2583-00 | Cardinal | 10 tablets | — | AB | FDA listed | — |
| Ibuprofen 400 mg 72789-0590-30 | PD-Rx | 30 tablets | — | — | FDA listed | — |
Where does this data come from?
⏳ Availability & generic status
This product is an FDA-approved generic. Other versions of the same drug are listed under Therapeutic equivalents, least expensive first.
Where does this data come from?
📊 Medicare Part D spend CMS · PART D · 2026 (Q1)
🔬 Reported adverse events (FAERS)
Top reported reactions
Age at onset
Reporter sex
Serious outcomes
Where does this data come from?
📦 Packaging — all sizes for this product
| Package NDC | Description | Marketing start | Status |
|---|---|---|---|
| 71335-2682-01 | 20 TABLET in 1 BOTTLE (71335-2682-1) | 2025-09-17 | Active |
| 71335-2682-02 | 30 TABLET in 1 BOTTLE (71335-2682-2) | 2025-09-17 | Active |
| 71335-2682-03 You're viewing this | 40 TABLET in 1 BOTTLE (71335-2682-3) | 2025-09-17 | Active |
| 71335-2682-04 | 60 TABLET in 1 BOTTLE (71335-2682-4) | 2025-09-17 | Active |
| 71335-2682-05 | 90 TABLET in 1 BOTTLE (71335-2682-5) | 2025-09-17 | Active |
| 71335-2682-06 | 120 TABLET in 1 BOTTLE (71335-2682-6) | 2025-09-17 | Active |
| 71335-2682-07 | 100 TABLET in 1 BOTTLE (71335-2682-7) | 2025-09-17 | Active |
| 71335-2682-08 | 21 TABLET in 1 BOTTLE (71335-2682-8) | 2025-09-17 | Active |
| 71335-2682-09 | 15 TABLET in 1 BOTTLE (71335-2682-9) | 2025-09-17 | Active |
You're viewing one of 9 pack sizes for this product.
Pack size FAQ
What quantity is in NDC 71335-2682-03?
What is the difference between NDC 71335-2682-03 and NDC 71335-2682-09?
What NDC number is used to bill for this package of Ibuprofen 400 mg Tablet?
🧭 About this NDC listing & data coverage
What data is (and isn’t) available for this NDC — tap to expand
| NDC identity (package / product / labeler codes) | ✓ Available |
| Labeler | ✓ Available |
| Product & package description | ✓ Available |
| Marketing category & status | ✓ Available |
| Active ingredient / dosage form / route | ✓ Available |
| FDA label (SPL via DailyMed) | ✓ Available |
| Package photos | ✓ Available |
| Inactive ingredients (structured) | ✓ Available |
| NADAC pharmacy acquisition price (CMS) | — Not published for this NDC CMS publishes NADAC only for NDCs reported in its retail-pharmacy survey. |
| Orange Book / therapeutic-equivalence data | ✓ Available |
| HCPCS J-code billing crosswalk | — Not published for this NDC Most self-administered / retail products have no J-code — that is normal. |
| Medicaid utilization (CMS SDUD) | — Not published for this NDC CMS reports utilization only for NDCs with Medicaid claims above its privacy threshold. |
Questions about this listing
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📄 Full prescribing information FDA SPL
🚨 Boxed Warning ▾
Cardiovascular Thrombotic Events Nonsteroidal anti-inflammatory drugs (NSAIDs) cause an increased risk of serious cardiovascular thrombotic events, including myocardial infarction and stroke, which can be fatal. This risk may occur early in treatment and may increase with duration of use [see Warnings and Precautions ]. Ibuprofen tablets are contraindicated in the setting of coronary artery bypass graft (CABG) surgery [see Contraindications and Warnings ].
Gastrointestinal Risk NSAIDs cause an increased risk of serious gastrointestinal adverse events including bleeding, ulceration, and perforation of the stomach or intestines, which can be fatal. These events can occur at any time during use and without warning symptoms. Elderly patients are at greater risk for serious gastrointestinal events (see WARNINGS ).
