Ibuprofen Antacids

Antacids as needed for heartburn, ibuprofen as needed for headache... 

NSAIDs ANTACIDS 1. Magnesium hydroxide T absorption of ibuprofen, flurbiprofen, mefenamic acid and tolfenamic acid 2. Aluminium-containing antacids l absorption of these NSAIDs Uncertain These effects are 1 by taking these drugs with food... 

Flurbiprofen, 100 mg three times daily, is a well-established first-line NSAID providing there is no evidence of vascular closure or scleral destruction on biomicroscopy. Flurbiprofen should provide pain relief within 2 days and improvement in clinical signs within 1 week. Indomethacin SR fiarmulation, 75 mg twice daily, is a well-established second-choice drug when flurbiprofen is not effective but has also been used as first line. NSAIDs that have shown efficacy and are now available in over-the-counter formulations include naproxen, 500 mg twice daily, and ibuprofen, 600 mg four times daily. If a simplified dosing schedule is a consideration, then pirox-icam, 20 mg/day, may be considered. Once effective control is established, a lower maintenance dose may suffice until the scleritis enters remission. To reduce the risk of gastrointestinal side effects, patients should be instructed to take NSAIDs with food or antacids. 

Two chapters of collections were published in the early 1990s wherein solid dosage from analysis was discussed. Based on a presentation at the Fourth International Conference on NIRS, Stark used a newly developed diode-array spectrometer scanning between 520 and 1800nm to analyze specimens. Samples were placed on glass slides and the light collected at a fixed angle. Intact acetaminophen, ibuprofen, and antacid tablets were collected. 

Suggest the client take the ibuprofen with food or an antacid. 

Information is very limited but it would appear that if rapid analgesia is needed with either mefenamic acid or tolfenamic acid, magnesium hydroxide can be given concurrently but aluminium hydroxide should be avoided. However, note that this applies to the fasted state, whereas NSAIDs are usually taken with or after food. Also note that magnesium hydroxide increased the endoscopically-detected gastric toxicity of ibuprofen in one study, see NSAIDs Ibuprofen and related drugs -i- Antacids , below. Aluminium hydroxide markedly reduces the speed of absorption. Sodium bicarbonate does not interact. Consider also NSAIDs Miscellaneous + Antacids , p.l42. 

A sodium/potassium salt (kanwa), often taken as an antacid in some West African countries, appeared to reduce the absorption of ibuprofen. The bioavailability of ibuprofen 400 mg given to 6 healthy subjects with a millet meal containing the salt extract (pH of 8.9) was reduced, compared with the millet meal alone (pH 5.3) or following overnight fasting (approximate AUCs 20, 120, 110 micrograms/mL per hour, respectively). ... 

Magnesium hydroxide appears to improve the rate of absorption of some acidic NSAIDs (which become more soluble as the pH rises) such as ibuprofen and flurbiprofen. Why this increased the gastric toxicity of ibuprofen in the one pharmacodynamic study is unclear. Sodium bicarbonate appears to have a similar effect on rate of absorption. Aluminium antacids do not produce soluble salts with these NSAIDs, and may therefore reduce the rate/extent of absorption. 

Gontarz N, Small RE, Comstock TJ, Stalker DJ, Johnson SM, WUUs HE. Effect of antacid suspension on the pharmacokinetics of ibuprofen. ClinPharm (1987) 6, 413-16. 

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