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ibuprofen

ibuprofen
Brand names: Motrin
Form Strength
SUSPENSION, ORAL 100 mg/2.5 mL PED; 100 mg/5 mL
TABLET, ORAL 200 mg; 800 mg
Display Other Nonsteroidal Anti-inflammatory Agents Class: 28080492
Medication comments:
 Available ED To-Go medications. 
Description (Qty)
ibuprofen (Motrin) 100 mg / 5 ml cups (#6)
ibuprofen (Motrin) 800 mg tablets (#2)
Anticoagulant / Antiplatelet Stoppage For Procedures
generic (Brand) Dept. Procedure Type
(hover over entry for examples)		 Stop Medication Prior To Procedure Restart after:
ibuprofen
(Motrin)		 Anesthesia High-risk 24 hours Restart after 24 hours
Intermediate-risk No hold Restart after 24 hours
Low-risk No hold Restart after 24 hours
Patients with high risk of bleeding (eg, old age, history of bleeding tendency, concurrent uses of other anticoagulants/antiplatelets, liver cirrhosis or advanced liver disease, and advanced renal disease) undergoing low- or intermediate-risk procedures should be treated as intermediate or high risk, respectively.
Radiology
 Invasive Procedures 24 hours
Paracentesis/Thoracentesis No hold
Surgery High-risk 7 days Restart after 24 hours
Low-risk No Hold Restart after 24 hours
2023 American Geriatrics Society Beers Criteria® for potentially inappropriate medication use in older adults.
Medication: ibuprofen (Caldolor, Motrin)
Criteria 1: Potentially inappropriate medication use in older adults. (Table 2)
Drug(s) non-COX-2-selective NSAIDs, oral
Rationale Increased risk of GI bleeding or peptic ulcer disease in high-risk groups, including those >75 years old or taking oral or parenteral corticosteroids, anticoagulants, or antiplatelet agents; use of proton-pump inhibitor or miSOPROStol reduces but does not eliminate risk. Upper GI ulcers, gross bleeding or perforation caused by NSAIDs occur in ~1% of patients treated for 3-6 months and in ~2%-4% of patients treated for 1 year; these trends continue with longer duration of use. Also can increase blood pressure and induce kidney injury. Risks are dose-related.
Recommendation Avoid chronic use unless other alternatives are not effective and the patient can take a gastroprotective agent (proton-pump inhibitor or miSOPROStol).
Avoid short-term scheduled use in combination with oral or parenteral corticosteroids, anticoagulants or antiplatelet agents unless other alternatives are not effective and the patient can take a gastroprotective agent (proton-pump inhibitor or miSOPROStol).
 Quality of evidence: Moderate, Strength of Recommendation: Strong
 
Criteria 2: Potentially inappropriate medication use in older adults due to drug–disease or drug–syndrome interactions that may exacerbate the disease or syndrome. (Table 3)
Drug(s) ⇆ disease or syndrome NSAIDs and COX-2 inhibitors ⇄ Heart failure
Rationale Potential to promote fluid retention and/or exacerbate heart failure.
Recommendation Use with caution in patients with heart failure who are asymptomatic; avoid in patients with symptomatic heart failure.
 Quality of evidence: Moderate, Strength of Recommendation: Strong
 
Drug(s) ⇆ disease or syndrome non-COX-2 selective NSAIDs ⇄ History of gastric or duodenal ulcers
Rationale May exacerbate existing ulcers or cause new/additional ulcers
Recommendation Avoid unless other alternatives are not effective and the patient can take a gastroprotective agent (i.e., proton-pump inhibitor or miSOPROStol).
 Quality of evidence: Moderate, Strength of Recommendation: Strong
 
Criteria 5: medications that should be avoided or have their dosage reduced with varying levels of kidney function in older adults. (Table 6)
CrCl (mL/min) at which action is required <30
Rationale NSAIDs (oral and parenteral) may increase the risk of acute kidney injury and a further decline in kidney function.
Recommendation Avoid
 Quality of evidence: Moderate, Strength of Recommendation: Strong
Last updated: Sep. 24, 2025
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