More info
Active ingredients
Ibuprofen + paracetamol
Release form
Pills
Composition
Active ingredients: ibuprofen, paracetamol. Excipients: calcium hydrophosphate, corn starch, povidone, talc, hypromellose, titanium dioxide (E 171), dye yellow sunset FCF (E 110), macrogol 6000, propylene glycol, sodium lauryl sulfate, shellac, ferric oxide black (E172)
Pharmacological effect
Ibuprofen has anti-inflammatory effects. Paracetamol is an analgesic, reduces pain, preventing sensitization of nerve endings through suppression of prostaglandin synthesis E. The combination of ibuprofen and paracetamol has a powerful analgesic effect.
Pharmacokinetics
Both active components of Brustan do not affect the pharmacokinetics of each other, are well absorbed after ingestion. Plasma protein binding levels are very high. The half-life of paracetamol is 2-2.5 hours, ibuprofen - 2.7-3.5 hours. Both components are metabolized mainly in the liver. Excreted mainly through urine, a small amount from bile
Indications
A febrile reaction in acute respiratory diseases, influenza, post-vaccination reactions and other infectious and inflammatory diseases. Pain syndrome of weak or moderate intensity, including: headache and toothache, migraine, neuralgia, lumbago, myalgia, fibrositis, tenovaginitis, arthralgia with rheumaticmasma , osteoarthrosis, gout, spondyloarthritis, etc., pain in diseases of ENT organs, in injuries of soft tissues and musculoskeletal system (sprains, bruises, sprains, fractures, etc.), postoperative pain, and algodas ismenorrhea
Contraindications
Hypersensitivity to the components of the drug. The history of bronchospasm, bronchial asthma, rhinitis, or skin rash associated with the use of acetylsalicylic acid or other nonsteroidal anti-inflammatory drugs. The history of gastrointestinal bleeding and perforation after using non-steroidal patterns, after the action of a non-steroidal pattern, is not necessary for the use of a non-steroidal, for example, in the history of gastrointestinal bleeding and non-steroidal anti-inflammatory drugs. disease of the stomach and duodenum / bleeding at present or in history (two or more distinct episodes of acute peptic ulcer or shelter • Severe renal, cardiac or hepatic failure. Congenital hyperbilirubinemia. Deficiency of glucose-6-phosphate dehydrogenase. Alcoholism. Blood diseases, Gilbert syndrome, severe anemia,leukopenia. Simultaneous use of the drug with other NSAIDs, including selective COX-2 inhibitors (COX-2).
Precautionary measures
With the simultaneous use of indirect anticoagulants - control of blood coagulation
Use during pregnancy and lactation
The drug Brustan contraindicated in the III trimester of pregnancy. Use in the I and II trimester, the lactation period should be discussed with your doctor
Dosage and administration
Inside Adults - on 1 tab. 3-4 times a day. For children - in a daily dose of 20 mg / kg in several doses.
Side effects
When using the drug Brustan Side effects are rarely observed. Gastrointestinal: NSAID gastropathy (nausea, vomiting, heartburn, abdominal pain, constipation, flatulence, loss of appetite, rarely ulceration of the gastrointestinal tract, in some cases complicated by bleeding and perforation), irritation or dryness of the oral mucosa, pain in the mouth , ulceration of the mucous membrane of the gums. Hepato-biliary system: hepatitis Allergic reactions: skin rash (usually erythematous or urticaria), pruritus, angioedema, anaphylactoid reactions, anaphylactic shock, bronchospasm or dyspnea, fever, much Normal exudative erythema (including Stevens-Johnson syndrome), toxic epidermal necrolysis (Lyell's syndrome), eosinophilia, allergic rhinitis. Cardiovascular system: heart failure, tachycardia, increased blood pressure. Central and peripheral nervous system: headache , dizziness, insomnia, anxiety, nervousness and irritability, psychomotor agitation, drowsiness, depression, confusion, hallucinations, rarely - aseptic meningitis (more often in patients with autoimmune diseases bolevaniyami) Agencies blood: anemia (including hemolytic, aplastic), thrombocytopenia and thrombocytopenic purpura, agranulocytosis, leukopenia. Respiratory system: dyspnea, bronchospasm. eye, conjunctival edema and eyelid allergic genesis, scotoma) Urinary system: acute renal failure, allergic nephritis,nephrotic syndrome (edema), polyuria, cystitisLaboratory indicators: bleeding time, serum creatinine concentration, hepatic transaminase activity (may increase); serum glucose concentration, creatinine clearance, hematocrit, or hemoglobin (may decrease).
