Disclaimer
We do not guarantee the accuracy, currency or completeness of information regarding medications or medical products, and official sources should be verified before making any decisions. By using this blog, you agree to assume personal responsibility for relying on the information provided.
This article is intended for educational and informational purposes only and does not replace the advice, diagnosis, or treatment provided by a qualified healthcare professional. Medication decisions should be based on the patient's individual clinical condition, current official prescribing information, and professional medical judgment.
1. Summary
Ibugesic 200 mg and 400 mg tablets are oral preparations containing ibuprofen, a non-steroidal anti-inflammatory drug (NSAID) with analgesic, anti-inflammatory, and antipyretic properties.
Ibuprofen inhibits cyclooxygenase (COX) enzymes and thereby reduces prostaglandin synthesis. It is used for the management of inflammatory and painful musculoskeletal and rheumatologic conditions, as well as mild-to-moderate pain, including dysmenorrhea, dental pain, postoperative pain, headache, and migraine. The manufacturer's product portfolio also identifies Ibugesic as having analgesic, antipyretic, and anti-inflammatory uses.
As with other NSAIDs, ibuprofen should be used at the lowest effective dose for the shortest duration necessary. Important risks include gastrointestinal ulceration, bleeding and perforation; renal impairment; fluid retention and cardiovascular complications; hypersensitivity reactions; and, rarely, serious cutaneous adverse reactions.
High-dose or prolonged NSAID treatment may increase cardiovascular risk. The source product information specifically identifies a greater concern with high-dose ibuprofen, particularly 2,400 mg/day, and long-term treatment.
2. Brand Name
IBUGESIC
Available strengths covered by this commentary:
- Ibugesic 200 mg sugar-coated tablets
- Ibugesic 400 mg sugar-coated tablets
The manufacturer's current portfolio also lists Ibugesic 200 mg and 400 mg tablets in boxes of 30 tablets (3 strips × 10 tablets).
3. Category
Therapeutic category: Non-steroidal anti-inflammatory drug (NSAID)
Pharmacological class: Propionic acid derivative
Primary pharmacological effects:
- Analgesic
- Anti-inflammatory
- Antipyretic
Ibuprofen belongs to the propionic acid derivative group of NSAIDs.
4. Active Ingredient
Each tablet contains:
- Ibugesic 200 mg: Ibuprofen 200 mg
- Ibugesic 400 mg: Ibuprofen 400 mg
5. Pharmaceutical Form & Strength
Dosage form: Sugar-coated oral tablets.
The source product information describes the tablets as red-magenta, sugar-coated tablets.
Available strengths:
- 200 mg
- 400 mg
6. Manufacturer & Marketing Authorization Holder
Manufacturer:
Kahira Pharm. & Chem. Ind. Co., Cairo, Egypt
The supplied product information identifies the manufacturer as Kahira Pharm. & Chem. Ind. Co. in Cairo, Egypt.
The manufacturer's own product portfolio confirms that Ibugesic 200 mg and 400 mg tablets contain ibuprofen and identifies the product within Kahira Pharmaceuticals' analgesic, antipyretic and anti-inflammatory portfolio.
Marketing Authorization Holder (MAH):
A separate, current official source identifying a distinct Marketing Authorization Holder from the manufacturer could not be independently verified from the available sources. Therefore, the manufacturer should not automatically be described as the MAH without confirmation from the current Egyptian regulatory documentation or the current package leaflet.
7. Mechanism of Action
Ibuprofen produces its therapeutic effects primarily through inhibition of the cyclooxygenase (COX) pathway, resulting in a marked reduction in prostaglandin synthesis.
Reduced prostaglandin production contributes to:
- Reduction of pain
- Reduction of inflammation
- Reduction of fever
The supplied product information states that ibuprofen's therapeutic effects as an NSAID are thought to result from inhibition of cyclooxygenase and consequent reduction in prostaglandin synthesis.
Ibuprofen can also interfere with the antiplatelet effect of low-dose aspirin under certain dosing circumstances. Experimental data cited in the product information demonstrated reduced aspirin-mediated platelet effects when ibuprofen 400 mg was taken within specific time windows around immediate-release aspirin administration, although the clinical significance of these findings remains uncertain, particularly with occasional ibuprofen use.
