In this article, you will find out everything you need to know about ibuprofen and the most effective alternatives to relieve pain, including an advanced treatment called Prolotherapy.
How Long Does It Take For Ibuprofen To Work?
There are numerous FDA-approved painkillers available under different brand names. These include Paracetamol, Naproxen, Diclofenac and Ibuprofen. The two common brands under which Ibuprofen is sold include Advil and Motrin. Ibuprofen, a Non-steroidal anti-inflammatory drug (NSAID), is mainly prescribed as an over-the-counter drug that is used to relieve pain and decrease inflammation. Even though it was initially discovered as a therapy for rheumatoid arthritis, it is now recommended for pain like menstrual cramps, back pain, toothache, migraine, muscle sprains, joint pains, sports injuries, sore throat, and other minor injuries. A doctor also prescribes this medication to treat swelling caused by different disorders. Additionally, it is available in non-enzymatic coated form and liquid form. The body absorbs this medicine for 1 to 2 hours of oral administration.
Moreover, doctors prescribe this medicine to treat mild to moderate pain. The over-the-counter forms of Ibuprofen for adults are often designed for mild pains. The effect of Ibuprofen on severe types of pain, as seen after an operation, has been investigated in several clinical trials. The results of such studies show that patients who take ibuprofen via the Intravenous route had lower pain scores than those given other NSAIDs like Acetaminophen. (1)
How Does It Work?
One possible mechanism is Ibuprofen works by reducing hormones that produce swelling and pain in the body. Other researches provide evidence that NSAIDs like ibuprofen work by inhibiting the release of prostaglandin and its precursors which causes the blood vessels to constrict. Whenever the body undergoes a pathological stimulus, chemicals like arachidonic acid are produced by an enzyme known as Phospholipase A2. This arachidonic acid then undergoes certain enzymatic pathways. These include cyclooxygenase, lipoxygenase, or cytochrome P450 pathway.
The cyclooxygenase pathways work by forming prostaglandins from arachidonic acid, while the lipoxygenase pathway causes the formation of hydroxy eicosatetraenoic acids and leukotriene. The Cytochrome P450 pathway converts arachidonic acid to eicosatetraenoic hydroxy acids and epoxyeicosatrienoic acids. (2) The release of these chemicals by conversion of arachidonic acid brings about several changes in the body. These include increased vascular permeability, muscle tone, platelet aggregation, and replication of cells. They are also involved in promoting inflammation, atopy, angiogenesis, and cancer. (3)
When an individual takes Ibuprofen, the drug inhibits the COX 1 and COX 2 pathways in the body, which in turn causes reduced production of prostaglandins. The reduced prostaglandins then further reduce the pathological changes in the body. This is what gives NSAIDs like Ibuprofen their analgesic, anti-inflammatory, and anti-pyretic properties. (4) While the effect of different NSAIDs is not identical, Ibuprofen has a much greater affinity for the Cox 1 pathways than inhibition of cox two pathways.
How Can Ibuprofen Be Administered?
Over-the-counter use of Ibuprofen has become common in many countries around the world. This may be available in the form of intravenous solutions, topics ointments and gels, oral supplements, chewable tablet, sprays, and even a combination of the above. Healthcare professionals often recommend that oral tablets of Ibuprofen be taken with food. They should be never taken on an empty stomach. However, the intravenous route is not commonly recommended and should only be opted in a healthcare setup after medical advice. (5) The IV formulation for Ibuprofen are a mixture of Lysine and ibuprofen. Moreover, they are administered over 30 minutes to the adults and 10 minutes to the younger children.
Additionally, oral Children ibuprofen may be administered to children aged 3 months or older and weighing at least 5kg (11 lb) to reduce fever, irritation, and pain.
How Long Does Ibuprofen Take to Work?
According to the NHS, OTC ibuprofen begins to work at least 20 to 30 minutes to show its effects. When Ibuprofen is taken orally, it may reach its maximum concentration in the blood between one to two hours. So if even the individual may start feeling some relief after 30 minutes, they may experience the maximum effects between 1 to 2 hours, when their plasma concentration is the highest. Some individuals feel instant relief. However, this may vary between different formulations of oral supplements. The pharmacokinetics for these drugs normally show linear patterns as well. (6)
At the dose recommended by the doctor, the drug gets firmly bound to the plasma proteins, so it is able to show its effect for longer. (7) Individuals who are taking other drugs like Phenytoin and Warfarin should be careful while starting Ibuprofen since there may be chances of drug-drug interaction – even if they are being used in the lowest possible dose. In addition, while the pain relief effects of Ibuprofen are experienced much earlier, it may take a slightly longer time for the anti-inflammatory effects to become apparent. They may vary from a few days to as much as a few weeks.
