Nurofen express lady coated pills 400mg N12
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Active ingredients
Ibuprofen
Release form
Pills
Composition
Active ingredient: ibuprofen Concentration of active ingredient (mg): 400 mg
Pharmacological effect
The mechanism of action of ibuprofen, a derivative of propionic acid from the group of nonsteroidal anti-inflammatory drugs (NSAIDs), is due to the inhibition of the synthesis of prostaglandins - mediators of pain, inflammation and hyperthermia. Indiscriminately blocks COX-1 and COX-2, as a result of which it inhibits prostaglandn synthesis. It has a quick directional effect against pain (pain reliever), antipyretic and anti-inflammatory effect. In addition, ibuprofen reversibly inhibits platelet aggregation.
Pharmacokinetics
Absorption and distribution Absorption - high, quickly and almost completely absorbed from the gastrointestinal tract. After taking the drug on an empty stomach Сmax of ibuprofen in the blood plasma is reached in 30-35 minutes. Taking the drug with food may increase Tmax. Binding to plasma proteins by more than 90%. Slowly penetrates the cavity of the joints, lingers in the synovial fluid, creating greater concentrations in it than in the blood plasma. Metabolism and excretion After absorption, about 60% of the pharmacologically inactive R-form slowly transforms into the active S-form. Metabolized in the liver. T1 / 2 - 2 hours. Excreted by the kidneys (unchanged, no more than 1%) and, to a lesser extent, with bile. In limited studies, ibuprofen was found in breast milk at very low concentrations. Pharmacokinetics in special groups of patients differences in the pharmacokinetic profile of the drug compared with younger people.
Indications
headache; migraine; toothache; neuralgia; myalgia; backache; rheumatic pains; algomenorrhea; fever with flu and ARVI, painful menstruation.
Contraindications
hypersensitivity to ibuprofen or any of the components that make up the drug; hypersensitivity to acetylsalicylic acid or other NSAIDs in history (in particular, bronchial asthma, rhinitis, angioedema or urticaria). erosive and ulcerative diseases of the gastrointestinal tract in the acute stage or in history (including peptic ulcer and duodenal ulcer disease of the stomach and the duodenal ulcerCrohn's disease, ulcerative colitis), ulcerative bleeding in the acute period or in history (two or more confirmed episodes of peptic ulcer or ulcerative bleeding); history of gastrointestinal ulcer bleeding or perforation, triggered by the use of NSAIDs, severe liver failure or active liver disease, severe renal failure (creatinine clearance <30 ml / min), confirmed hyperkalemia, severe heart failure, decompensated heart failure. fructose intolerance, glucose-galactose malabsorption, sucrase-isomaltase deficiency, hemophilia, and other bleeding disorders (including hypocoagulation), emorragicheskie diathesis, period after coronary artery bypass surgery; intracranial hemorrhage; children under 12 years.
Precautionary measures
Do not exceed recommended doses.
Use during pregnancy and lactation
Use of the drug in the III trimester of pregnancy is contraindicated. It is necessary to avoid the use of the drug in the I-II trimesters of pregnancy, if necessary, you should consult with your doctor. There is evidence that ibuprofen in small quantities can penetrate into breast milk without any negative consequences for the health of the infant, therefore usually with short-term There is no need to stop breastfeeding. If you need long-term use of the drug, you should contact your doctor to decide whether to stop breastfeeding for the period of use of the drug. Information for women planning pregnancy: these drugs suppress COX and prostaglandin synthesis, affect ovulation, impairing female reproductive function (reversibly after discontinuation of treatment ).
Dosage and administration
Adults and children over 12 years old with 1 tablet. Drink the tablet with water. Do not take more than 3 pills within 24 hours. The maximum daily dose is 1200 mg. The maximum daily dose for children from 12-17 years old is 1000 mg. If you take symptoms for 2-3 days while taking the drug, you must stop the treatment and turn to to the doctor.
Side effects
On the part of the digestive system: nausea, vomiting, heartburn, anorexia, epigastric discomfort, diarrhea, flatulence, erosive and ulcerative lesions of the gastrointestinal tract (in some cases complicated by perforation and bleeding), abdominal pain, irritation, dryness and pain in the mucous membrane of the cavity mouth, ulceration of the gums, aphthous stomatitis, pancreatitis, constipation, hepatitis. On the CNS side: headache, dizziness, insomnia, agitation, drowsiness, depression, confusion, hallucinations are possible; rarely, aseptic meningitis (more often in patients with autoimmune diseases). On the part of the sense organs: reversible toxic neuritis of the optic nerve, blurred vision, diplopia, dryness and eye irritation, conjunctival and eyelid edema (allergic genesis, scotoma); hearing loss, ringing or tinnitus. From the cardiovascular system: heart failure, increased blood pressure, tachycardia. From the urinary system: nephrotic syndrome, acute renal failure, nephritis, polyuria, cystitis. From the hematopoietic system: anemia (in including hemolytic, aplastic), thrombocytopenia, thrombocytopenic purpura, agranulocytosis, leukopenia. Allergic reactions: skin rash, pruritus, urticaria, Quincke's edema, anaphylactoid reactions, anaphylactic shock, fever, exudative erythema multiforme (including Stevens-Johnson syndrome), toxic epidermal necrolysis (Lyell's syndrome, eo syndrome, eo syndrome, eo syndrome, eos syndrome, eozyme syndrome, eos syndrome, eozyme syndrome, eo syndrome side of the respiratory system: bronchospasm, shortness of breath. Other: increased sweating. With prolonged use in high doses: ulceration of the gastrointestinal mucosa, bleeding (including from the gastrointestinal tract, gums, uterine, hemorrhoidal), visual impairment vision, scotoma, amblyopia).
