9Feb

Advil PM (Ibuprofen and diphenhydramine)

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Advil PM (Ibuprofen and diphenhydramine) is a combination of an NSAID and antihistamine. It is used to relieve pain, fever, inflammation that may cause insomnia or disturbs the patient's sleep.

Advil PM (Ibuprofen and diphenhydramine) Uses:

  • Insomnia and pain:

    • It is used in patients with minor aches and pains that result in insomnia or the patient does not achieve an adequate full night's sleep.

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Advil PM (Ibuprofen and diphenhydramine) Dose in the treatment of Insomnia and pain: 


  • Diphenhydramine citrate 38 mg and ibuprofen 200 mg per caplet:

    • Two caplets at bedtime to a maximum dose of 2 caplets per day.


  • Diphenhydramine hydrochloride 25 mg and ibuprofen 200 mg per capsule:

    • Two capsules at bedtime to a maximum dose of 2 capsule per day.

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Advil PM (Ibuprofen and diphenhydramine) dose in children:


It should be avoided in children younger than 12 years of age.

Doses may be given as adults, however, in young children, the maximum dose should not exceed 10 mg/kg per dose of ibuprofen or 400 mg per dose of ibuprofen (or 40 mg/kg per day of ibuprofen).

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Ibuprofen and diphenhydramine Pregnancy Category: C/D

See individual agents for detailed dosing regarding its use during pregnancy and lactation:

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Dose in Kidney Disease:

There are no dosage adjustments provided in the manufacturer's labeling.

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Dose in Liver disease:

There are no dosage adjustments provided in the manufacturer's labeling.

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Side effects of Advil PM (Ibuprofen and diphenhydramine):

See individual agents here:

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Contraindications to Advil PM (Ibuprofen and diphenhydramine):

      • Allergy to diphenhydramine, ibuprofen or any other NSAID/pain-reliever medicine.

      • Patients undergoing coronary artery bypass surgery (CABG) experience persistent pain.

      • Concurrent use of diphenhydramine-containing products, such as lotions and topical creams, is not allowed.

      • Children under 12 years old

Warnings/Precautions


    • Anaphylactoid reactions

      • Patients allergic to aspirin may experience severe hypersensitivity reactions, such as bronchial asthma, aspirin intolerance, and even rhinitis, also known as the "aspirin trifecta".

      • If patients experience allergic reactions or hypersensitivity, they must stop receiving the treatment immediately.


    • CNS depression:

      • CNS depression can be caused by diphenhydramine, which may result in mental and physical impairments. It should not be used if the patient is required to drive or perform tasks that require mental alertness.


    • Events relating to GI:

      • NSAIDs, including ibuprofen, can increase the risk of gastrointestinal bleeding. Patients over 60 years old or with a history of peptic or gastrointestinal bleeding should not use the drug.

      • Patients taking anticoagulants such as warfarin, aspirin, and corticosteroids with their medications are at greater risk for gastrointestinal bleeding.

      • People who consume ethanol (three or more alcoholic drinks per week) could also experience gastrointestinal bleeding. To reduce the risk of GI hemorhage, it is important to use the lowest effective dose and for the shortest time.

      • If patients develop symptoms such as melena or hematemesis, stomach cramps, hypotension, or stomach pain, they should stop receiving treatment immediately.

      • Patients with a history or tendency to have lower gastrointestinal bleeding should not take non-aspirin anti-inflammatory drugs (NSAIDs) if they are prone to diverticulosis and telangiectasias.


    • Reactions to skin:

      • NSAIDs can cause serious skin reactions. If a skin rash develops, the treatment should be stopped immediately.


    • Aseptic meningitis

      • Patients on NSAIDs therapy are at greater risk for aseptic meningitis. Aseptic meningitis is more common in patients with systemic lupus, mixed connective tissue disorders and patients with systemic lupus.


    • Asthma

      • Asthma patients should be cautious when using NSAIDs. Patients with asthma who are sensitive to aspirin may experience worsening symptoms.


    • Bariatric surgery

      • Gastric ulceration

        • Patients undergoing bariatric surgery should avoid non-selective NSAIDs peri-operatively due to the possibility of developing perforations or anastomotic lesions.

        • For short periods of time, patients may be prescribed intravenous ketorolac or celecoxib (etoricoxib), to manage pain.


    • Cardiovascular disease

      • Negative cardiovascular events have been linked to NSAIDs, including stroke, myocardial injury, and heart failure.

      • Patients with underlying or preexisting cardiac disease are at greater risk for developing adverse cardiac events.

      • Before treatment can be initiated, patients must be assessed for any underlying heart disease, especially elderly patients.

      • Patients with heart disease should avoid NSAIDs as they can cause fluid retention.

      • Aspirin can be affected by NSAIDs administered in combination with it. Therefore, they should not be taken for longer than necessary.

      • If necessary, patients may be prescribed alternative pain medication.


    • Glaucoma and increased intraocular pressure:

      • It is possible to develop angle-closure or intraocular pressure problems. Ocular pain and vision changes should be closely monitored by patients.


    • Hepatic impairment

        • Patients suffering from liver disease or hepatic impairment need to be cautious when taking the drug.


    • Hypertension:

      • Preexisting hypertension patients should be cautious when using NSAIDs. Pre-existing hypertension may be worsened by NSAIDs. Long-term, chronic use of NSAIDs can lead to new-onset hypertension.

      • Concurrent use of NSAIDs can reduce the antihypertensive effects ACE inhibitors, thiazides or loop diuretics.


    • Prostatic hyperplasia/urinary block:

      • Patients suffering from prostatic hyperplasia and genitourinary block should be cautious when taking the drug. It may make the condition worse.


    • Occlusion of the pyloroduodenum:

      • Patients with pyloroduodenal obstruction (including those with stenotic peptic ulcer) should be cautious.


    • Renal impairment

      • Preexisting renal impairment patients should be cautious when using it. Patients with a CrCl lower than 30 ml/minute should not take Ibuprofen.


    • Respiratory disease

      • Patients suffering from emphysema, chronic bronchitis or concomitant hypertension should be cautious. These patients are at greater risk for respiratory depression.


    • Thyroid dysfunction:

      • Patients suffering from thyroid dysfunction should be cautious when using it.

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Monitoring Parameters:

Monitor the response to treatment. Monitor for kidney impairment especially in patients who are at risk of developing renal failure.

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How to administer Ibuprofen and diphenhydramine?


It may be administered with food or milk to avoid gastrointestinal-related side effects.

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Mechanism of action of Advil PM (Ibuprofen and diphenhydramine):

Ibuprofen, a reversible inhibitor, of the enzyme cyclooxygenase I and II, is a medication that reduces inflammation, fever, and pain.

You can find detailed pharmacology information here.Ibuprofen (Brufen).

Diphenhydramine is an antihistamine that blocks H-1 receptors. It blocks the release of histamine, has sedative effects and anticholinergic qualities. See detailed pharmacology of diphenhydramine here: Diphenhydramine (Benadryl).

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International Brand Names of Ibuprofen and diphenhydramine:

  • Advil PM

  • GoodSense Ibuprofen PM

  • Motrin PM

  • Advil Night

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Ibuprofen and diphenhydramine Brand Names in Pakistan:

No Brands Available in Pakistan.

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