8. Spectrum of Activity
Not applicable in the antimicrobial sense.
Ibugesic is not an antibiotic or antimicrobial drug. It has no conventional antibacterial, antiviral, antifungal, or antiparasitic spectrum.
Its pharmacological activity is directed toward the inflammatory and pain pathways through inhibition of prostaglandin synthesis.
9. Pharmacokinetics
Ibuprofen is rapidly absorbed from the gastrointestinal tract following oral administration.
According to the supplied product information:
- Peak serum concentrations occur approximately 1–2 hours after administration.
- The elimination half-life is approximately 2 hours.
- Ibuprofen is extensively bound to plasma proteins.
- It is metabolized in the liver to two inactive metabolites.
- Unchanged ibuprofen and its metabolites are eliminated through the kidneys, either unchanged or as conjugates.
- Renal excretion is described as rapid and complete in the supplied product information.
Because renal prostaglandins may contribute to maintaining renal perfusion in susceptible patients, NSAID-induced reduction in prostaglandin synthesis can precipitate renal impairment, particularly in patients with renal dysfunction, heart failure, liver dysfunction, dehydration, or in those taking diuretics or ACE inhibitors.
10. Indications
Ibugesic is indicated for its analgesic and anti-inflammatory effects in a range of rheumatologic, musculoskeletal, and painful conditions.
Rheumatologic and inflammatory conditions
It may be used in:
- Rheumatoid arthritis
- Juvenile rheumatoid arthritis / Still's disease
- Ankylosing spondylitis
- Osteoarthritis
- Other non-rheumatoid (seronegative) arthropathies
Non-articular rheumatic conditions
The supplied product information includes:
- Frozen shoulder (capsulitis)
- Bursitis
- Tendinitis
- Tenosynovitis
- Low back pain
Soft-tissue injuries
It may also be used for:
- Sprains
- Strains
Mild-to-moderate pain
The listed analgesic indications include:
- Dysmenorrhea
- Dental pain
- Postoperative pain
- Headache
- Migraine headache
The manufacturer's portfolio similarly describes Ibugesic as having anti-inflammatory, analgesic, and antipyretic properties and lists rheumatoid arthritis, osteoarthritis, non-articular rheumatism, soft-tissue injuries, dysmenorrhea, migraine, postoperative pain, ankylosing spondylitis, sprains and strains among its uses.
11. Administration
Ibugesic is administered orally.
The supplied product information recommends that it be taken preferably with or after food.
As a general NSAID safety principle, adverse effects can be minimized by using the:
lowest effective dose for the shortest possible duration necessary to control symptoms.
Patients should not routinely combine Ibugesic with other NSAIDs, including selective COX-2 inhibitors, because this can increase the risk of adverse effects, particularly gastrointestinal toxicity.
12. Dosage
Adults
The supplied product information recommends:
- 1,200–1,800 mg daily in divided doses
- Some patients may be maintained on 600–1,200 mg daily
- In severe or acute conditions, the dose may be increased until the acute phase is controlled, provided that the total daily dose does not exceed 2,400 mg, administered in divided doses.
Because NSAID toxicity is dose- and duration-related, higher doses should be reserved for appropriate clinical situations and used for the shortest possible period.
Children
The supplied Ibugesic product information states:
- 20 mg/kg/day in divided doses
- In juvenile rheumatoid arthritis, up to 40 mg/kg/day in divided doses may be used.
- It is not recommended for children weighing less than 7 kg.
Pediatric dosing should nevertheless be individualized according to age, weight, indication, formulation, renal status, hydration status, and current official pediatric prescribing guidance.
Elderly
Elderly patients have an increased risk of serious NSAID adverse reactions, particularly gastrointestinal bleeding and perforation.
If an NSAID is considered necessary:
- The lowest effective dose should be used.
- Treatment should be as short as possible.
- Patients should be monitored appropriately, including for gastrointestinal bleeding.
- Dose selection should be individualized when renal or hepatic function is impaired.
13. Method of Preparation
Not applicable for the tablet dosage form.