The plasma half-life of Ibuprofen is also found to be between one to three hours, which means repeated intake may be required. (7) Moreover, it is also observed that the effects of Ibuprofen last much longer in adults as compared to children, who have a much faster metabolism.
Common Side Effects of Ibuprofen
Even though Ibuprofen is considered a generally safe drug, when taken according to the recommended dose and frequency, individuals taking ibuprofen should be extra careful while using it. These include individuals with cardiovascular problems, kidney disease, raised blood pressure, a recent history of heart attack or prolonged cardiovascular disease, expecting mothers, or those who are breastfeeding.
Too much ibuprofen or ibuprofen use at higher doses may cause ulcers, upset stomach, bleeding, holes in the stomach or intestine, reduced fertility, unborn baby, and stomach narrowing. These problems may develop at any time during treatment, may happen without warning symptoms, and may cause death. Patients can also experience pain with ibuprofen use at high doses. Therefore, it should be used as your doctor prescribed.
In some individuals, NSAIDs can cause edema and fluid retention. You may notice that your ankles are swollen and your weight has increased significantly within a few hours of taking ibuprofen. Having so much additional water on board can exacerbate preexisting diseases like heart failure and high blood pressure.
In elderly individuals, the renal functions should be constantly monitored, especially when they are on high-dose diuretics or taking ibuprofen. The assessment of blood pressure should also accompany this. Children who are at increased risk for liver problems and are taking Ibuprofen should also be kept under close observation, as the use of Acetaminophen and Ibuprofen may lead to NSAID-induced liver injury. This is even more serious because there is usually no cure for the liver injury caused by NSAID use. This is why adults are often advised to only give medications to children after medical advice. (8)
The other less common side effects which may be associated with ibuprofen tablets include bloating, stomach pain, stomach bleeding heartburn, stomach ulcers, indigestion, constipation, and stomach upset. These complications may arise at any point during therapy, without warning, and are potentially fatal. These individuals should first be evaluated for any adverse symptoms before taking the next dose. Some individuals may also experience an allergic reaction, which may present as rashes or shortness of breath. (9) Additionally, people who take ibuprofen, aspirin, other NSAIDs, or other medications for an extended period, who are elderly, who are in poor health, and people who drink alcohol multiple times a day may be at increased risk. Other risk factors include the poor health status of individuals. This is why a doctor recommends that patients taking ibuprofen should always start with the lowest dose of Ibuprofen in order to lower the risk of adverse effects. Moreover, people should avoid drinking alcohol along with ibuprofen use.
How Long Do The Effects of Ibuprofen Last?
The effects of Ibuprofen may last between 4 to 6 hours; however, it may take at least 24 hours for Ibuprofen itself to leave the body. The half-life of Ibuprofen is usually 2 hours, so every two hours that pass since the intake of an ibuprofen tablet, its levels inside the body fall by half. This continues until it is completely removed. (10)
Prolotherapy: an alternative way to treat swelling and pain.
In recent years, Prolotherapy has built its reputation within the medical community for its clinically proven ability to help with pain and swelling.
Published research has proven its pain-relieving, anti-inflammatory and regenerative benefits.
Prolotherapy involves injecting a natural regenerative solution with small needles. This has been shown to reduce swelling, which helps reduce swelling and pain.
As prolotherapy is helping to treat the root cause of swelling and pain, it is deemed to be a permanent fix, preventing the symptoms from returning.
What should I know about this storage and storage and disposal?
Keep this medication in its original container, properly sealed, out of the reach of children. Keep it at room temperature and out of the reach of excessive moisture and heat (not in the bathroom).
It is essential to keep all medications away from children, as many medication boxes (such as weekly pill organizers and containers for eye inhalers, patches, creams and drops are not child-resistant and can be readily opened by young children. To protect small children from medicinal poisoning, put on a safety cap and keep the medication in a secure location that is out of sight and out of reach.