🎯 Indications and Usage ▾
INDICATIONS AND USAGE Carefully consider the potential benefits and risks of ibuprofen tablets and other treatment options before deciding to use ibuprofen. Use the lowest effective dose for the shortest duration consistent with individual patient treatment goals (see WARNINGS ). Ibuprofen tablets are indicated for relief of the signs and symptoms of rheumatoid arthritis and osteoarthritis.
Ibuprofen tablets are indicated for relief of mild to moderate pain. Ibuprofen tablets are also indicated for the treatment of primary dysmenorrhea. Controlled clinical trials to establish the safety and effectiveness of ibuprofen tablets in children have not been conducted.
⏱️ Dosage and Administration ▾
DOSAGE AND ADMINISTRATION Carefully consider the potential benefits and risks of ibuprofen tablets and other treatment options before deciding to use ibuprofen tablets. Use the lowest effective dose for the shortest duration consistent with individual patient treatment goals (see WARNINGS ). After observing the response to initial therapy with ibuprofen tablets, the dose and frequency should be adjusted to suit an individual patient's needs.
Do not exceed 3200 mg total daily dose. If gastrointestinal complaints occur, administer ibuprofen tablets with meals or milk. Rheumatoid arthritis and osteoarthritis, including flare-ups of chronic disease Suggested Dosage: 1200 mg to 3200 mg daily (300 mg qid; 400 mg, 600 mg or 800 mg tid or qid).
Individual patients may show a better response to 3200 mg daily, as compared with 2400 mg, although in well-controlled clinical trials patients on 3200 mg did not show a better mean response in terms of efficacy. Therefore, when treating patients with 3200 mg/day, the physician should observe sufficient increased clinical benefits to offset potential increased risk. The dose should be tailored to each patient, and may be lowered or raised depending on the severity of symptoms either at time of initiating drug therapy or as the patient responds or fails to respond.
In general, patients with rheumatoid arthritis seem to require higher doses of ibuprofen tablets than do patients with osteoarthritis. The smallest dose of ibuprofen tablets that yields acceptable control should be employed. A linear blood level doseresponse relationship exists with single doses up to 800 mg (See CLINICAL PHARMACOLOGY for effects of food on rate of absorption).
The availability of three tablet strengths facilitates dosage adjustment. In chronic conditions, a therapeutic response to therapy with ibuprofen tablets is sometimes seen in a few days to a week but most often is observed by two weeks. After a satisfactory response has been achieved, the patient's dose should be reviewed and adjusted as required.
Mild to moderate pain: 400 mg every 4 to 6 hours as necessary for relief of pain. In controlled analgesic clinical trials, doses of ibuprofen tablets greater than 400 mg were no more effective than the 400 mg dose. Dysmenorrhea For the treatment of dysmenorrhea, beginning with the earliest onset of such pain, ibuprofen tablets should be given in a dose of 400 mg every 4 hours as necessary for the relief of pain.
⛔ Contraindications ▾
CONTRAINDICATIONS Ibuprofen tablets are contraindicated in patients with known hypersensitivity to Ibuprofen. Ibuprofen tablets should not be given to patients who have experienced asthma, urticaria, or allergic-type reactions after taking aspirin or other NSAIDs. Severe, rarely fatal, anaphylactic-like reactions to NSAIDs have been reported in such patients (see WARNINGS , Anaphylactoid Reactions , and PRECAUTIONS , Preexisting Asthma ).
In the setting of coronary artery bypass graft (CABG) surgery [see Warnings ]
⚠️ Warnings ▾
WARNINGS Cardiovascular Effects Cardiovascular Thrombotic Events Clinical trials of several COX-2 selective and nonselective NSAIDs of up to three years duration have shown an increased risk of serious cardiovascular (CV) thrombotic events, including myocardial infarction (MI) and stroke, which can be fatal. Based on available data, it is unclear that the risk for CV thrombotic events is similar for all NSAIDs. The relative increase in serious CV thrombotic events over baseline conferred by NSAID use appears to be similar in those with and without known CV disease or risk factors for CV disease.
