Marcofen™ — Ibuprofen — NSAID — Analgesic, Antipyretic, Anti-inflammatory
1- Disclaimer
This monograph is intended for general medical and pharmaceutical information. It does not replace the current locally approved prescribing information, package leaflet, professional clinical judgment, or individual medical advice. Product availability, approved indications, excipients, manufacturer details, and dosing instructions may change over time and may differ between formulations and countries.
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. Readers are responsible for independently verifying the information before relying on it.
For patient-specific treatment decisions, particularly in children, pregnancy, older adults, or patients with cardiovascular, gastrointestinal, renal, hepatic, or bleeding risks, a physician or pharmacist should be consulted. The current Egyptian regulatory information and the leaflet supplied with the specific Marcofen presentation should take precedence over general ibuprofen information.
2- Summary
Marcofen™ contains ibuprofen, a non-steroidal anti-inflammatory drug (NSAID) of the propionic-acid derivative class. Ibuprofen has analgesic, antipyretic, and anti-inflammatory actions through reversible inhibition of cyclo-oxygenase enzymes and consequent reduction of prostaglandin synthesis.
Marcofen has been marketed in Egypt in several formulations, including a 400 mg coated tablet, 400 mg sustained-release capsule, 100 mg/5 mL oral suspension, and 100 mg, 300 mg and 500 mg suppositories. These presentations are reported in Egyptian medicine-market databases; however, the current regulatory or commercial status of each presentation should be verified from the latest Egyptian Drug Authority-approved information or the current product packaging.
NSAIDs can cause serious gastrointestinal bleeding, ulceration or perforation and can increase the risk of cardiovascular thrombotic events. Risk generally increases with higher doses, longer exposure and the presence of patient-specific risk factors. Current regulatory information therefore emphasizes use of the lowest effective dose for the shortest necessary duration.
3- Brand Name
Marcofen™
The monograph covers single-ingredient Marcofen products containing ibuprofen.
Marcofen Flu, which contains ibuprofen plus pseudoephedrine, is a separate combination product and is not covered by this monograph.
4- Category
- Non-steroidal anti-inflammatory drug (NSAID).
- Propionic-acid derivative.
- Analgesic.
- Antipyretic.
- Anti-inflammatory agent.
- ATC classification: M01AE01 – Ibuprofen.
5- Active Ingredient
Ibuprofen
Ibuprofen is a racemic propionic-acid derivative with analgesic, anti-inflammatory and antipyretic activity.
It reversibly inhibits prostaglandin synthesis and can also temporarily inhibit platelet aggregation.
6- Pharmaceutical Form & Strength
Presentations reported for Marcofen in Egyptian medicine-market databases include:
- Coated tablets: Ibuprofen 400 mg.
- Sustained-release capsules: Ibuprofen 400 mg.
- Oral suspension: Ibuprofen 100 mg/5 mL; 120 mL bottle.
- Infantile suppositories: Ibuprofen 100 mg.
- Paediatric suppositories: Ibuprofen 300 mg.
- Suppositories: Ibuprofen 500 mg.
These six ibuprofen-only Marcofen presentations have been reported in Egyptian medicine-market listings. Their current regulatory and commercial status should be verified from the latest Egyptian Drug Authority-approved information or current product packaging.
The inactive ingredients differ substantially between the tablet, sustained-release capsule, suspension and suppository formulations. Because excipient compositions may be revised, patients with allergies or intolerance to specific excipients should verify the ingredient list on the current package leaflet rather than assuming that different Marcofen formulations have identical inactive ingredients.
7- Manufacturer & Marketing Authorization Holder
Egyptian medicine listings identify GlaxoSmithKline (GSK)/GlaxoSmithKline Egypt as the company associated with Marcofen products.
Manufacturing sites and the legally designated Marketing Authorization Holder can change during a product's commercial life. The exact current manufacturer and Marketing Authorization Holder should therefore be verified from the current Egyptian Drug Authority-approved package and leaflet.
8- Mechanism of Action
Ibuprofen is a non-selective, reversible inhibitor of cyclo-oxygenase (COX) activity, reducing the synthesis of prostaglandins.
Reduction of prostaglandin formation accounts for its:
- Analgesic effect: decreased sensitization of pain receptors at sites of inflammation.
