Ibuprofen & Percocet together?

[FemmeRN]

Hi all,

I'm a new nurse working on a mother/baby floor. Our standard orders for post partum patients include Ibuprofen 800mg Q6H and also Percocet 5/325 Q4H prn for pain >/= 5/10.

During my orientation, I've seen that some nurses will hold the Ibuprofen dose, if the pt recently (for example, within 30 minutes) got Percocet, and the pain is controlled, or give the Percocet instead of the Ibuprofen, if the pt is complaining of pain 8/10 at the time of the scheduled Ibuprofen dose.

My understanding is that the Ibuprofen is more to reduce inflammation (in addition to pain relief) and it should be kept "on board" around the clock to be most beneficial.

So, my question to all of you more experienced nurses...would you hold the Ibuprofen? Is there a clinical reason not to give them together? Or is it better to have a pt c/o 8/10 pain try the Ibuprofen at the scheduled time, and reassess in 30-60 min, and then give the Percocet, if the pain is still not controlled?

Thanks for your input. You all are such a wealth of knowledge!

[hoppermom3]

I give the Ibuprofen as scheduled. I have often given 1 or 2 Percocet with the Ibuprofen.

[Elvish, BSN, DNP, RN, NP]

I think it's perfectly appropriate to give ibu along with the percocet (1 or 2). It's been my experience that they work better together. No clinical reason not to. I've seen some people try to 'ration' Percocets which kind of annoys me. That's not really the point, as long as you're under the 4000mg APAP per 24 hrs.

If somebody's pain is 8/10, I'd be inclined to give them 2 percs and a motrin.

[grandkids4]

I agree. The ibuprofen should be given around the clock and add the percocet for pain. The percocet has acetametaphin and there is no reason to hold one or the other.

[CoffeeRTC, BSN, RN]

I loved them both, LOL. I think the ibu RTC and percs prn works the best for alot of types of pain.

[babyktchr, BSN, RN]

Ibuprofen is fabulous. I like it round the clock and percocet added in when needed. I think the patients do a lot better on that combo than using PCA anything.

Anyone have luck with Vicoprofen?? Just wondering?

[kat7ap]

My unit used to have the "rule" that ibuprofen and percocet could not be given within 30 min of each other. It was then re-examined and found there was no real rationale behind it so the policy was changed. However our dose for ibuprofen is 600mg and for Percocet 5/325 1 or 2 tabs.

[Moe75_Rn]

The rationale behind not giving both at the same time is that if the patient has a drug reaction then its more difficult to pinpoint which one might of caused the reaction. Me personally, thinks that 2 Percs and 600-800 of Mortin works really well for the patients but our nursing manager wants us to give them an hour apart. If a patient is in pain though, you do what you can to get that pain under control.

[jaccimv]

Cont with the Ibuprofen. I get an occasional hys pt and they love the ibuprofen...think about how it helps around that time of the month - kinda along the same lines. Great anti inflam.

[GrumpyRN63, ADN, RN]

I always enc pts to take the motrin ATC esp for the first 4-5 days, and additionally percocet prn- same time is ok. I explain the motrin will help, but as an anti-inflammatory it will also help decr the pain down the road as it is helping the source of the pain, the percs will just help w/the pain at the time it is given, but won't reduce inflammation, so the combo is much more effective for the acute pain and to reduce the pain overall during the recovery phase, --works great for postops in general

[NursePaula]

It's been a long day so excuse the stupid questions, but isn't 2400 mg the max dose for ibuprofen in 24 hours?.......

[GrumpyRN63, ADN, RN]

Yep, either 400 mg q 4hrs, 600mg q6 hrs or 8oo mg q 8 hrs