However, patients with known CV disease or risk factors had a higher absolute incidence of excess serious CV thrombotic events, due to their increased baseline rate. Some observational studies found that this increased risk of serious CV thrombotic events began as early as the first weeks of treatment. The increase in CV thrombotic risk has been observed most consistently at higher doses.
To minimize the potential risk for an adverse CV event in NSAID-treated patients, use the lowest effective dose for the shortest duration possible. Physicians and patients should remain alert for the development of such events, throughout the entire treatment course, even in the absence of previous CV symptoms. Patients should be informed about the symptoms of serious CV events and the steps to take if they occur.
There is no consistent evidence that concurrent use of aspirin mitigates the increased risk of serious CV thrombotic events associated with NSAID use. The concurrent use of aspirin and an NSAID, such as ibuprofen, increases the risk of serious gastrointestinal (GI) events [ see Warnings ]. Status Post Coronary Artery Bypass Graft (CABG) Surgery Two large, controlled clinical trials of a COX-2 selective NSAID for the treatment of pain in the first 10 to 14 days following CABG surgery found an increased incidence of myocardial infarction and stroke.
NSAIDs are contraindicated in the setting of CABG [ see Contraindications ]. Post-MI Patients Observational studies conducted in the Danish National Registry have demonstrated that patients treated with NSAIDs in the post-MI period were at increased risk of reinfarction, CV-related death, and all-cause mortality beginning in the first week of treatment. In this same cohort, the incidence of death in the first year post MI was 20 per 100 person years in NSAID-treated patients compared to 12 per 100 person years in non-NSAID exposed patients.
Although the absolute rate of death declined somewhat after the first year post-MI, the increased relative risk of death in NSAID users persisted over at least the next four years of follow-up. Avoid the use of ibuprofen tablets in patients with a recent MI unless the benefits are expected to outweigh the risk of recurrent CV thrombotic events. If ibuprofen tablets are used in patients with a recent MI, monitor patients for signs of cardiac ischemia.
Hypertension NSAIDs including ibuprofen tablets, can lead to onset of new hypertension or worsening of pre-existing hypertension, either of which may contribute to the increased incidence of CV events. Patients taking thiazides or loop diuretics may have impaired response to these therapies when taking NSAIDs. NSAIDs, including ibuprofen tablets, should be used with caution in patients with hypertension.
Blood pressure (BP) should be monitored closely during the initiation of NSAID treatment and throughout the course of therapy. Heart Failure and Edema The Coxib and traditional NSAID Trialists’ Collaboration meta-analysis of randomized controlled trials demonstrated an approximately two-fold increase in hospitalizations for heart failure in COX-2 selective-treated patients and nonselective NSAID-treated patients compared to placebo-treated patients. In a Danish National Registry study of patients with heart failure, NSAID use increased the risk of MI, hospitalization for heart failure, and death.
Additionally, fluid…
🤒 Adverse Reactions ▾
ADVERSE REACTIONS The most frequent type of adverse reaction occurring with ibuprofen tablets is gastrointestinal. In controlled clinical trials the percentage of patients reporting one or more gastrointestinal complaints ranged from 4% to 16%. In controlled studies when ibuprofen tablets were compared to aspirin and indomethacin in equally effective doses, the overall incidence of gastrointestinal complaints was about half that seen in either the aspirin- or indomethacin-treated patients.
Adverse reactions observed during controlled clinical trials at an incidence greater than 1% are listed in the table. Those reactions listed in Column one encompass observations in approximately 3,000 patients. More than 500 of these patients were treated for periods of at least 54 weeks.