- Anti-inflammatory effect: reduction of inflammatory pain, swelling and related inflammatory responses.
- Antipyretic effect: reduction of prostaglandin-mediated elevation of hypothalamic temperature regulation.
- Effect in dysmenorrhoea: reduction of uterine prostaglandin synthesis and prostaglandin-mediated uterine contractions.
Ibuprofen also reversibly inhibits platelet aggregation. Its antiplatelet effect is considerably shorter and mechanistically different from the irreversible platelet inhibition produced by aspirin.
Experimental and pharmacodynamic data indicate that regularly administered ibuprofen may competitively interfere with the platelet-inhibitory action of low-dose aspirin when the drugs are taken at certain times relative to one another. The clinical significance is greatest when regular ibuprofen treatment is being considered in a patient taking aspirin for cardiovascular protection.
9- Spectrum of Activity
Ibuprofen is not an antimicrobial drug, so an antibacterial, antiviral or antifungal “spectrum” does not apply.
Its pharmacological spectrum includes:
- Analgesic activity.
- Antipyretic activity.
- Anti-inflammatory activity.
- Reversible inhibition of platelet aggregation.
Its effects are symptomatic; it does not eradicate the underlying infectious cause of fever or pain.
10- Pharmacokinetics
Absorption:
Immediate-release oral ibuprofen is rapidly absorbed from the gastrointestinal tract. Peak serum concentrations generally occur approximately 1–2 hours after administration. Food may delay the rate of absorption without necessarily reducing the overall extent of absorption.
The absorption profile of a sustained-release formulation differs from that of an immediate-release formulation, so pharmacokinetic timing for conventional tablets should not automatically be applied to Marcofen SR capsules.
Distribution:
Ibuprofen is rapidly distributed and is approximately 99% bound to plasma proteins.
Metabolism:
Ibuprofen is metabolised predominantly in the liver, including hydroxylation and carboxylation pathways. CYP2C9 contributes significantly to ibuprofen metabolism, which explains clinically relevant interactions with potent CYP2C9 inhibitors such as fluconazole and voriconazole.
Elimination:
The elimination half-life of conventional ibuprofen is approximately 2–2.5 hours in healthy individuals. Pharmacologically inactive metabolites are eliminated mainly through the kidneys, with a smaller contribution from biliary excretion.
11- Indications
Ibuprofen is used for symptomatic treatment of pain, inflammation and fever. Depending on the particular Marcofen formulation, locally approved uses may include:
Inflammatory and rheumatic conditions
- Rheumatoid arthritis.
- Juvenile idiopathic/rheumatoid arthritis under medical supervision.
- Osteoarthritis.
- Ankylosing spondylitis.
- Other inflammatory arthropathies.
Non-articular musculoskeletal conditions
- Bursitis.
- Tendinitis and tenosynovitis.
- Capsulitis/frozen shoulder.
- Low-back pain.
- Soft-tissue injuries, including sprains and strains.
Pain
- Mild to moderate pain.
- Dental pain.
- Musculoskeletal pain.
- Post-operative pain where an NSAID is appropriate.
- Primary dysmenorrhoea.
- Headache.
- Migraine.
Fever
- Symptomatic reduction of fever, including paediatric fever when an age- and weight-appropriate ibuprofen formulation is used.
A current 400 mg ibuprofen SmPC similarly includes mild-to-moderate pain, migraine, dysmenorrhoea, fever, rheumatoid/degenerative arthritic conditions and painful inflammation after soft-tissue injury.
12- Administration
The lowest effective dose should be used for the shortest duration necessary to control symptoms.
Adults – conventional oral ibuprofen
For mild-to-moderate pain or fever, commonly authorised oral regimens use 200–400 mg per dose, repeated when required with appropriate dosing intervals. For short-term non-prescription-type treatment, a total dose of 1200 mg/day should generally not be exceeded unless directed by a physician.
For inflammatory rheumatic diseases, prescription regimens may use 1200–1800 mg/day in divided doses. In acute or severe disease, a physician may temporarily increase the total dose to a maximum of 2400 mg/day.
High-dose ibuprofen at 2400 mg/day or more is associated with a small increased risk of arterial thrombotic events and should be avoided in patients with significant cardiovascular disease and used cautiously in those with cardiovascular risk factors.
