CALDOLOR®

Surgical Surveillance Trial8

Title of Study

A Multi-Center, Open-Label, Surgical Surveillance Trial To Evaluate The Safety And Efficacy Of A Shortened Infusion Time of Intravenous Ibuprofen

Tong J. Gan, MD; Keith Candiotti, MD; Alparslan Turan, MD; Asokumar Buvanendran, MD; Beverly K. Philip, MD; Eugene R. Viscusi, MD; Suren Soghomonyan, MD, PhD; Sergio D. Bergese, MD

Study Description

This was a Phase IV, multicenter, open-label, clinical surveillance study. It was conducted in 21 hospitals, and 300 adult hospitalized patients undergoing surgery were enrolled. Patients received 800 mg of IV ibuprofen administered over 5 – 10 minutes preoperatively. Vital signs, adverse events, and pain scores were assessed.

Study Results

The authors concluded that IV Ibuprofen infused over 5 – 10 minutes at induction of anesthesia was a safe administration option for surgical patients.

Types of surgical procedures during which ibuprofen infusion was administered.
Data are given as n (%) of patients

Pain
800 mg Ibuprofen
n=139 (%)
Hernia repair 41 (14)
Hysterectomy 40 (13)
Cholecystectomy 29 (10)
Knee arthroplasty 27 (9)
Hip arthroscopy 23 (8)
Cystectomy 22 (7)
Hip arthroplasty 20 (6)
Oophorectomy 13 (4)
Rhizotomy 10 (3)
Permanent spinal cord stimulation 10 (3)
Foot arthroplasty 7 (2)
Mastectomy 6 (2)
Biopsy 6 (2)
Prostatectomy 5 (2)
Laparotomy 5 (2)
Tumor resection 4 (1)
Intrathecal drug delivery pump 4 (1)
Rectocele repair 3 (1)
Ankle arthroscopy 3 (1)
Foot revision 3 (1)
Meniscectomy 3 (1)
Shoulder arthroscopy 2 (1)
Ankle arthrodesis 2 (1)
Thyroid lobectomy 2 (1)
Pelviscopy 2 (1)
Shoulder manipulation 2 (1)
Other 6 (2)

 

  • The most common adverse events reported in this study were infusion site pain, nausea, flatulence, anemia and bradycardia.

CALDOLOR must be diluted prior to use. Infusion of the drug product without dilution can cause hemolysis. CALDOLOR should not be given as an IV bolus or IM injection.1

INDICATIONS AND USAGE1
CALDOLOR is indicated in adults and pediatric patients 6 months and older for the:

  • Management of mild to moderate pain and the management of moderate to severe pain as an adjunct to opioid analgesics
  • Reduction of fever

IMPORTANT DOSAGE AND ADMINISTRATION INSTRUCTIONS1
CALDOLOR must be diluted prior to administration.
Do not exceed 3,200 mg total daily dose in adults. Do not exceed 40 mg/kg or 2,400 mg, whichever is less, total daily dose in pediatric patients less than 17 years of age.

IMPORTANT SAFETY INFORMATION1
CONTRAINDICATIONS
CALDOLOR is contraindicated in patients with known hypersensitivity (e.g., anaphylactic reactions and serious skin reactions) to ibuprofen or any components of the drug product, and in patients who have a history of asthma, urticaria, or other allergic-type reactions after taking aspirin or other NSAIDs. Severe, sometimes fatal, anaphylactic reactions to NSAIDs have been reported in such patients. CALDOLOR is contraindicated in the setting of coronary artery bypass graft (CABG) surgery.

WARNINGS AND PRECAUTIONS1
CALDOLOR should be used with caution in patients with known cardiovascular (CV) disease or risk factors for CV disease, a history of peptic ulcer disease and/or GI bleeding, liver disease or symptoms of, hypertension, and heart failure. When used in such patients, attention to using the lowest effective dose for the shortest time period is important to reduce the risk of serious adverse events. Avoid use in pregnant women starting at 30 weeks gestation.

ADVERSE REACTIONS1
The most common adverse reactions are nausea, flatulence, vomiting, headache, hemorrhage and dizziness (>5%). The most common adverse reactions in pediatric patients are infusion site pain, vomiting, nausea, anemia and headache (≥2%).

WARNING: RISK OF SERIOUS CARDIOVASCULAR AND GASTROINTESTINAL EVENTS1

Cardiovascular Thrombotic Events

  • Non-steroidal anti-inflammatory drugs (NSAIDs) cause an increased risk of serious cardiovascular thrombotic events, including myocardial infarction and stroke, which can be fatal. This risk may occur early in treatment and may increase with duration of use.
  • CALDOLOR is contraindicated in the setting of coronary artery bypass graft (CABG) surgery.
Gastrointestinal Bleeding, Ulceration and Performation
  • NSAIDs cause an increased risk of serious gastrointestinal (GI) adverse events including bleeding, ulceration, and perforation of the stomach or intestines, which can be fatal. These events can occur at any time during use and without warning symptoms. Elderly patients and patients with a prior history of peptic ulcer disease and/or GI bleeding are at greater risk for serious GI events.

PLEASE SEE FULL PRESCRIBING INFORMATION INCLUDING BOXED WARNING