Still other reactions occurring less frequently than 1 in 100 were reported in controlled clinical trials and from marketing experience. These reactions have been divided into two categories: Column two of the table lists reactions with therapy with ibuprofen tablets where the probability of a causal relationship exists: for the reactions in Column three, a causal relationship with ibuprofen tablets has not been established. Reported side effects were higher at doses of 3200 mg/day than at doses of 2400 mg or less per day in clinical trials of patients with rheumatoid arthritis.
The increases in incidence were slight and still within the ranges reported in the table. Incidence Greater than 1% (but less than 3%) Probable Causal Relationship Precise Incidence Unknown (but less than 1%) Probable Causal Relationship* Precise Incidence Unknown (but less than 1%) Causal Relationship Unknown* *Reactions are classified under "Probable Causal Relationship (PCR)" if there has been one positive rechallenge or if three or more cases occur which might be causally related. Reactions are classified under "Causal Relationship Unknown" if seven or more events have been reported but the criteria for PCR have not been met. † Reactions occurring in 3% to 9% of patients treated with ibuprofen.
(Those reactions occurring in less than 3% of the patients are unmarked). GASTROINTESTINAL Nausea†, epigastric pain†, heartburn†, diarrhea, abdominal distress, nausea and vomiting, indigestion, constipation, abdominal cramps or Pain, fullness of GI tract (bloating and flatulence) Gastric or duodenal ulcer with bleeding and/or perforation, gastrointestinal hemorrhage, melena, gastritis, hepatitis, jaundice, abnormal liver function tests; pancreatitis CENTRAL NERVOUS SYSTEM Dizziness†, headache, nervousness Depression, insomnia, confusion, emotional liability, somnolence, aseptic meningitis with fever and coma (see PRECAUTIONS ) Paresthesias, hallucinations, dream abnormalities, pseudo-tumor cerebri DERMATOLOGIC Rash† (including maculopapular type), pruritus Vesiculobullous eruptions, urticaria, erythema multiforme, Stevens- Johnson syndrome, alopecia Toxic epidermal necrolysis, photoallergic skin reactions SPECIAL SENSES Tinnitus Hearing loss, amblyopia (blurred and/or diminished vision, scotomata and/or changes in color vision) (see PRECAUTIONS ) Conjunctivitis, diplopia, optic neuritis, cataracts HEMATOLOGIC Neutropenia, agranulocytosis, aplastic anemia, hemolytic anemia (sometimes Coombs positive), thrombocytopenia with or without purpura, eosinophilia, decreases in hemoglobin and hematocrit (see PRECAUTIONS ) Bleeding episodes (eg epistaxis, menorrhagia) METABOLIC/ENDOCRINE Decreased appetite Gynecomastia, hypoglycemic reaction, acidosis CARDIOVASCULAR Edema, fluid retention (generally responds promptly to drug discontinuation) (see PRECAUTIONS ) Congestive heart failure in patients with marginal cardiac function, elevated blood pressure, palpitations Arrhythmias (sinus tachycardia, sinus bradycardia) ALLERGIC Syndrome of abdominal pain, fever, chills, nausea and vomiting; anaphylaxis; bronchospasm (see CONTRAINDICATIONS ) Serum sickness, lupus erythematosus syndrome.
Henoch- Schonlein…
🔄 Drug Interactions ▾
Preexisting asthma Patients with asthma may have aspirin-sensitive asthma. The use of aspirin in patients with aspirin-sensitive asthma has been associated with severe bronchospasm, which can be fatal. Since cross reactivity, including bronchospasm, between aspirin and NSAIDs has been reported in such aspirin-sensitive patients, ibuprofen tablets should not be administered to patients with this form of aspirin sensitivity and should be used with caution in patients with preexisting asthma.