Tablets should be swallowed with water. Taking ibuprofen with or after food may improve gastric tolerability, although food can delay absorption.
Sustained-release capsules
Marcofen SR should be taken according to the instructions in the current product leaflet. The modified-release contents should not be crushed or chewed, because disruption of the release-controlling system may alter drug release. The capsule should not be opened unless the current product information specifically permits this.
The exact dosing schedule of the Marcofen 400 mg SR formulation should be taken from its current Egyptian leaflet or prescription, because modified-release ibuprofen preparations are formulation-specific and dosing schedules from conventional tablets or other sustained-release brands should not be substituted automatically.
Paediatric oral suspension
Paediatric dosing should preferably be calculated according to body weight.
For pain and fever, an established ibuprofen regimen is approximately 20 mg/kg/day in divided doses, with individual doses appropriately spaced. Some specialist indications may require higher doses under medical supervision.
The minimum authorised age, duration of treatment and exact age/weight bands should be verified on the current Marcofen suspension leaflet. Different ibuprofen 100 mg/5 mL products do not necessarily have identical licensed age limits.
Dehydrated children have an increased risk of NSAID-associated renal impairment.
Suppositories
Marcofen suppositories are available in substantially different strengths—100 mg, 300 mg and 500 mg—and these strengths are not interchangeable.
Rectal ibuprofen dosing should be based on the patient's age, body weight and the specific authorised product instructions. The current Egyptian leaflet should be followed rather than selecting a suppository solely by age or by comparing its milligram strength with an oral dose.
Elderly
No automatic fixed dose reduction applies solely because of age; however, older adults have substantially higher risks of gastrointestinal bleeding, renal dysfunction and other NSAID complications. The lowest effective dose for the shortest necessary period should be used.
Renal or hepatic impairment
In mild-to-moderate impairment, use the lowest effective dose and monitor function when clinically appropriate.
Ibuprofen is contraindicated in severe renal failure or severe hepatic failure.
13- Method of Preparation
Coated tablets:
No preparation is required. Swallow with water.
Sustained-release capsules:
Take according to the current product leaflet. Do not crush or chew the modified-release contents. Do not open the capsule unless the current product information specifically permits this.
Oral suspension:
Shake the bottle thoroughly before each dose to redisperse the suspended drug. Measure the dose using an appropriate calibrated oral syringe, cup or dosing spoon rather than an ordinary household spoon.
Suppositories:
Remove the wrapper and administer rectally. Suppositories should not be swallowed. Use the strength specifically appropriate for the patient and prescribed dose.
14- Contraindications
Ibuprofen should not be used in patients with:
- Hypersensitivity to ibuprofen or any formulation ingredient.
- Previous asthma, bronchospasm, rhinitis, urticaria, angioedema or other hypersensitivity reaction triggered by aspirin or another NSAID.
- Previous gastrointestinal bleeding or perforation associated with NSAID treatment.
- Active or recurrent peptic ulceration or gastrointestinal haemorrhage.
- Severe renal failure.
- Severe hepatic failure.
- Severe heart failure, particularly NYHA class IV.
- Active cerebrovascular or other significant active bleeding where included in the specific product labeling.
- The third trimester of pregnancy.
- Significant dehydration when an ibuprofen preparation identifies this as a contraindication, particularly in paediatric patients.
Ibuprofen tablets are also contraindicated for the treatment of peri-operative pain in the setting of coronary artery bypass graft (CABG) surgery in current NSAID prescribing information.
15- Warnings & Precautions
Gastrointestinal toxicity
NSAIDs may cause gastrointestinal ulceration, bleeding or perforation, which can be fatal and can occur at any time, with or without warning symptoms.
Risk increases with:
- Increasing NSAID dose.
- Longer treatment.
- Previous peptic ulcer, especially if complicated by bleeding or perforation.
- Older age.
- Concomitant anticoagulants.
- Antiplatelet drugs.
- Corticosteroids.
- SSRIs.
- Other NSAIDs.
Patients at high gastrointestinal risk may require a gastroprotective strategy such as a proton-pump inhibitor or misoprostol when clinically appropriate.
Treatment should be stopped if gastrointestinal bleeding or ulceration develops.
Cardiovascular and cerebrovascular risk
NSAIDs can increase the risk of serious arterial thrombotic events, including myocardial infarction and stroke.