Ibugesic 200 mg and 400 mg are supplied as ready-to-use sugar-coated tablets and do not require reconstitution or preparation before administration.
14. Contraindications
Ibugesic is contraindicated in patients with:
Hypersensitivity
- Hypersensitivity to ibuprofen or any of the excipients.
- Previous hypersensitivity reactions such as asthma, urticaria, angioedema, or rhinitis after ibuprofen, aspirin, or other NSAIDs.
Gastrointestinal disease
- Previous gastrointestinal bleeding or perforation related to previous NSAID therapy.
- Active peptic ulcer disease.
- History of recurrent peptic ulcer disease.
- History of gastrointestinal hemorrhage, particularly two or more distinct episodes of proven ulceration or bleeding.
Bleeding disorders
- Conditions associated with an increased tendency to bleed.
Severe organ dysfunction
- Severe heart failure.
- Severe hepatic failure.
- Severe renal failure.
Pregnancy
The supplied product information contraindicates ibuprofen during the third trimester. Current FDA safety guidance is more restrictive: systemic NSAIDs should generally be avoided from around 20 weeks of pregnancy onward unless specifically advised by a healthcare professional, because of fetal renal dysfunction and oligohydramnios; NSAIDs should be avoided at around 30 weeks and later because of the additional risk of premature closure of the fetal ductus arteriosus.
15. Warnings & Precautions
15.1 Cardiovascular Risk
NSAIDs may increase the risk of serious cardiovascular thrombotic events, including:
- Myocardial infarction
- Stroke
These events can be fatal.
The risk may increase with the duration of treatment, and patients with cardiovascular disease or cardiovascular risk factors may be at greater risk.
NSAIDs are contraindicated for the treatment of peri-operative pain in the setting of coronary artery bypass graft (CABG) surgery.
Epidemiological data indicate that ibuprofen, particularly at 2,400 mg/day and during long-term treatment, may be associated with a small increase in arterial thrombotic events. The supplied product information states that epidemiological studies do not suggest that low-dose ibuprofen, for example ≤1,200 mg/day, is associated with increased arterial thrombotic risk to the same extent.
Particular caution is required in patients with:
- Uncontrolled hypertension
- Congestive heart failure
- Established ischemic heart disease
- Peripheral arterial disease
- Cerebrovascular disease
- Hyperlipidemia
- Diabetes mellitus
- Smoking history
Long-term treatment should be carefully evaluated in patients with cardiovascular risk factors.
15.2 Gastrointestinal Risk
NSAIDs can cause serious gastrointestinal adverse events, including:
- Inflammation
- Ulceration
- Bleeding
- Perforation
These events may be fatal and can occur at any time during treatment, sometimes without warning symptoms.
The risk increases with:
- Higher NSAID doses
- Older age
- Previous peptic ulcer disease
- Previous ulcer bleeding or perforation
- Concomitant medications that increase gastrointestinal bleeding risk
Patients at increased risk should generally receive the lowest appropriate dose. Gastroprotective therapy, such as a proton pump inhibitor, may be considered in selected high-risk patients, particularly those requiring low-dose aspirin or other medications that increase gastrointestinal risk.
If gastrointestinal bleeding or ulceration occurs, Ibugesic should be discontinued.
15.3 Renal Effects
Ibuprofen can cause a dose-dependent reduction in renal prostaglandin synthesis and may precipitate renal failure in susceptible patients.
Patients at greatest risk include those with:
- Pre-existing renal impairment
- Heart failure
- Liver dysfunction
- Dehydration
- Concomitant diuretic therapy
- Concomitant ACE inhibitor therapy
- Advanced age
Renal function should be monitored in patients at increased risk.
Patients who are significantly dehydrated should receive particular caution before starting ibuprofen.
Long-term NSAID administration has been associated with renal papillary necrosis and other renal pathological changes.
15.4 Respiratory Effects
Caution is required in patients with current or previous bronchial asthma because NSAIDs may precipitate:
- Bronchospasm
- Asthma exacerbation
- Dyspnea
15.5 Hepatic Effects
Caution is required in patients with hepatic impairment.
