Ibuprofen – systemiskt
Ibuprofen – systemiskt
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Alindrin, Ardinex, Brufen, Brufen Retard, Burana, Burana Comp, Childre......
Alindrin, Ardinex, Brufen, Brufen Retard, Burana, Burana Comp, Childrens Ibuprofen, Comboval, Dolerin, Ibetin, Ibumax, Ibumetin, Ibuprofen 2care4, Ibuprofen ABECE, Ibuprofen Accord, Ibuprofen Actavis, Ibuprofen Apofri, Ibuprofen Aristo, Ibuprofen B. Braun, Ibuprofen Bril, Ibuprofen Evolan, Ibuprofen Fyro, Ibuprofen NET, Ibuprofen Orifarm, Ibuprofen Orion, Ibuprofen Pfleger, Ibuprofen Zentiva, Ibuprofen ratiopharm, Ibux, Ifenin, Ipren, Iprensa, Neoprofen, Nurofen, Nurofen Apelsin, Nurofen Jordgubb, Nurofen Junior, Nurofen voor Kinderen, Nurofen voor Kinderen suppo, Pedea, Perdophen PediatrieATC-koder
C01EB, C01EB16, M01AE01, N02AJ08, N02BE51
C01EB, C01EB16, M01AE01, N02AJ08, N02BE51Substanser
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ibuprofen, ibuprofen dc 85, ibuprofen-D,L-lysin, ibuprofenarginin, ibu......
ibuprofen, ibuprofen dc 85, ibuprofen-D,L-lysin, ibuprofenarginin, ibuprofennatriumdihydratBedömning
Ibuprofen skall inte användas under graviditetens andra hälft, förutom i enstaka fall och då på strikt läkarordination. Behandling under andra halvan av graviditeten ökar bland annat risken för för tidig slutning av ductus arteriosus, minskad mängd fostervatten och nedsatt njurfunktion hos fostret och den nyfödda.
Användning under tidig graviditet tycks inte öka den generella risken för fosterskador även om ett samband mellan hjärtfel och NSAID-preparat som grupp har diskuterats. Kontinuerlig, regelbunden användning bör därför undvikas. Den eventuella riskökningen för hjärtfel är dock knappast så stor i det enskilda fallet att det finns anledning till oro om kvinnan ändå har använt ibuprofen under tidig graviditet.
Bakgrund
Gemensamt för NSAID
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Läkemedel som tillhör NSAID-gruppen hämmar prostaglandinsyntesen vilket ökar risken för komplikationer hos foster som exponeras under graviditetens andra hälft. Behandling kan då orsaka konstriktion av ductus arteriosus intrauterint [1-6], vilket kan leda till pulmonell hypertension [2,5,7] och andningsproblem hos det nyfödda barnet [1-5] eller i......
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Koren G, Florescu A, Costei AM, Boskovic R, Moretti ME. Nonsteroidal antiinflammatory drugs during third trimester and the risk of premature closure of the ductus arteriosus: a meta-analysis. Ann Pharmacother. 2006;40:824-9.
Norton ME. Teratogen update: fetal effects of indomethacin administration during pregnancy. Teratology. 1997;56:282-92.
Souter D, Harding J, McCowan L, O´Donnell C, McLeay E, Baxendale H. Antenatal indomethacin - adverse fetal effects confirmed. Aust N Z J Obstet Gynaecol 1998;38:11-6.
Dathe K, Hultzsch S, Pritchard LW, Schaefer C. Risk estimation of fetal adverse effects after short-term second trimester exposure to non-steroidal anti-inflammatory drugs: a literature review. Eur J Clin Pharmacol. 2019;75(10):1347-1353.
Hernández-Díaz S, García-Rodríguez LA. Epidemiologic assessment of the safety of conventional nonsteroidal anti-inflammatory drugs. Am J Med. 2001;110 Suppl 3A:20S-7S.
Dathe K, Frank J, Padberg S, Hultzsch S, Beck E, Schaefer C. Fetal adverse effects following NSAID or metamizole exposure in the 2nd and 3rd trimester: an evaluation of the German Embryotox cohort. BMC Pregnancy Childbirth. 2022;22(1):666.
Alano MA, Ngougmna E, Ostrea EM Jr, Konduri GG. Analysis of nonsteroidal antiinflammatory drugs in meconium and its relation to persistent pulmonary hypertension of the newborn. Pediatrics 2001;107:519-23.
Hendricks SK, Smith JR, Moore DE, Brown ZA. Oligohydramnios associated with prostaglandin synthetase inhibitors in preterm labour. Br J Obstet Gynaecol. 1990;97:312-6.
