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Ibuprofen is a medication in the nonsteroidal anti-inflammatory drug (NSAID) class that is used for treating pain, fever, and inflammation.[6] This includes painful menstrual periods, migraines, and rheumatoid arthritis.[6] It may also be used to close a patent ductus arteriosus in a premature baby.[6] It can be used by mouth or intravenously.[6] It typically begins working within an hour.[6] Common side effects include heartburn and a rash.[6] Compared to other NSAIDs, it may have fewer side effects such as gastrointestinal bleeding.[7] It increases the risk of heart failure, kidney failure, and liver failure.[6] At low doses, it does not appear to increase the risk of heart attack; however, at higher doses it may.[7] Ibuprofen can also worsen asthma.[7] While it is unclear if it is safe in early pregnancy,[6] it appears to be harmful in later pregnancy and therefore is not recommended.[8] Like other NSAIDs, it works by inhibiting the production of prostaglandins by decreasing the activity of the enzyme cyclooxygenase.[6] Ibuprofen is a weaker anti-inflammatory agent than other NSAIDs.[7] Ibuprofen was discovered in 1961 by Stewart Adams and initially marketed as Brufen.[9] It is available under a number of trade names, including Advil and Motrin.[6][10] It was first marketed in 1969 in the United Kingdom and in the United States in 1974.[6][9] It is on the World Health Organization's List of Essential Medicines, which lists the safest and most effective medicines needed in a health system.[11] It is available as a generic medication.[6] The wholesale cost in the developing world is between US$0.01 and US$0.04 per dose.[12] In the United States, it costs about US$0.05 per dose.[6] In 2016, it was the 35th-most prescribed medication in the United States, with more than 21 million prescriptions.