Hepatic adverse effects reported with ibuprofen include:
- Abnormal liver function
- Hepatitis
- Jaundice
- Hepatic failure
15.6 Gastrointestinal Inflammatory Diseases
NSAIDs should be used cautiously in patients with:
- Ulcerative colitis
- Crohn's disease
because these conditions may be exacerbated.
15.7 Dermatological Reactions
Rare serious cutaneous reactions have been reported with NSAIDs, including:
- Exfoliative dermatitis
- Stevens-Johnson syndrome (SJS)
- Toxic epidermal necrolysis (TEN)
Most serious reactions occur relatively early in treatment, with many cases occurring during the first month.
Ibugesic should be discontinued at the first appearance of:
- Skin rash
- Mucosal lesions
- Other signs of hypersensitivity
15.8 Hematological Effects
Ibuprofen may interfere with platelet aggregation and can prolong bleeding time.
Patients receiving concomitant antiplatelet or anticoagulant treatment require particular caution.
15.9 Infection
Like other NSAIDs, ibuprofen may mask signs and symptoms of infection, potentially delaying recognition of an underlying infection.
15.10 Systemic Lupus Erythematosus and Connective Tissue Disease
Patients with systemic lupus erythematosus (SLE) or mixed connective tissue disease may have an increased risk of aseptic meningitis associated with ibuprofen. However, rare cases have also been reported in patients without an underlying chronic disease.
15.11 Female Fertility
The supplied product information states that ibuprofen may impair female fertility because of its effects on prostaglandin synthesis.
It is therefore not recommended for women attempting to conceive, and withdrawal should be considered in women experiencing difficulty conceiving or undergoing infertility investigations.
15.12 Lactose-related Disorders
The supplied formulation contains lactose-related excipient information and states that patients with rare hereditary problems of:
- Galactose intolerance
- Lapp lactase deficiency
- Glucose-galactose malabsorption
should not take the medication.
16. Drug Interactions
Antihypertensive drugs, beta-blockers and diuretics
NSAIDs may reduce the antihypertensive effect of:
- ACE inhibitors
- Beta-blockers
- Diuretics
Diuretics may also increase the risk of NSAID-associated nephrotoxicity.
Cardiac glycosides
NSAIDs may:
- Exacerbate heart failure
- Reduce glomerular filtration rate
- Increase plasma concentrations of cardiac glycosides
Cholestyramine
Concomitant administration may reduce gastrointestinal absorption of ibuprofen. The clinical significance of this interaction is uncertain.
Lithium
Ibuprofen may decrease lithium elimination and consequently increase lithium exposure.
Methotrexate
NSAIDs may inhibit renal tubular secretion of methotrexate and reduce its clearance, potentially increasing methotrexate exposure and toxicity.
This interaction is particularly important with higher-dose methotrexate or in patients with impaired renal function.
Ciclosporin
Concomitant use may increase the risk of nephrotoxicity.
Mifepristone
A theoretical reduction in the efficacy of mifepristone may occur because of the antiprostaglandin properties of NSAIDs.
However, limited evidence cited in the supplied product information indicates that NSAID administration on the day of prostaglandin administration did not adversely influence cervical ripening or uterine contractility or reduce clinical efficacy in the studied context.
Other NSAIDs and COX-2 inhibitors
Concomitant use of two or more NSAIDs, including selective COX-2 inhibitors, should generally be avoided because it increases the risk of adverse effects, particularly gastrointestinal toxicity and bleeding.
Aspirin
Concurrent administration of ibuprofen and aspirin is generally not recommended because of increased adverse-effect risk.
Importantly, experimental data suggest that ibuprofen can interfere with the antiplatelet effect of low-dose aspirin when the drugs are taken within certain time windows. The clinical relevance is not completely established, and occasional ibuprofen use is considered less likely to produce a clinically relevant effect according to the supplied product information.
Corticosteroids
Concomitant corticosteroid therapy increases the risk of gastrointestinal ulceration and bleeding.
Anticoagulants
NSAIDs may enhance the effects of anticoagulants such as warfarin, increasing bleeding risk.
Quinolone antibiotics
NSAIDs may increase the risk of convulsions associated with quinolone antibiotics.