Clinical evidence indicates a small increased cardiovascular risk with high-dose ibuprofen, particularly around 2400 mg/day, whereas an increased arterial thrombotic risk has not been demonstrated for doses up to 1200 mg/day in the same way.
Patients with uncontrolled hypertension, congestive heart failure, established ischaemic heart disease, peripheral arterial disease or cerebrovascular disease require careful assessment before treatment, particularly before high-dose or long-term therapy.
NSAIDs may also cause fluid retention, oedema or worsening hypertension.
Kounis syndrome
Kounis syndrome has been reported with ibuprofen. This is an acute coronary syndrome associated with an allergic or hypersensitivity reaction and may lead to myocardial ischaemia or infarction.
Renal effects
NSAID-induced inhibition of renal prostaglandin synthesis may reduce renal perfusion and precipitate renal decompensation, particularly in:
- Patients with pre-existing renal disease.
- Heart failure.
- Liver disease.
- Dehydration.
- Older adults.
- Patients receiving diuretics, ACE inhibitors or angiotensin-II receptor blockers.
Long-term high-dose use and overdose have additionally been associated with renal tubular acidosis and hypokalaemia.
Hepatic effects
Use cautiously in hepatic impairment. Periodic liver-function monitoring should be considered during prolonged treatment or when clinically indicated.
Severe cutaneous adverse reactions
Potentially life-threatening or fatal severe cutaneous adverse reactions have been reported, including:
- Stevens-Johnson syndrome (SJS).
- Toxic epidermal necrolysis (TEN).
- Erythema multiforme.
- Exfoliative dermatitis.
- Drug reaction with eosinophilia and systemic symptoms (DRESS).
- Acute generalised exanthematous pustulosis (AGEP).
Most severe reactions occur early in treatment. Ibuprofen should be stopped immediately if a serious rash, mucosal lesion or other evidence of severe hypersensitivity develops.
Infection
Ibuprofen can mask fever, pain and other symptoms of infection, potentially delaying recognition and treatment of an underlying infection.
If symptoms persist or worsen, particularly during treatment for an infection, medical assessment is required.
NSAIDs should generally be avoided in varicella/chickenpox where possible because worsening of serious skin and soft-tissue infectious complications cannot be excluded.
Respiratory disease
Bronchospasm may occur, particularly in patients with asthma, nasal polyps, chronic rhinitis or previous NSAID sensitivity.
SLE and connective-tissue disease
Patients with systemic lupus erythematosus or mixed connective-tissue disease may have an increased risk of aseptic meningitis.
Haematological effects
Ibuprofen may temporarily inhibit platelet aggregation and prolong bleeding time. Patients with coagulation disorders or receiving anticoagulant treatment require particular caution.
Medication-overuse headache
Prolonged and frequent analgesic use can cause or worsen chronic headache. Increasing the analgesic dose is not an appropriate treatment for medication-overuse headache.
Long-term therapy
During prolonged treatment, particularly at higher doses or in high-risk patients, periodic monitoring of:
- Renal function.
- Hepatic function.
- Full blood count.
- Blood pressure.
may be appropriate.
16- Drug Interactions
Clinically important interactions include:
Aspirin:
Regular ibuprofen use may reduce the antiplatelet effect of low-dose aspirin depending on timing and frequency. Concomitant use can also increase gastrointestinal adverse effects.
Other NSAIDs and COX-2 inhibitors:
Avoid concomitant use because additive toxicity increases gastrointestinal and renal risk.
Anticoagulants such as warfarin and heparin:
Increased bleeding risk; NSAIDs may enhance anticoagulant effects.
Antiplatelet agents such as clopidogrel:
Increased gastrointestinal bleeding risk.
Corticosteroids:
Increased gastrointestinal ulceration and bleeding.
SSRIs:
Increased gastrointestinal bleeding risk.
ACE inhibitors, angiotensin-II receptor blockers, beta blockers and other antihypertensives:
NSAIDs may reduce antihypertensive efficacy.
Diuretics:
NSAIDs can reduce the diuretic response and increase nephrotoxicity. Renal impairment is particularly concerning with the combination of an NSAID, a renin-angiotensin-system inhibitor and a diuretic.