Østensen M, Khamashta M, Lockshin M, Parke A, Brucato A, Carp H et al. Anti-inflammatory and immunosuppressive drugs and reproduction. Arthritis Res Ther. 2006;8:209.
UK Teratology Information Service (UKTIS). USE OF NON-STEROIDAL ANTI-INFLAMMATORY DRUGS (NSAIDs) IN PREGNANCY 2023 September Version 40. UKTIS [www]. [cited 2024-03-13].
Lopes LM, Carrilho MC, Francisco RP, Lopes MA, Krebs VL, Zugaib M. Fetal ductus arteriosus constriction and closure: analysis of the causes and perinatal outcome related to 45 consecutive cases. J Matern Fetal Neonatal Med. 2016;29(4):638-45.
Dos Santos CS, Silva PV, Castelo R, Tiago J. Premature closure of ductus arteriosus after a single dose of diclofenac during pregnancy. BMJ Case Rep. 2021;14(6):.
Nielsen GL, Sorensen HT, Larsen H, Pedersen L. Risk of adverse birth outcome and miscarriage in pregnant users of non-steroidal anti-inflammatory drugs: population based observational study and case-control study. BMJ 2001;322:266-70.
Ofori B, Oraichi D, Blais L, Rey E, Berard A. Risk of congenital anomalies in pregnant users of non-steroidal anti-inflammatory drugs: A nested case-control study. Birth Defects Res B Dev Reprod Toxicol 2006;77:268-79.
Ericson A, Kallen BA. Nonsteroidal anti-inflammatory drugs in early pregnancy. Reprod Toxicol 2001;15:371-5.
Li DK, Liu L, Odouli R. Exposure to non-steroidal anti-inflammatory drugs during pregnancy and risk of miscarriage: population based cohort study. Brit Med J 2003;327:368-72.
Nakhai-Pour HR, Broy P, Sheehy O, Bérard A. Use of nonaspirin nonsteroidal anti-inflammatory drugs during pregnancy and the risk of spontaneous abortion. CMAJ. 2011;183:1713-20.
Nielsen GL, Skriver MV, Pedersen L Sorensen HT. Danish group reanalyses miscarriage in NSAID users. Brit Med J 2004;328:109.
Daniel S, Koren G, Lunenfeld E, Bilenko N, Ratzon R, Levy A. Fetal exposure to nonsteroidal anti-inflammatory drugs and spontaneous abortions. CMAJ. 2014;186:E177-82.
Edwards DR, Aldridge T, Baird DD, Funk MJ, Savitz DA, Hartmann KE. Periconceptional over-the-counter nonsteroidal anti-inflammatory drug exposure and risk for spontaneous abortion. Obstet Gynecol. 2012;120:113-22.
Källén BA, Otterblad Olausson P. Maternal drug use in early pregnancy and infant cardiovascular defect. Reprod Toxicol 2003;17:255-61.
Ferencz C, C.-V.A., Loffredo CA, Wilson PD, Genetics and environmental risk factors of major cardiovascular malformations: the Baltimore-Washington Infant Study: 1981–1989. Perspect Ped Cardiol 5. Vol. 5. 1997, New York: Futura Publishing Comp., Inc.
Cleves MA, Savell VH, Raj S, Correa A, Werler MM, Hobbs CA. Maternal use of acetaminophen and nonsteroidal anti-inflammatory drugs (NSAIDs), and muscular ventricular septal defects. Birth Def Res Part A 2004;70:107-13.
- Koren G, Florescu A, Costei AM, Boskovic R, Moretti ME. Nonsteroidal antiinflammatory drugs during third trimester and the risk of premature closure of the ductus arteriosus: a meta-analysis. Ann Pharmacother. 2006;40:824-9.
- Norton ME. Teratogen update: fetal effects of indomethacin administration during pregnancy. Teratology. 1997;56:282-92.
- Souter D, Harding J, McCowan L, O´Donnell C, McLeay E, Baxendale H. Antenatal indomethacin - adverse fetal effects confirmed. Aust N Z J Obstet Gynaecol 1998;38:11-6.
- Dathe K, Hultzsch S, Pritchard LW, Schaefer C. Risk estimation of fetal adverse effects after short-term second trimester exposure to non-steroidal anti-inflammatory drugs: a literature review. Eur J Clin Pharmacol. 2019;75(10):1347-1353.
- Hernández-Díaz S, García-Rodríguez LA. Epidemiologic assessment of the safety of conventional nonsteroidal anti-inflammatory drugs. Am J Med. 2001;110 Suppl 3A:20S-7S.