Sulfonylureas
NSAIDs may potentiate the hypoglycemic effect of sulfonylurea medications. Rare cases of hypoglycemia have been reported.
Antiplatelet agents and SSRIs
The combination may increase the risk of gastrointestinal bleeding.
Tacrolimus
Concomitant use may increase the risk of nephrotoxicity.
Zidovudine
Concomitant use may increase hematological toxicity.
An increased risk of hemarthroses and hematoma has been reported in HIV-positive hemophiliac patients receiving zidovudine with ibuprofen.
Aminoglycosides
NSAIDs may decrease aminoglycoside excretion.
Ginkgo biloba
Ginkgo biloba may potentiate the bleeding risk associated with NSAIDs.
CYP2C9 inhibitors
Ibuprofen is a CYP2C9 substrate.
Concomitant administration with CYP2C9 inhibitors may increase ibuprofen exposure.
The supplied product information specifically reports that voriconazole and fluconazole increased exposure to the S(+)-ibuprofen enantiomer by approximately 80–100%.
A reduction in ibuprofen dose should therefore be considered when potent CYP2C9 inhibitors are administered concomitantly, particularly when high-dose ibuprofen is being used with voriconazole or fluconazole.
17. Side Effects
Common or frequently reported gastrointestinal effects
The gastrointestinal system is the most commonly affected system.
Reported adverse effects include:
- Dyspepsia
- Nausea
- Vomiting
- Abdominal pain
- Diarrhea
- Constipation
- Flatulence
- Gastritis
More serious events include:
- Peptic ulceration
- Gastrointestinal bleeding
- Gastrointestinal perforation
- Melena
- Hematemesis
Gastrointestinal perforation has been reported rarely, and pancreatitis has been reported very rarely.
Hypersensitivity and allergic reactions
Reported reactions include:
- Nonspecific allergic reactions
- Anaphylaxis
- Asthma exacerbation
- Bronchospasm
- Dyspnea
- Rash
- Pruritus
- Urticaria
- Purpura
- Angioedema
Rare severe cutaneous reactions include:
- Exfoliative dermatitis
- Bullous dermatoses
- Erythema multiforme
- Stevens-Johnson syndrome
- Toxic epidermal necrolysis
Cardiovascular adverse effects
Reported effects include:
- Edema
- Hypertension
- Cardiac failure
High-dose and long-term treatment may be associated with an increased risk of arterial thrombotic events such as:
- Myocardial infarction
- Stroke
Hematological effects
Less commonly reported events include:
- Leukopenia
- Thrombocytopenia
- Neutropenia
- Agranulocytosis
- Aplastic anemia
- Hemolytic anemia
Psychiatric effects
Reported events include:
- Insomnia
- Anxiety
- Depression
- Confusional state
- Hallucination
Neurological effects
Reported effects include:
- Headache
- Paresthesia
- Dizziness
- Somnolence
- Optic neuritis
Aseptic meningitis
Rare cases of aseptic meningitis have been reported, particularly in patients with autoimmune diseases such as SLE and mixed connective tissue disease.
Symptoms may include:
- Stiff neck
- Headache
- Nausea
- Vomiting
- Fever
- Disorientation
Eye and ear disorders
Reported effects include:
- Visual impairment
- Toxic optic neuropathy
- Hearing impairment
- Tinnitus
- Vertigo
Hepatobiliary effects
Reported effects include:
- Abnormal liver function
- Hepatitis
- Jaundice
- Hepatic failure
Skin reactions
Reported effects include:
- Bullous reactions
- Stevens-Johnson syndrome
- Toxic epidermal necrolysis
- Photosensitivity reactions
SJS and TEN are very rare but potentially life-threatening.
Renal effects
Reported effects include:
- Impaired renal function
- Toxic nephropathy
- Interstitial nephritis
- Nephrotic syndrome
- Renal failure
General effects
- Malaise
- Fatigue
18. Use in Special Populations
Pregnancy
Pregnancy requires particular caution with ibuprofen.
The supplied product information states that prostaglandin synthesis inhibition may adversely affect pregnancy and fetal development and describes associations with miscarriage and certain fetal malformations during early pregnancy. It recommends avoiding Ibugesic unless clearly necessary during the first and second trimesters and contraindicates its use during the third trimester.