🔄 Drug / Laboratory Test Interactions ▾
Ophthalmological effects Blurred and/or diminished vision, scotomata, and/or changes in color vision have been reported. If a patient develops such complaints while receiving ibuprofen tablets, the drug should be discontinued, and the patient should have an ophthalmologic examination which includes central visual fields and color vision testing.
🤰 Pregnancy ▾
Information for Patients Patients should be informed of the following information before initiating therapy with an NSAID and periodically during the course of ongoing therapy. Patients should also be encouraged to read the NSAID Medication Guide that accompanies each prescription dispensed. Cardiovascular Thrombotic Events Advise patients to be alert for the symptoms of cardiovascular thrombotic events, including chest pain, shortness of breath, weakness, or slurring of speech, and to report any of these symptoms to their health care provider immediately [ see Warnings ].
Ibuprofen tablets, like other NSAIDs, can cause GI discomfort and, rarely, serious GI side effects, such as ulcers and bleeding, which may result in hospitalization and even death. Although serious GI tract ulcerations and bleeding can occur without warning symptoms, patients should be alert for the signs and symptoms of ulcerations and bleeding, and should ask for medical advice when observing any indicative signs or symptoms including epigastric pain, dyspepsia, melena, and hematemesis. Patients should be apprised of the importance of this follow-up (see WARNINGS , Gastrointestinal Effects- Risk of Ulceration, Bleeding and Perforation ).
Serious Skin Reactions, including DRESS Advise patients to stop taking ibuprofen tablets immediately if they develop any type of rash or fever and to contact their healthcare provider as soon as possible [ see Warnings ]. Heart Failure And Edema Advise patients to be alert for the symptoms of congestive heart failure including shortness of breath, unexplained weight gain, or edema and to contact their healthcare provider if such symptoms occur [ see Warnings ] . Patients should be informed of the warning signs and symptoms of hepatotoxicity (e.g., nausea, fatigue, lethargy, pruritus, jaundice, right upper quadrant tenderness and "flu-like" symptoms).
If these occur, patients should be instructed to stop therapy and seek immediate medical therapy. Patients should be informed of the signs of an anaphylactoid reaction (e.g. difficulty breathing, swelling of the face or throat). If these occur, patients should be instructed to seek immediate emergency help (see WARNINGS ).
Fetal Toxicity Inform pregnant women to avoid use of ibuprofen tablets and other NSAIDs starting at 30 weeks gestation because of the risk of the premature closing of the fetal ductus arteriosus. If treatment with ibuprofen tablets is needed for a pregnant woman between about 20 to 30 weeks gestation, advise her that she may need to be monitored for oligohydramnios, if treatment continues for longer than 48 hours [ see WARNINGS; Fetal Toxicity , PRECAUTIONS; Pregnancy ] .
🧒 Pediatric Use ▾
Labor and Delivery In rat studies with NSAIDs, as with other drugs known to inhibit prostaglandin synthesis, an increased incidence of dystocia, delayed parturition, and decreased pup survival occurred. The effects of ibuprofen tablets on labor and delivery in pregnant women are unknown.
🧓 Geriatric Use ▾
Nursing Mothers It is not known whether this drug is excreted in human milk. Because many drugs are excreted in human-milk and because of the potential for serious adverse reactions in nursing infants from ibuprofen tablets, a decision should be made whether to discontinue nursing or discontinue the drug, taking into account the importance of the drug to the mother.
🆘 Overdosage ▾
OVERDOSAGE Approximately 1½ hours after the reported ingestion of from 7 to 10 ibuprofen tablets (400 mg), a 19-month old child weighing 12 kg was seen in the hospital emergency room, apneic and cyanotic, responding only to painful stimuli. This type of stimulus, however, was sufficient to induce respiration. Oxygen and parenteral fluids were given; a greenish-yellow fluid was aspirated from the stomach with no evidence to indicate the presence of ibuprofen.