Potassium-sparing diuretics/ACE inhibitors:
Increased risk of hyperkalaemia in susceptible patients.
Lithium:
Ibuprofen may decrease lithium elimination and increase serum lithium concentrations.
Digoxin:
Serum digoxin concentrations may increase.
Methotrexate:
Reduced methotrexate clearance and increased toxicity may occur, especially with high-dose methotrexate or impaired renal function.
Ciclosporin and tacrolimus:
Increased nephrotoxicity.
Mifepristone:
Some ibuprofen product information advises avoiding NSAIDs for approximately 8–12 days after mifepristone because of a theoretical concern that prostaglandin-synthesis inhibition could reduce mifepristone-related treatment effects. However, contemporary medication-abortion evidence and guidelines support the use of NSAIDs, including ibuprofen, for pain control and have not demonstrated a clinically important reduction in treatment efficacy. Follow the specific mifepristone treatment protocol and its current prescribing information.
Aminoglycosides:
NSAIDs may reduce aminoglycoside elimination and increase toxicity.
Quinolone antibiotics:
Possible increased risk of convulsions.
Sulfonylureas:
The hypoglycaemic effect may be enhanced; glucose monitoring may be appropriate.
Zidovudine:
Increased risk of haematological toxicity, haemarthrosis or haematoma in susceptible patients.
Ginkgo biloba:
May increase bleeding risk.
Potent CYP2C9 inhibitors such as fluconazole and voriconazole:
Can substantially increase exposure to ibuprofen; dose reduction may be appropriate, particularly with high-dose ibuprofen.
Alcohol:
May increase gastrointestinal and central nervous system adverse effects.
17- Side Effects
The most frequently reported adverse effects are gastrointestinal and tend to be dose-dependent.
Gastrointestinal
- Dyspepsia.
- Heartburn.
- Nausea.
- Vomiting.
- Abdominal pain.
- Diarrhoea.
- Constipation.
- Flatulence.
- Gastritis.
- Gastrointestinal ulceration.
- Gastrointestinal bleeding.
- Gastrointestinal perforation.
- Haematemesis.
- Melaena.
- Exacerbation of Crohn's disease or ulcerative colitis.
- Rarely pancreatitis.
Serious gastrointestinal bleeding or perforation can be fatal, particularly in older patients.
Hypersensitivity
- Rash.
- Pruritus.
- Urticaria.
- Angioedema.
- Bronchospasm.
- Asthma exacerbation.
- Anaphylaxis or severe anaphylactic-type reactions.
Skin
Rare or very rare serious reactions include:
- Stevens-Johnson syndrome.
- Toxic epidermal necrolysis.
- Erythema multiforme.
- Exfoliative dermatitis.
- DRESS syndrome.
- AGEP.
- Photosensitivity reactions.
Cardiovascular
- Oedema.
- Hypertension.
- Heart failure.
- Myocardial infarction.
- Stroke/arterial thrombotic events, particularly with high-dose treatment.
- Kounis syndrome.
Renal
- Reduced renal function.
- Acute renal failure.
- Interstitial nephritis.
- Nephrotic syndrome.
- Renal papillary necrosis during prolonged use.
- Renal tubular acidosis.
- Hypokalaemia, particularly following prolonged excessive use or overdose.
Hepatic
- Increased liver enzymes.
- Hepatitis.
- Jaundice.
- Rare hepatic failure.
Haematological
Rare blood dyscrasias include:
- Anaemia.
- Haemolytic anaemia.
- Thrombocytopenia.
- Leukopenia.
- Neutropenia.
- Agranulocytosis.
- Pancytopenia.
- Aplastic anaemia.
Nervous system
- Headache.
- Dizziness.
- Somnolence.
- Vertigo.
- Paraesthesia.
- Rare aseptic meningitis.
Eye and ear
- Visual disturbances.
- Tinnitus.
- Rare optic neuritis or other visual abnormalities.
Any unexplained gastrointestinal bleeding, severe rash, facial/throat swelling, breathing difficulty, severe chest pain, marked reduction in urine output or other serious reaction requires immediate medical assessment.
18- Use in Special Populations
Pregnancy
During the first and second trimesters, ibuprofen should not be used unless clearly necessary. If treatment is required, use the lowest effective dose for the shortest possible duration.
