Foundation-supported researchers have reported the results of a high-dose ibuprofen study in The New England Journal of Medicine, March 30, 1995. Ibuprofen slowed the rate of pulmonary decline over a four-year period in patients with cystic fibrosis (CF). All patients had mild lung disease at the start of the study. The research was conducted at Rainbow Babies and Childrens Hospital and Case Western Reserve University School of Medicine, in Cleveland, with assistance from Children's Hospital Medical Center of Akron.
The effect on pulmonary function took years to become evident. The patients who benefitted the most were those who took the drug consistently throughout the four-year study, and those who were younger than 13 years of age when the research began
The Upjohn Company developed ibuprofen as a prescription drug under the trade name Motrin. It is an anti-inflammatory drug, a "non-steroidal" agent (won't upset hormonal balance), most often prescribed to treat arthritis, fever, menstrual symptoms, and pain. After the drug patent expired, ibuprofen was released for over-the-counter sale. Many companies now market it under the trade names: Advil; Nuprin; Motrin-IB; and others.
Which individuals with CF should be taking ibuprofen?
Only your physician can determine whether ibuprofen is appropriate for you. There are several factors to consider before taking this drug long-term. Also, the risk of side effects may change depending upon your particular condition.In this study, researchers found that ibuprofen was effective in patients with mild lung disease who were old enough to perform pulmonary function test (5 years and older). Patients who were younger, or who had moderate to severe pulmonary disease were not assessed. Researchers project, however, that those with more severe diseases would not benefit.
The study also indicates that too low or too high a level of ibuprofen can cause side effects.
Why shouldn't I just buy ibuprofen over-the-counter and start taking it now?
Ibuprofen will not be right for everyone with CF. First your physician needs to confirm that you will most likly benefit from the drug and do not have any other conditions that would make the use of ibuprofen unwise. Further, your physician will be able to prescribe the specific amount of drug for you. The doses needed are quite high and are determined by a special blood test.
Again, it is unwise to start taking ibuprofen from the drug store without consulting your physician. Too low a dose means that you will miss all the benefit and still risk side effects. And, of course, there is even more of a risk if your dose is too high.
Once I start taking ibuprofen how soon should I expect to feel better?
Ibuprofen will not make you feel better right away. It slows down the rate of lung deterioration in people with CF; it does not improve pulmonary function or eliminate exacerbation (flare-ups) immediately. The benefits of four years of ibuprofen were substantial, but after only one year, few patients actually felt better. You will need to keep taking the drug, day in and day out, year after year, to fully benefit.
What are the common side effects of ibuprofen?
Stomach upset is the most commonly reported side effect for anyone who takes ibuprofen. CF patients generally experience more stomach upset than others even when not on ibuprofen; therefore, you need to tell your physician whenever new stomach problems occur, don't just assume they are due to ibuprofen.
Ibuprofen may also interfere with the ability of the blood to form a clot, which leads to bleeding "tendencies." Nosebleeds, for example, might be worse when you are on such a drug. If you have bleeding tendencies, mention this to your physician when you discuss the pros and cons of taking ibuprofen. Overall, ibuprofen appears less risky than aspirin.
There has been some publicity recently that ibuprofen causes kindley damage. This can occur, but is unusual. Scientists know that ibuprofen decreases blood flow to the kidneys and slows down the kidney's ability to clear out other drugs. Your physician may need to adjust the doses of other drugs, accordingly.
Other side effects are more or less unusual or less severe. Your physician can discuss these with you.
How much is the ibuprofen going to cost and can I take the cheapest brand?
Ibuprofen treatment for CF, even at the highest dose, will cost less than $200 per year. Because the release of ibuprofen into the body from different brands varies, you should use the brand prescribed by your physician. This fact, rather than the cost difference among brands, must be the deciding factor. Once your blood levels of ibuprofen are measured and adjusted using one brand, you should use this same brand to get the optimal amount of ibuprofen in your bloodstream.
August 22, 1997.
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