Ibuprofen Arginate for Rapid-Onset Pain Relief in Daily Practice: A Review of Its Use in Different Pain Conditions

Relative effectiveness and gastrointestinal safety of NSAIDs being prescribed for upper respiratory tract infections: an explorative cohort study in primary care

BACKGROUND

Non-steroidal anti-inflammatory drugs (NSAIDs) are prescribed to control pain, inflammation, and fever in upper respiratory tract infections (URTIs).

AIM

To explore the relative effectiveness and gastrointestinal (GI)-related safety of individual NSAIDs to control symptoms of URTIs.

METHOD

Using an Italian primary care data source, we identified patients aged ≥ 15 years who were newly prescribed NSAIDs for URTIs between 2013 and 2022. Switching to another NSAID for the same indication within the 30-day follow-up was a proxy for drug effectiveness. The study outcome for GI safety analysis was upper gastrointestinal bleeding (UGIB).

RESULTS

In a cohort of 57,971 patients, the most prevalent subgroups were those treated with ketoprofen (39.5%) and dexibuprofen/ibuprofen (22.4%). Ketoprofen showed the lowest rate of switching to another NSAID [Hazard Ratio (HR) 0.40 (95% CI 0.20-0.83)] against acetylsalicylic acid/coxibs/diclofenac. Dexibuprofen/ibuprofen showed similar results [HR 0.50 (95% CI 0.22-1.10)], with no significant association. Ketoprofen and dexibuprofen/ibuprofen were prescribed as lysine and arginine salts in 85 and 6% of URTIs sufferers, respectively. Across NSAIDs, we did not find any significant difference in the risk of UGIB.

CONCLUSION

Our findings indicated that various NSAIDs may exhibit differing levels of effectiveness in treating URTIs, particularly those formulated for quick onset of action. No NSAIDs-UGIBs association was found. Further prospective, larger studies are needed to confirm these findings.

Clinical Benefits of Ibuprofen Arginine: A Narrative Review

Ibuprofen arginine (IBA) combines well-established analgesic and anti-inflammatory properties with enhanced pharmacokinetics. The addition of arginine significantly improves solubility and absorption, leading to a faster onset of action compared to conventional ibuprofen. Clinical studies consistently demonstrate that IBA achieves meaningful pain relief within a shorter timeframe while maintaining a favorable safety profile. IBA's rapid action is particularly valuable in managing acute exacerbations of chronic pain and preventing central sensitization, thus improving patient comfort, adherence, and overall quality of life. By addressing both the inflammatory and nociceptive components of pain, IBA offers an effective and well-tolerated alternative in multimodal pain management strategies. This review explores the clinical benefits of IBA in pain management among various clinical settings.

New Ibuprofen Cystamine Salts With Improved Solubility and Anti-Inflammatory Effect

Two novel ibuprofen cystamine salts (IBU-CYS 1 and IBU-CYS 2) are synthesized by coupling the anion of ibuprofen with cystamine dihydrochloride in 1 : 1 and 2 : 1 ratio to improve the solubility and bioavailability of ibuprofen. The salts are characterized by 1H NMR, FT-IR and UV-Vis spectroscopy, differential scanning calorimetry (DSC), thermogravimetry (TGA, DTA) and X-ray diffraction measurements. IBU-CYS 1 and IBU-CYS 2 show higher solubility (6.11 and 7.81 mg/mL) compared to ibuprofen (0.04 mg/mL) in water. IBU-CYS2 was encapsulated into 2-hydroxyethyl methacrylate: poly (ethylene glycol) acrylate hydrogels for enhanced delivery. The in vitro studies in PBS (pH 7.4) indicate that the salts are effective in relieving inflammatory responses induced by lipopolysaccharide in RAW264.7 macrophage cells (nitrite inhibition percentages of IBU-CYS 1, IBU-CYS 2 and ibuprofen: approximately 34.29, 27.03 and 31.50 respectively) while indicating no cytotoxicity. Therefore, these salts may be promising candidates for the development of effective formulations of this drug.

Comparative effectiveness of preemptive administration of ibuprofen and ibuprofen-arginine on the anesthetic success of inferior alveolar nerve block in teeth with symptomatic irreversible pulpitis - A double-blind randomized clinical trial

OBJECTIVES

This study examined the impact of premedication with ibuprofen and ibuprofen-arginine and the influence of preoperative pain and anxiety on inferior alveolar nerve block (IANB) efficacy in cases of symptomatic irreversible pulpitis.

MATERIALS AND METHODS

The study involved 150 SIP patients who were randomly assigned to receive ibuprofen (600 mg), ibuprofen-arginine (1,155 mg), or a placebo 30 min before IANB. Preoperative anxiety and pain levels were assessed using the Modified Dental Anxiety Scale and the Heft-Parker visual scale. IANB efficacy was determined by the absence of or mild pain during the procedure. Statistical analysis included chi-square, z-tests, Analysis of Variance, and Student's t tests.

RESULTS

The ibuprofen and ibuprofen-arginine groups exhibited significantly higher IANB success rates (62% and 78%, respectively) compared to the placebo group (34%). However, no significant difference was observed between the ibuprofen and ibuprofen-arginine groups. Patients with successful IANB in the ibuprofen and ibuprofen-arginine groups displayed lower median anxiety scores (8) than those with failed blocks (15) and lower mean preoperative pain scores (118.3).

