Medication Use Evaluation of Intravenous Ibuprofen at a 591-Bed Teaching Hospital

Introduction: The objective of this study was to evaluate the safety and efficacy of IV ibuprofen. The primary outcome is reduction in pain score and opioid usage within 24 hours of ibuprofen initiation. Additional outcomes include incidence of AKI or gastrointestinal bleeding.


Methods: This is a retrospective chart review of 267 adult and pediatric patients who were prescribed IV ibuprofen between June and August 2024 at NYU Langone Hospital Long Island. Electronic medical records were analyzed for demographic information, admitting department, ordering service, and intravenous ibuprofen administration records. Opioid usage expressed in morphine milligram equivalents (MME) and average pain scores were calculated before and after ibuprofen initiation. Both opioid and non-opioid analgesic medications charted within 24 hours of intravenous ibuprofen were analyzed. Charts were reviewed further for the incidence of GI bleeding or AKI.


Results: Forty-five percent of patients experienced a decrease in pain score after initiating IV ibuprofen; average pain score before ibuprofen was 3.9 and 3.2 after ibuprofen (average decrease of 17.9%). Compliance of pain scale documentation is 92.5%. Sixty-six percent of patients experienced a decrease in opioid usage after initiating ibuprofen; average MME before ibuprofen was 30.4 mg and 19.1 mg after initiation (average decrease of 37.2%) per patient. Sixty-one percent of patients were treated concurrently with both opioids and nonopioids. The most predominant ordering service was surgery, which comprised 44.9% of the total sample size. Fixed-dosing was pursued in a majority of patients (80%), with 800 mg being the most frequently ordered dose at 64%. Majority of patients (73.8%) received ibuprofen indicated for pain only. There were 3 incidences of AKI and zero incidence of GI bleed, however the AKI was unlikely to be related to IV ibuprofen.


Conclusions: IV ibuprofen is commonly utilized in our institution for the treatment of pain and fever, either as monotherapy or in combination with opioid and non-opioid medications. It is a safe and effective opioid-sparing analgesic, given low incidence of adverse effects and modest reduction in both opiate usage and pain score.