From approximately 20 weeks of pregnancy onward, NSAID exposure including ibuprofen may cause foetal renal dysfunction leading to oligohydramnios. Ductus arteriosus constriction has also been reported after second-trimester exposure.
If ibuprofen treatment for several days is considered necessary from week 20 onward, antenatal monitoring for oligohydramnios and ductal constriction may be considered. Treatment should be discontinued if either occurs.
Ibuprofen is contraindicated during the third trimester, because prostaglandin inhibition can cause:
- Premature constriction or closure of the foetal ductus arteriosus.
- Pulmonary hypertension.
- Foetal renal dysfunction.
- Prolonged maternal/neonatal bleeding time.
- Delayed or prolonged labour.
Breastfeeding
Ibuprofen passes into breast milk only in very small quantities. Current lactation evidence considers ibuprofen a preferred analgesic/anti-inflammatory NSAID during breastfeeding because of its very low milk concentrations, short half-life and established paediatric use. Short-term treatment at usual therapeutic doses generally does not require interruption of breastfeeding.
Prolonged high-dose treatment should nevertheless be medically supervised.
Fertility
COX/prostaglandin inhibition can reversibly impair ovulation and female fertility. Ibuprofen is therefore not recommended for women experiencing difficulty conceiving or undergoing investigation for infertility unless clinically necessary.
Children
Dose according to body weight and the licensed instructions for the relevant formulation.
Children who are dehydrated because of vomiting, diarrhoea or poor fluid intake are at increased risk of NSAID-associated renal injury.
Elderly
Older patients have an increased frequency of serious NSAID adverse effects, especially gastrointestinal bleeding and perforation.
Use the lowest effective dose for the shortest duration and consider renal function, gastrointestinal protection and concomitant medication.
Renal impairment
Avoid in severe renal failure. Use cautiously with monitoring in mild-to-moderate impairment.
Hepatic impairment
Avoid in severe hepatic failure. Use cautiously at the lowest effective dose in less severe hepatic dysfunction.
Cardiovascular disease
Patients with uncontrolled hypertension, heart failure, ischaemic heart disease, peripheral arterial disease, previous stroke or major cardiovascular risk factors should be individually assessed before long-term or high-dose treatment.
19- Storage Conditions
For the Marcofen oral suspension, the available product information specifies storage below 25°C and protection from light. For tablets, capsules and suppositories, the package-specific storage instructions should be followed.
General precautions:
- Keep medicines out of the sight and reach of children.
- Keep the product in its original packaging when appropriate.
- Do not use after the expiry date.
- Do not use a suspension or suppository that shows abnormal physical deterioration.
- Follow any storage requirements printed on the current outer pack.
20- Additional Sections
Major NSAID Safety Information
NSAIDs can cause an increased risk of serious cardiovascular thrombotic events, including myocardial infarction and stroke. Such events may be fatal, may occur relatively early in treatment and may become more likely with increasing duration or dose.
NSAIDs also increase the risk of serious gastrointestinal bleeding, ulceration and perforation. These complications can occur without warning and can be fatal. Older patients and patients with previous gastrointestinal disease are at greater risk.
Overdose
Symptoms may include:
- Nausea.
- Vomiting.
- Epigastric pain.
- Diarrhoea.
- Tinnitus.
- Headache.
- Dizziness.
- Drowsiness.
- Gastrointestinal bleeding.
Severe poisoning can cause:
- Altered consciousness or coma.
- Convulsions.
- Metabolic acidosis.
- Hypotension.
- Respiratory depression.
- Acute renal failure.
- Hepatic injury.
- Potassium abnormalities.
- Renal tubular acidosis.
There is no specific antidote for ibuprofen poisoning. Treatment is supportive and symptomatic, with airway and cardiovascular monitoring as indicated. Significant overdose requires urgent medical or poison-centre assessment.
Driving and operating machinery
Ibuprofen usually has little or no effect on driving at ordinary doses. However, patients who develop dizziness, vertigo, somnolence, fatigue or visual disturbance should not drive or operate machinery until these effects have resolved. Alcohol may intensify impairment.
Monitoring during prolonged treatment
Where prolonged or high-dose therapy is medically required, periodic assessment may include:
- Full blood count.
- Renal function.
- Hepatic function.
- Blood pressure.