Two hours after ingestion the child's condition seemed stable; she still responded only to painful stimuli and continued to have periods of apnea lasting from 5 to 10 seconds. She was admitted to intensive care and sodium bicarbonate was administered as well as infusions of dextrose and normal saline. By four hours post-ingestion she could be aroused easily, sit by herself and respond to spoken commands.
Blood level of ibuprofen was 102.9 mcg/mL approximately 8½ hours after accidental ingestion. At 12 hours she appeared to be completely recovered. In two other reported cases where children (each weighing approximately 10 kg) accidentally, acutely ingested approximately 120 mg/kg, there were no signs of acute intoxication or late sequelae.
Blood level in one child 90 minutes after ingestion was 700 mcg/mL — about 10 times the peak levels seen in absorption-excretion studies. A 19-year old male who had taken 8,000 mg of ibuprofen over a period of a few hours complained of dizziness, and nystagmus was noted. After hospitalization, parenteral hydration and three days bed rest, he recovered with no reported sequelae.
In cases of acute overdosage, the stomach should be emptied by vomiting or lavage, though little drug will likely be recovered if more than an hour has elapsed since ingestion. Because the drug is acidic and is excreted in the urine, it is theoretically beneficial to administer alkali and induce diuresis. In addition to supportive measures, the use of oral activated charcoal may help to reduce the absorption and reabsorption of ibuprofen tablets.
🧬 Clinical Pharmacology ▾
CLINICAL PHARMACOLOGY Ibuprofen tablets contain ibuprofen which possesses analgesic and antipyretic activities. Its mode of action, like that of other NSAIDs, is not completely understood, but may be related to prostaglandin synthetase inhibition. In clinical studies in patients with rheumatoid arthritis and osteoarthritis, ibuprofen tablets have been shown to be comparable to aspirin in controlling pain and inflammation and to be associated with a statistically significant reduction in the milder gastrointestinal side effects (see ADVERSE REACTIONS ).
Ibuprofen tablets may be well tolerated in some patients who have had gastrointestinal side effects with aspirin, but these patients when treated with ibuprofen tablets should be carefully followed for signs and symptoms of gastrointestinal ulceration and bleeding. Although it is not definitely known whether ibuprofen tablets causes less peptic ulceration than aspirin, in one study involving 885 patients with rheumatoid arthritis treated for up to one year, there were no reports of gastric ulceration with ibuprofen tablets whereas frank ulceration was reported in 13 patients in the aspirin group (statistically significant p<.001).
Gastroscopic studies at varying doses show an increased tendency toward gastric irritation at higher doses. However, at comparable doses, gastric irritation is approximately half that seen with aspirin. Studies using 51 Cr-tagged red cells indicate that fecal blood loss associated with ibuprofen tablets in doses up to 2400 mg daily did not exceed the normal range, and was significantly less than that seen in aspirin-treated patients.
In clinical studies in patients with rheumatoid arthritis, ibuprofen tablets have been shown to be comparable to indomethacin in controlling the signs and symptoms of disease activity and to be associated with a statistically significant reduction of the milder gastrointestinal (see ADVERSE REACTIONS ) and CNS side effects. Ibuprofen tablets may be used in combination with gold salts and/or corticosteroids. Controlled studies have demonstrated that ibuprofen tablets are a more effective analgesic than propoxyphene for the relief of episiotomy pain, pain following dental extraction procedures, and for the relief of the symptoms of primary dysmenorrhea.
In patients with primary dysmenorrhea, ibuprofen tablets have been shown to reduce elevated levels of prostaglandin activity in the menstrual fluid and to reduce resting and active intrauterine pressure, as well as the frequency of uterine contractions. The probable mechanism of action is to inhibit prostaglandin synthesis rather than simply to provide analgesia. Pharmacodynamics In a healthy volunteer study, ibuprofen 400 mg given once daily, administered 2 hours prior to immediate-release aspirin (81 mg) for 6 days, showed an interaction with the antiplatelet activity of aspirin as measured by % serum thromboxane B2 (TxB2) inhibition at 24 hours following the day-6 aspirin dose [53%].