However, current FDA safety guidance provides an important update to this older wording:
- Avoid systemic NSAIDs, including ibuprofen, at 20 weeks of pregnancy or later unless specifically advised by a healthcare professional.
- Between approximately 20 and 30 weeks, if treatment is necessary, use the lowest effective dose for the shortest possible duration.
- If treatment extends beyond 48 hours, ultrasound monitoring of amniotic fluid may be considered.
- NSAIDs should generally be avoided at approximately 30 weeks and later because of the additional risk of premature closure of the fetal ductus arteriosus.
Therefore, the pregnancy information in the older supplied leaflet should not be used as the sole basis for current prescribing decisions.
Breastfeeding
The supplied older product information states that NSAIDs can appear in breast milk at very low concentrations and recommends avoiding NSAIDs if possible during breastfeeding.
More recent evidence provides a more reassuring and clinically useful assessment specifically for ibuprofen.
The U.S. National Library of Medicine's LactMed database, updated August 15, 2025, states that ibuprofen has extremely low levels in breast milk, a short half-life, and is considered a preferred analgesic or anti-inflammatory agent in nursing mothers. Reported relative infant exposure is extremely low, and published cases of breastfed infants exposed through maternal ibuprofen use have not identified adverse effects.
Thus, the older statement that ibuprofen should preferably be avoided during breastfeeding should be regarded as outdated and more restrictive than current evidence-based lactation references.
Elderly Patients
Elderly patients are at increased risk of serious NSAID toxicity, particularly:
- Gastrointestinal bleeding
- Ulceration
- Perforation
- Renal impairment
The lowest effective dose should be used for the shortest possible duration, with appropriate monitoring.
Renal Impairment
Ibuprofen should be used cautiously in patients with renal impairment and is contraindicated in severe renal failure according to the supplied product information.
Renal function should be monitored in patients at increased risk.
Hepatic Impairment
The product information contraindicates Ibugesic in severe hepatic failure. Dose selection should be individualized in patients with hepatic impairment.
Heart Failure and Hypertension
Ibuprofen should be used cautiously in patients with:
- Hypertension
- Mild-to-moderate congestive heart failure
because fluid retention and edema have been reported.
Patients with established cardiovascular disease require careful benefit-risk assessment.
19. Effects on Driving and Operating Machinery
NSAIDs, including ibuprofen, may cause:
- Dizziness
- Drowsiness
- Fatigue
- Visual disturbances
Patients experiencing these effects should avoid driving or operating machinery.
20. Overdose
The supplied product information states that toxicity has generally not been observed at doses below 100 mg/kg in children or adults, although supportive care may be necessary in some cases.
In children, signs and symptoms of toxicity have been observed after ingestion of approximately 400 mg/kg or more.
However, individual susceptibility varies, and a potentially toxic ingestion should not be considered safe simply because a dose is below a particular numerical threshold.
Symptoms of overdose
Symptoms usually develop within approximately 4–6 hours after a significant ingestion.
Common symptoms include:
- Nausea
- Vomiting
- Abdominal pain
- Lethargy
- Drowsiness
Other possible manifestations include:
- Headache
- Tinnitus
- Dizziness
- Convulsions
- Loss of consciousness
- Nystagmus
- Metabolic acidosis
- Hypothermia
- Renal impairment
- Gastrointestinal bleeding
- Coma
- Apnea
- CNS depression
- Respiratory depression
- Diarrhea
- Disorientation
- Excitation
- Fainting
- Hypotension
- Bradycardia
- Tachycardia
Severe overdose may result in:
- Renal failure
- Liver injury
Management
Treatment is primarily supportive and symptomatic.
The supplied product information states that:
- Activated charcoal may be considered within one hour of ingestion of a potentially toxic amount.
- In adults, gastric lavage may be considered within one hour following a potentially life-threatening overdose.
- Adequate urine output should be maintained.
- Renal and hepatic function should be closely monitored.
- Patients should be observed for at least four hours after potentially toxic ingestion.
- Frequent or prolonged convulsions may be treated with intravenous diazepam.