- Gastrointestinal risk.
- Cardiovascular risk.
- Concomitant medicines.
21- Frequently Asked Questions (FAQ)
Q1: Is Marcofen the same as ibuprofen?
Marcofen is a brand containing ibuprofen. Different Marcofen presentations deliver ibuprofen in different strengths and dosage forms.
Q2: Is Marcofen an antibiotic?
No. Ibuprofen is an NSAID. It reduces pain, fever and inflammation but does not kill bacteria or treat an infectious organism.
Q3: Should Marcofen be taken with food?
Ibuprofen may be taken with food or after a meal when gastric irritation is a concern. Food can slow absorption somewhat, but may improve gastrointestinal tolerability.
Q4: Can Marcofen be taken with another NSAID such as diclofenac, naproxen or another ibuprofen product?
Generally no. Combining NSAIDs increases gastrointestinal, renal and other adverse effects without providing a proportionate safety benefit.
Q5: Can Marcofen be used with low-dose aspirin?
This combination requires caution. Ibuprofen may interfere with aspirin's antiplatelet action when taken regularly and can increase gastrointestinal adverse effects. Patients taking aspirin for cardiovascular protection should obtain professional advice before regularly using ibuprofen.
Q6: Can Marcofen be used during pregnancy?
Use during pregnancy requires medical advice. It should be avoided unless clearly necessary during the first and second trimesters, carries important foetal renal/ductal risks from about week 20 onward, and is contraindicated in the third trimester.
Q7: Can Marcofen be used while breastfeeding?
Short-term ibuprofen at therapeutic doses is generally compatible with breastfeeding, and ibuprofen is considered one of the preferred NSAIDs for nursing mothers.
Q8: Is the 400 mg SR capsule equivalent to a 400 mg conventional tablet?
They contain the same total amount of ibuprofen but do not have the same drug-release characteristics. They should not automatically be substituted dose-for-dose or taken using the same schedule.
Q9: Can an adult use a paediatric suppository or a child use a higher-strength suppository by adjusting frequency?
The different strengths should not be interchanged without confirming an appropriate weight-based dose and the instructions for the exact product.
Q10: What warning symptoms require urgent medical attention?
Seek urgent care for black stools, vomiting blood, severe persistent abdominal pain, chest pain, stroke-like symptoms, difficulty breathing, facial or throat swelling, severe blistering rash, markedly reduced urine production, or signs of a severe allergic reaction.
22- References
- Current ibuprofen 400 mg film-coated tablet Summary of Product Characteristics, including indications, dosing, contraindications, warnings, interactions, adverse reactions, pregnancy and pharmacokinetics; updated July 2026.
- Current ibuprofen 100 mg/5 mL oral suspension Summary of Product Characteristics, including paediatric weight-based dosing and paediatric precautions.
- European Medicines Agency review of high-dose ibuprofen cardiovascular safety, confirming a small increased cardiovascular risk at doses of 2400 mg/day or higher.
- U.S. Food and Drug Administration safety communication regarding NSAID exposure from approximately 20 weeks of pregnancy and the risk of foetal renal dysfunction and oligohydramnios.
- Drugs and Lactation Database (LactMed), Ibuprofen, revised August 2025: ibuprofen is considered a preferred analgesic/anti-inflammatory agent in breastfeeding because of extremely low milk levels and its short half-life.
- Current NSAID/ibuprofen prescribing information concerning serious cardiovascular and gastrointestinal events and CABG-associated contraindication.
- Current ibuprofen safety information concerning severe cutaneous adverse reactions, Kounis syndrome, renal tubular acidosis and hypokalaemia.
- Egyptian medicine-market listings reporting Marcofen ibuprofen presentations including 100 mg/5 mL suspension, 100 mg and 300 mg suppositories, 400 mg coated tablets, 400 mg SR capsules and 500 mg suppositories, associated with GlaxoSmithKline. These listings should not be taken as confirmation of the current regulatory or commercial status of every presentation.
- World Health Organization. Abortion care guideline, 2nd edition (2025), including Recommendation 15 on routine provision of pain management such as NSAIDs for medical abortion; and American College of Obstetricians and Gynecologists guidance on medication abortion, which recommends NSAIDs for pain management and notes that available evidence does not indicate reduced medication-abortion success from their use.