An interaction was still observed, but minimized, when ibuprofen 400 mg given once-daily was administered as early as 8 hours prior to the immediate-release aspirin dose [90.7%]. However, there was no interaction with the antiplatelet activity of aspirin when ibuprofen 400 mg, given once daily, was administered 2 hours after (but not concomitantly, 15 min, or 30 min after) the immediate-release aspirin dose [99.2%]. In another study, where immediate-release aspirin 81 mg was administered once daily with ibuprofen 400 mg given three times daily (1, 7, and 13 hours post-aspirin dose) for 10 consecutive days, the mean % serum thromboxane B2 (TxB2) inhibition suggested no interaction with the antiplatelet activity of aspirin [98.3%].
However, there were individual subjects with serum TxB2 inhibition below 95%, with the lowest being 90.2%. When a similarly designed study was conducted with enteric-coated aspirin, where healthy subjects were administered enteric-coated aspirin 81 mg once daily for 6…
📦 How Supplied / Storage and Handling ▾
HOW SUPPLIED Ibuprofen Tablets USP, 400 mg are white to off-white, film-coated, oval shaped tablets debossed with ‘I4’ on one side and plain on the other side. NDC: 71335-2682-1: 20 Tablets in a BOTTLE NDC: 71335-2682-2: 30 Tablets in a BOTTLE NDC: 71335-2682-3: 40 Tablets in a BOTTLE NDC: 71335-2682-4: 60 Tablets in a BOTTLE NDC: 71335-2682-5: 90 Tablets in a BOTTLE NDC: 71335-2682-6: 120 Tablets in a BOTTLE NDC: 71335-2682-7: 100 Tablets in a BOTTLE NDC: 71335-2682-8: 21 Tablets in a BOTTLE NDC: 71335-2682-9: 15 Tablets in a BOTTLE Store at 20° to 25°C (68° to 77°F) [see USP Controlled Room Temperature].
Avoid excessive heat 40ºC (104ºF). Repackaged/Relabeled by: Bryant Ranch Prepack, Inc. Burbank, CA 91504
📋 Description ▾
DESCRIPTION Ibuprofen tablets USP contain the active ingredient ibuprofen, which is (±) - 2 - ( p - isobutylphenyl) propionic acid. Ibuprofen is a white to off-white, crystalline powder with a melting point of 74 to 77°C and is very soluble in alcohol, in methanol, in acetone and in chloroform, slightly soluble in ethyl acetate, practically insoluble in water. The structural formula is represented below: Ibuprofen tablets USP, a nonsteroidal anti-inflammatory drug (NSAID), is available in 400 mg, 600 mg, and 800 mg tablets for oral administration.
Inactive ingredients: colloidal silicon dioxide, croscarmellose sodium, microcrystalline cellulose, polyethylene glycol, polyvinyl alcohol-part. hydrolyzed, povidone, stearic acid, talc and titanium dioxide.
💬 Information for Patients ▾
Hepatic effects Borderline elevations of one or more liver tests may occur in up to 15% of patients taking NSAIDs, including ibuprofen tablets. These laboratory abnormalities may progress, may remain unchanged, or may be transient with continuing therapy. Notable elevations of ALT or AST (approximately three or more times the upper limit of normal) have been reported in approximately 1% of patients in clinical trials with NSAIDs.
In addition, rare cases of severe hepatic reactions, including jaundice, fulminant hepatitis, liver necrosis, and hepatic failure, some of them with fatal outcomes have been reported. A patient with symptoms and/or signs suggesting liver dysfunction, or with abnormal liver test values, should be evaluated for evidence of the development of a more severe hepatic reaction while on therapy with ibuprofen tablets. If clinical signs and symptoms consistent with liver disease develop, or if systemic manifestations occur (e.g., eosinophilia, rash, etc.), ibuprofen tablets should be discontinued.