- Dathe K, Frank J, Padberg S, Hultzsch S, Beck E, Schaefer C. Fetal adverse effects following NSAID or metamizole exposure in the 2nd and 3rd trimester: an evaluation of the German Embryotox cohort. BMC Pregnancy Childbirth. 2022;22(1):666.
- Alano MA, Ngougmna E, Ostrea EM Jr, Konduri GG. Analysis of nonsteroidal antiinflammatory drugs in meconium and its relation to persistent pulmonary hypertension of the newborn. Pediatrics 2001;107:519-23.
- Hendricks SK, Smith JR, Moore DE, Brown ZA. Oligohydramnios associated with prostaglandin synthetase inhibitors in preterm labour. Br J Obstet Gynaecol. 1990;97:312-6.
- Østensen M, Khamashta M, Lockshin M, Parke A, Brucato A, Carp H et al. Anti-inflammatory and immunosuppressive drugs and reproduction. Arthritis Res Ther. 2006;8:209.
- UK Teratology Information Service (UKTIS). USE OF NON-STEROIDAL ANTI-INFLAMMATORY DRUGS (NSAIDs) IN PREGNANCY 2023 September Version 40. UKTIS [www]. [cited 2024-03-13].
- Lopes LM, Carrilho MC, Francisco RP, Lopes MA, Krebs VL, Zugaib M. Fetal ductus arteriosus constriction and closure: analysis of the causes and perinatal outcome related to 45 consecutive cases. J Matern Fetal Neonatal Med. 2016;29(4):638-45.
- Dos Santos CS, Silva PV, Castelo R, Tiago J. Premature closure of ductus arteriosus after a single dose of diclofenac during pregnancy. BMJ Case Rep. 2021;14(6):.
- Nielsen GL, Sorensen HT, Larsen H, Pedersen L. Risk of adverse birth outcome and miscarriage in pregnant users of non-steroidal anti-inflammatory drugs: population based observational study and case-control study. BMJ 2001;322:266-70.
- Ofori B, Oraichi D, Blais L, Rey E, Berard A. Risk of congenital anomalies in pregnant users of non-steroidal anti-inflammatory drugs: A nested case-control study. Birth Defects Res B Dev Reprod Toxicol 2006;77:268-79.
- Ericson A, Kallen BA. Nonsteroidal anti-inflammatory drugs in early pregnancy. Reprod Toxicol 2001;15:371-5.
- Li DK, Liu L, Odouli R. Exposure to non-steroidal anti-inflammatory drugs during pregnancy and risk of miscarriage: population based cohort study. Brit Med J 2003;327:368-72.
- Nakhai-Pour HR, Broy P, Sheehy O, Bérard A. Use of nonaspirin nonsteroidal anti-inflammatory drugs during pregnancy and the risk of spontaneous abortion. CMAJ. 2011;183:1713-20.
- Nielsen GL, Skriver MV, Pedersen L Sorensen HT. Danish group reanalyses miscarriage in NSAID users. Brit Med J 2004;328:109.
- Daniel S, Koren G, Lunenfeld E, Bilenko N, Ratzon R, Levy A. Fetal exposure to nonsteroidal anti-inflammatory drugs and spontaneous abortions. CMAJ. 2014;186:E177-82.
- Edwards DR, Aldridge T, Baird DD, Funk MJ, Savitz DA, Hartmann KE. Periconceptional over-the-counter nonsteroidal anti-inflammatory drug exposure and risk for spontaneous abortion. Obstet Gynecol. 2012;120:113-22.
- Källén BA, Otterblad Olausson P. Maternal drug use in early pregnancy and infant cardiovascular defect. Reprod Toxicol 2003;17:255-61.
- Ferencz C, C.-V.A., Loffredo CA, Wilson PD, Genetics and environmental risk factors of major cardiovascular malformations: the Baltimore-Washington Infant Study: 1981–1989. Perspect Ped Cardiol 5. Vol. 5. 1997, New York: Futura Publishing Comp., Inc.
- Cleves MA, Savell VH, Raj S, Correa A, Werler MM, Hobbs CA. Maternal use of acetaminophen and nonsteroidal anti-inflammatory drugs (NSAIDs), and muscular ventricular septal defects. Birth Def Res Part A 2004;70:107-13.
Författare
Karin Källén och Birger Winbladh för Region Stockholm.
Karin Källén och Birger Winbladh för Region Stockholm.Uppdaterat
Innehållet uppdaterat 3/15/2024
Uppgifterna från födelseregistret är hämtade 4/1/2020
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