Overdose
Problems of overdose occur very rarely, however, in case of accidental overdose, you should immediately consult a doctor. Symptoms of overdose of the drug Brustan: abdominal pain, nausea, vomiting, headache, tinnitus, metabolic acidosis, coma, acute renal failure, decreased blood pressure , bradycardia, tachycardia. A hepatotoxic effect is possible with the development of hepatonecrosis associated with paracetamol. Treatment: gastric lavage (only one hour after ingestion), activated in mole, alkaline drink, forced diuresis, the introduction of SH-group donators and the precursors of the synthesis of glutathione - methionine and N-acetylcysteine. The need for additional therapeutic measures (the further introduction of methionine, in / in the introduction of N-acetylcysteine) is determined depending on the concentration of paracetamol in the blood, as well as the time elapsed after taking it. In addition, symptomatic therapy is indicated.
Interaction with other drugs
Inducers of microsomal oxidation (phenytoin, ethanol, barbiturates, rifampicin, phenylbutazon, tricyclic antidepressants) increase the production of hydroxylated active metabolites, increasing the risk of severe hepatotoxic reactions. The inhibitors of microsomal oxidation reduce the risk of hepatotoxic action. "Calcium channel and ACE inhibitors), natriuric and diuretic - furosemide and hydrochlorothiazide. Reduces the effectiveness of uricosuric drugs, enhances the effect of indirect anticoagulants, antiplatelet agents, fibrinolytics (increased risk of hemorrhagic complications), ulcerogenic effects with bleeding glucocorticosteroids, colchicine, estrogen, ethanol; enhances the effect of oral hypoglycemic drugs and insulin. Antacids and colestyramine reduce ibuprofen absorption. Increases blood concentration of digoxin, lithium preparations and methotrexate.Caffeine enhances the analgesic effect. When administered simultaneously, the active ingredient in Brustan - ibuprofen reduces the anti-inflammatory and antiplatelet effect of acetylsalicylic acid (ASA) (after starting ibuprofen, it is possible to increase the incidence of acute coronary insufficiency in patients receiving small doses of ASA as an antiplatelet agent) with anticoagulants and thrombolytic drugs (alteplazy, streptokinase, urokinase), serot-reuptake inhibitors Onin (citalopram, fluoxetine, paroxetine, sertraline) increases the risk of serious gastrointestinal tract bleeding. kidney, which is manifested by increased nephrotoxicity. Ibuprofen increases the plasma concentration of cyclosporine and the likelihood of its hepatotoxic effects. Drugs that block tubular secretion, reduce excretion and increase the plasma concentration of ibuprofen
special instructions
Treatment with Brustan should be carried out in the minimum effective dose, the shortest possible course. During treatment, monitoring of the pattern of peripheral blood and the functional state of the liver and kidneys is necessary. When symptoms of gastropathy appear, close monitoring is shown, including esophagogastroduodenoscopy, a blood test with hemoglobin, hematocrit, and fecal occult blood. To prevent the development of NSAID-gastropathy, it is recommended to combine prostaglandin E (misoprostol) with drugs. Patients should refrain from all activities that require increased attention, quick mental and motor responses. During treatment, the intake of alcohol (ethanol) is not recommended. When taken simultaneously with indirect anticoagulants, it is necessary to control the blood coagulation system.