Strict disposal procedures must be followed to prevent children, pets, and other individuals from ingesting unused drugs, However, this drug should not be flushed down the toilet. Instead, the best approach to dispose of medicines is through a service that collects unused drugs. Consult your pharmacist or “local garbage/recycling department” for information on take-back programs in your area. If you do not have access to a take-back programme, check the website for the Safe Disposal of Medicines program for further information.
What other information do I need?
If you are prescribed ibuprofen, do not share your medication with anybody else. Ask the pharmacist for any concerns you have about replenishing your prescription.
It is essential that you maintain a list of all prescription and nonprescription (over-the-counter) medications you are taking, along with many vitamins, dietary supplements, minerals, and other medications. You should bring this list with you whenever you visit a physician or are hospitalized. It is also essential to take this information with you in case of an emergency.
References:
1. Ekinci, M., Ciftci, B., Celik, E. C., Köse, E. A., Karakaya, M. A., & Ozdenkaya, Y. (2020). A Randomized, Placebo-Controlled, Double-Blind Study that Evaluates Efficacy of Intravenous Ibuprofen and Acetaminophen for Postoperative Pain Treatment Following Laparoscopic Cholecystectomy Surgery. Journal of gastrointestinal surgery: official journal of the Society for Surgery of the Alimentary Tract, 24(4), 780–785. https://doi.org/10.1007/s11605-019-04220-1
2. Hiľovská, L., Jendželovský, R., & Fedoročko, P. (2015). The potency of the nonsteroidal anti-inflammatory drug in chemotherapy. Molecular and clinical oncology, 3(1), 3–12. https://doi.org/10.3892/mco.2014.446
3. Harizi, H., Corcuff, J. B., & Gualde, N. (2008). Arachidonic-acid-derived eicosanoids: roles in biology and immunopathology. Trends in molecular medicine, 14(10), 461–469. https://doi.org/10.1016/j.molmed.2008.08.005
4. Schwier, N., & Tran, N. (2016). Nonsteroidal Anti-Inflammatory Drugs and Aspirin Therapy for the Treatment of Acute and Recurrent Idiopathic Pericarditis. Pharmaceuticals (Basel, Switzerland), 9(2), 17. https://doi.org/10.3390/ph9020017
5. Ferguson J. M. (2019). Pharmacotherapy for patent ductus arteriosus closure. Congenital heart disease, 14(1), 52–56. https://doi.org/10.1111/chd.12715
6. Evans, A. M., Nation, R. L., Sansom, L. N., Bochner, F., & Somogyi, A. A. (1990). The relationship between the pharmacokinetics of ibuprofen enantiomers and the dose of racemic Ibuprofen in humans. Biopharmaceutics & drug disposition, 11(6), 507–518. https://doi.org/10.1002/bdd.2510110605
7. Davies N. M. (1998). Clinical pharmacokinetics of ibuprofen. The first 30 years. Clinical pharmacokinetics, 34(2), 101–154. https://doi.org/10.2165/00003088-199834020-00002
8. Norman, H., Elfineh, M., Beijer, E., Casswall, T., & Németh, A. (2014). Även ibuprofen, inte bara paracetamol, kan ge barn allvarlig leverskada. NSAID bör användas med försiktighet hos barn, visar fall med letal utgäng [Also ibuprofen, not just paracetamol, can cause serious liver damage in children. NSAIDs should be used with caution in children, as shown in case with fatal outcome]. Lakartidningen, 111(40), 1709–1711.
9. Aljadhey, H., Tu, W., Hansen, R. A., Blalock, S. J., Brater, D. C., & Murray, M. D. (2012). Comparative effects of non-steroidal anti-inflammatory drugs (NSAIDs) on ) on blood pressure in patients having hypertension with BMC cardiovascular disorders, 12, 93. https://doi.org/10.1186/1471-2261-12-93
10. Mazaleuskaya, L. L., Theken, K. N., Gong, L., Thorn, C. F., FitzGerald, G. A., Altman, R. B., & Klein, T. E. (2015). PharmGKB summary: ibuprofen pathways. Pharmacogenetics and genomics, 25(2), 96–106. https://doi.org/10.1097/FPC.0000000000000113