- Additional measures should be guided by the patient's clinical condition.
Management of significant overdose should be undertaken in an appropriate medical setting.
21. Pharmaceutical Excipients
Ibugesic 200 mg sugar-coated tablets
Inactive ingredients listed in the supplied product information include:
- Maize starch
- Stearic acid
The sugar coating contains:
- Opalux Pink AS1539
- Carnauba wax
- Opaglos Regular
- Sucrose
- Acacia powder
- Calcium sulphate dihydrate
- Sodium carboxymethylcellulose
Ibugesic 400 mg sugar-coated tablets
Inactive ingredients include:
- Colloidal silicon dioxide
- Pregelled starch
- Maize starch
- Stearic acid
- Purified water
The sugar coating contains:
- Refined sugar
- Calcium sulphate dihydrate
- Sodium carboxymethylcellulose
- Opalux Pink AS1539
- Carnauba wax
- Opaglos Regular
- Acacia powder
22. Incompatibilities
Not applicable.
No pharmaceutical incompatibilities are specified for the tablet formulation in the supplied product information.
23. Shelf Life
The supplied product information states a shelf life of:
3 years
The expiry date printed on the individual marketed package should always be followed.
24. Storage Conditions
Store at a temperature not exceeding 30°C.
Protect from:
- Light
- Humidity
Keep the medicine out of the reach of children.
25. Packaging
Ibugesic 200 mg
Carton box containing:
- 3 PVC/Aluminium strips
- 10 tablets per strip
- Total: 30 tablets
- Inner leaflet
Ibugesic 400 mg
Carton box containing:
- 3 PVC/Aluminium strips
- 10 tablets per strip
- Total: 30 tablets
- Inner leaflet
The manufacturer's product portfolio also confirms packaging of 30 tablets (3 strips × 10 tablets).
26. Frequently Asked Questions (FAQ)
What is Ibugesic?
Ibugesic is a brand of ibuprofen, a non-steroidal anti-inflammatory drug (NSAID) used for pain, inflammation, and fever.
What is the active ingredient in Ibugesic 400 mg?
Each Ibugesic 400 mg tablet contains 400 mg of ibuprofen.
Is Ibugesic an antibiotic?
No. Ibugesic is an NSAID and does not treat bacterial, viral, fungal, or parasitic infections.
What is Ibugesic used for?
It is used for various painful and inflammatory conditions, including arthritis, ankylosing spondylitis, musculoskeletal disorders, sprains, strains, dysmenorrhea, dental pain, postoperative pain, headache, and migraine.
Should Ibugesic be taken with food?
The supplied product information recommends taking it preferably with or after food, particularly to improve gastrointestinal tolerability.
Can Ibugesic cause stomach bleeding?
Yes. Like other NSAIDs, ibuprofen can cause gastrointestinal ulceration, bleeding, and perforation, which can occasionally be life-threatening.
Can Ibugesic affect the kidneys?
Yes. NSAIDs can reduce renal perfusion and precipitate renal impairment, particularly in dehydrated patients and those with pre-existing renal disease, heart failure, liver dysfunction, or concomitant diuretic/ACE-inhibitor therapy.
Can Ibugesic increase blood pressure?
It may. NSAID treatment has been associated with fluid retention, edema, and hypertension, and patients with hypertension or heart failure require caution.
Can Ibugesic increase the risk of heart attack or stroke?
NSAIDs may increase cardiovascular thrombotic risk. The risk is particularly important with high-dose and long-term ibuprofen treatment and in patients who already have cardiovascular disease or cardiovascular risk factors.
Can I take Ibugesic with aspirin?
Routine concomitant use is generally not recommended because of increased adverse-effect risk. Ibuprofen may also interfere with the antiplatelet effect of low-dose aspirin under certain dosing conditions.
Can I take Ibugesic with methotrexate?
Caution is required. NSAIDs can inhibit renal tubular secretion of methotrexate and reduce its clearance, potentially increasing methotrexate exposure and toxicity.
Can Ibugesic be used during pregnancy?
