Evaluation of ibuprofens precipitation characteristics

Objective: non-steroidal anti-inflammatory drugs should always be considered a part of multimodal analgesia for acute postoperative pain management. administration of intravenous products together can result in compatibility problems and this is clinically hazardous. published reports from some studies can provide information about drugs' incompatibility characteristics hut there is limited data for new drugs such as ibuprofen,a commonly used non-steroidal anti-inflammatory drug. in this study,the aim was to investigate whether precipitation occurs when ibuprofen is used with other drugs commonly used in anesthesiology practice. method: to determine the precipitation properties of ibuprofenlsf (4 mg ml1),ibuprofenlrl (4 mg ml1) ibuprofenldextrose (4 mg ml1) and ibuprofen (100 mg ml1) forms,0.1 ml of the drug was mixed on a slide with the same volume of the test drug (0.1 ml). precipitation,or lack of,was observed with a magnifier. results: the presence of precipitation reaction (++++) was identified for the following drug combinations: ibuprofenlsalin (4 mg ml1) with dobutamine,diltiazem,haloperidol,ketamine,vancomycin,and verapamil; ibuprof enl ringer lactate (4 mg ml1) with dobutamine,diltiazem hcl,haloperidol,ketamine,rocuronium,and vancomycin; ibuprof enl dextrose (4 mg m1) with dobutamine,diltiazem hcl,rocuronium,and verapamil; and ibuprofen (100 mg ml1) with dobutamine,diltiazem hcl,gentamicin,haloperidol,calcium,metoclopramide,midazolam,prilocaine,protamine hydrochloride,rocuronium,and vancomycin. conclusion: precipitation reactions were observed for ibuprofen mixed with a variety of anesthetic medications and antibiotics. we obsen'ed a lower rate of precipitation reactions with ibuprofen diluted with saline compared to dilution with ringer lactate and 5% dextrose. as a result,we believe that in situations where drug administration occurs consecutively diluting ibuprofen with saline will cause less physical incompatibility and fewer drug interactions.