CONCLUSION

In cases of symptomatic irreversible pulpitis the preemptive medication with ibuprofen-arginine effectively increased the efficacy of the inferior alveolar nerve block The inferior alveolar nerve block efficacy was influenced by preoperative anxiety levels and the intensity of pain.

CLINICAL RELEVANCE

This research underscores the potential benefits of oral premedication with ibuprofen and ibuprofen-arginine in improving anesthesia outcomes in cases of symptomatic irreversible pulpitis.

Effect of topical application of ibuprofen/arginine on the in-office bleaching-induced tooth sensitivity: A randomized, triple-blind controlled trial

OBJECTIVE

The application of anti-inflammatories as topical desensitizers before dental bleaching is an approach to reduce bleaching-induced tooth sensitivity (TS). This randomized controlled trial compared the risk and intensity of TS and the color change resulting from in-office dental bleaching after using an experimental desensitizing gel containing ibuprofen and arginine.

METHODS

Sixty-two participants with upper canine shades A2 or darker were randomly assigned to either the ibuprofen-arginine desensitizing group or the placebo group. The desensitizing gel was applied for 15 min before in-office bleaching with 35 % hydrogen peroxide gel for 50 min (2 sessions). To assess the absolute risk and intensity of TS, visual (0-10) and numeric rating (0-5) scales were used, and group comparisons were made using the McNemar test, Wilcoxon test, and paired Student t-test (α = 0.05). Color change was evaluated using Vita Classical, Vita Bleachedguide (ΔSGU), and Vita EasyShade (ΔEab, ΔE00, and ΔWID) before and one month after the bleaching procedure. Group comparisons for color change were done using a paired t-test (α = 0.05).

RESULTS

The odds ratio for TS was 0.14 [95 % CI 0.02 to 0.6], meaning lower odds of TS for the desensitizing gel. A lower intensity of TS was also observed for the experimental group (p < 0.005) up to 48 h after bleaching. All color evaluation tools demonstrated effective and similar whitening for both groups (p > 0.05).

CONCLUSIONS

Using the experimental desensitizing gel containing ibuprofen and arginine effectively reduced the risk and intensity of TS without compromising the bleaching efficacy.

CLINICAL RELEVANCE

The topical application of ibuprofen/arginine on the in-office bleaching reduced risk and intensity of bleaching-induced tooth sensitivity.

Ibuprofen in a Lipid Bilayer: Nanoscale Spatial Arrangement

Ibuprofen is a non-steroidal anti-inflammatory drug (NSAID) with analgesic and antipyretic effects. Understanding the molecular mechanisms of drug interaction with cell membranes is important to improving drug delivery, uptake by cells, possible side effects, etc. Double electron-electron resonance spectroscopy (DEER, also known as PELDOR) provides information on the nanoscale spatial arrangement of spin-labeled molecules. Here, DEER was applied to study (mono-)spin-labeled ibuprofen (ibuprofen-SL) in a bilayer of palmitoyl-oleoyl-sn-glycerophosphocholine (POPC). The results obtained show that the ibuprofen-SL molecules are located within a plane in each bilayer leaflet. At their low molar concentration in the bilayer χ, the found surface concentration of ibuprofen-SL is two times higher than χ, which can be explained by alternative assembling in the two leaflets of the bilayer. When χ > 2 mol%, these assemblies merge. The findings shed new light on the nanoscale spatial arrangement of ibuprofen in biological membranes.

Synthesis of Spin-Labeled Ibuprofen and Its Interaction with Lipid Membranes

Ibuprofen is a non-steroidal anti-inflammatory drug possessing analgesic and antipyretic activity. Electron paramagnetic resonance (EPR) spectroscopy could be applied to study its interaction with biological membranes and proteins if its spin-labeled analogs were synthesized. Here, a simple sequence of ibuprofen transformations—nitration, esterification, reduction, Sandmeyer reaction, Sonogashira cross-coupling, oxidation and saponification—was developed to attain this goal. The synthesis resulted in spin-labeled ibuprofen (ibuprofen-SL) in which the spin label TEMPOL is attached to the benzene ring. EPR spectra confirmed interaction of ibuprofen-SL with 1-palmitoyl-2-oleoyl-sn-glycero-3-phosphocholine (POPC) bilayers. Using ²H electron spin echo envelope modulation (ESEEM) spectroscopy, ibuprofen-SL was found to be embedded into the hydrophobic bilayer interior.

Potential of Hibiscus sabdariffa L. Calyx (Rosella) extract as antibacterial agent in dental disease: Phytochemical and chemical components profiling

Chemical characteristics of natural products are influenced by different external factors, varying according to the geographic origin. The ethanol extract of Hibiscus sabdariffa L calyx Indonesia has been studied in vivo and in vitro provide potential effect for dental field uses. Ethanol extract showed antibacterial to Streptococcus sanguinis as an inducer gingivitis, had an effect on the treatment of oral mucosa ulceration, and could inhibit the development of alveolar bone destruction. This study aims to determine the chemical groups and components of ethanol extract of H. sabdariffa L. calyces (Indonesia origin). Chemical group of ethanol extract H. sabdariffa L calyx Indonesia was analysis through phytochemical screening, whereas chemical components were detected through gas chromatography-mass spectrometry analysis. Saponins, tannins, phenolic, flavonoids, triterpenoids and glycosides, and 17 chemical components were identified in the ethanol extract of H. sabdariffa L calyx Indonesia. Among the chemical components, fatty acids group showed the most dominant. For standardization and develop of oral drug preparation, a better chemical components and phytochemical profiling are essential because the extract quality of herbs has various quality.