Pregnancy requires special caution. Current FDA guidance recommends avoiding NSAIDs, including ibuprofen, from around 20 weeks of pregnancy onward unless specifically advised by a healthcare professional. NSAIDs should generally be avoided at approximately 30 weeks and later because of fetal renal and ductus arteriosus risks.
Can Ibugesic be used while breastfeeding?
Current evidence is considerably more reassuring than the older leaflet wording. LactMed's 2025 review identifies ibuprofen as a preferred analgesic or anti-inflammatory agent during breastfeeding because its transfer into breast milk is extremely low and its half-life is short.
Can Ibugesic affect female fertility?
The supplied product information states that ibuprofen may impair female fertility and recommends considering withdrawal in women who are attempting to conceive or undergoing infertility evaluation.
Can Ibugesic cause an allergic reaction?
Yes. Hypersensitivity reactions may include urticaria, angioedema, bronchospasm, asthma exacerbation, dyspnea, and anaphylaxis. Rare severe skin reactions such as SJS and TEN have also been reported.
Can Ibugesic cause serious skin reactions?
Rarely, yes. Stevens-Johnson syndrome and toxic epidermal necrolysis have been reported. Any new significant rash or mucosal lesion during treatment warrants prompt medical assessment and discontinuation when a serious drug reaction is suspected.
Can Ibugesic be taken with another NSAID?
Concomitant use of multiple NSAIDs, including COX-2 inhibitors, should generally be avoided because it increases the risk of adverse effects.
27. Key Clinical Safety Points
Before prescribing or recommending Ibugesic, particular attention should be given to:
- Previous peptic ulcer disease or gastrointestinal bleeding.
- Concurrent anticoagulant, antiplatelet, corticosteroid, or SSRI therapy.
- Cardiovascular disease or significant cardiovascular risk factors.
- Hypertension or heart failure.
- Renal impairment or dehydration.
- Hepatic impairment.
- Asthma or previous NSAID-induced bronchospasm.
- Pregnancy, especially from 20 weeks onward.
- Concomitant methotrexate or lithium.
- Concomitant use of another NSAID.
- History of serious NSAID hypersensitivity.
- Previous serious cutaneous drug reactions.
- Women attempting conception or undergoing infertility investigation.
The overall principle remains:
Use the lowest effective dose for the shortest duration necessary.
28. References
- Ibugesic 200 mg & 400 mg Tablets — supplied product information / package leaflet. The supplied document contains the product composition, indications, dosage, contraindications, warnings, interactions, adverse effects, pharmacokinetic information, excipients, storage conditions, packaging, and manufacturer information.
- Kahira Pharmaceuticals — Products Portfolio. The manufacturer's portfolio identifies Ibugesic 200 mg and 400 mg tablets as ibuprofen-containing analgesic, antipyretic and anti-inflammatory products and confirms 30-tablet packaging.
- U.S. Food and Drug Administration (FDA). FDA Drug Safety Communication regarding avoidance of NSAIDs at 20 weeks of pregnancy or later because of fetal renal dysfunction and oligohydramnios, with avoidance at approximately 30 weeks and later because of the additional risk of premature ductus arteriosus closure.
- LactMed — Ibuprofen. National Library of Medicine, Drugs and Lactation Database. Last revision: August 15, 2025. Current evidence supports ibuprofen as a preferred analgesic/anti-inflammatory agent during breastfeeding because of extremely low breast-milk concentrations and very low infant exposure.
- Current product listings / pharmaceutical databases. Current Egyptian listings identify Ibugesic 200 mg and 400 mg coated tablets as products of El Kahira Pharm. & Chem. Ind. Co.
29. Final Disclaimer
We do not guarantee the accuracy, currency or completeness of information regarding medications or medical products, and official sources should be verified before making any decisions. By using this blog, you agree to assume personal responsibility for relying on the information provided.
The information in this article is intended for general educational purposes and should not be used as a substitute for professional medical advice, diagnosis, or treatment. Drug formulations, indications, dosing recommendations, contraindications, regulatory status, and safety information may change over time and may differ between countries and manufacturers.
For prescribing or dispensing decisions, healthcare professionals should verify the latest official package insert, Summary of Product Characteristics (SmPC), Egyptian regulatory information, and other authoritative drug references applicable to the specific marketed product.