Overdose
In children, overdose symptoms may occur after taking the vine in excess of 400 mg / kg body weight. In adults, the dose-dependent effect of overdose is less pronounced. T1 / 2 of the drug in overdose is 1.5-3 hours. Symptoms: nausea, vomiting, pain in the epigastric region or, rarely, diarrhea, tinnitus, headache and gastrointestinal bleeding. In more severe cases, there are manifestations of the central nervous system: drowsiness, rarely - excitement, convulsions, disorientation, coma.In cases of severe poisoning, metabolic acidosis and an increase in prothrombin time, renal failure, liver tissue damage, decreased blood pressure, respiratory depression and cyanosis can develop. Patients with bronchial asthma may have an exacerbation of this disease. Treatment: symptomatic, with mandatory airway management, monitoring of ECG and basic vital signs until the patient's condition is normalized. Oral administration of activated charcoal or gastric lavage for 1 hour after administration of a potentially toxic dose of ibuprofen is recommended. If ibuprofen has already been absorbed, an alkaline drink may be given to remove the acidic ibuprofen derivative by the kidneys, forced diuresis. Frequent or prolonged seizures should be stopped in / in the introduction of diazepam or lorazepam. If bronchial asthma worsens, use of bronchodilators is recommended.
Interaction with other drugs
The simultaneous use of ibuprofen with the following drugs should be avoided. Acetylsalicylic acid: with the exception of low doses of acetylsalicylic acid (not more than 75 mg / day) prescribed by a doctor, because the combined use may increase the risk of side effects. With simultaneous use of ibuprofen reduces the anti-inflammatory and antiplatelet effect of acetylsalicylic acid (it is possible to increase the incidence of acute coronary insufficiency in patients receiving small doses of acetylsalicylic acid as an antiplatelet agent after starting ibuprofen). Other NSAIDs, in particular, selective COX-2 It is necessary to avoid the simultaneous use of two or more drugs from the group of NSAIDs because of the possible increase in the risk of side effects. ozhnostyu applied simultaneously with the following drugs and thrombolytic drugs sredstvamiAntikoagulyanty: NSAIDs may enhance the effect of anticoagulants, particularly warfarin and preparatov.Antigipertenzivnye thrombolytic agents (ACE inhibitors and angiotensin II) and diuretics NSAIDs may reduce efficacy of these groups.In some patients with impaired renal function (for example, in patients with dehydration or in elderly patients with impaired renal function), the simultaneous administration of ACE inhibitors or angiotensin II antagonists and COX inhibitors can lead to a deterioration in renal function, including the development of acute renal failure (usually reversible). These interactions should be considered in patients taking coxibs concurrently with ACE inhibitors or angiotensin II antagonists. In this regard, the joint use of the above funds should be prescribed with caution, especially for elderly patients. It is necessary to prevent dehydration in patients, as well as to consider the possibility of monitoring kidney function after the start of such combined treatment and periodically in the future. Diuretics and ACE inhibitors can increase the nephrotoxicity of NSAIDs. GCS: an increased risk of ulceration of the gastrointestinal tract and gastrointestinal bleeding.Antiagreganty and selective inhibitors of serotonin reuptake: an increased risk of gastrointestinal bleeding. to the aggravation of heart failure, a decrease in the glomerular filtration rate and an increase in the concentration of cardiac glycosides in the blood plasma. Preparations l tia: there are data on the likelihood of increasing the plasma concentration of lithium in the background of using NSAIDs. Metotrexat: there are data on the likelihood of increasing the concentration of methotrexate in the blood plasma on the background of using NSAIDs. should start no earlier than 8-12 days after taking mifepristone, because NSAIDs can reduce the effectiveness of mifepristone. Tacrolimus: while prescribing NSAIDs and tacrolimus You can increase the risk nefrotoksichnosti.Zidovudin: the simultaneous use of NSAIDs and zidovudine may increase gematotoksichnosti. There is evidence of an increased risk of hemarthrosis and hematomas in HIV-positive patients with hemophilia who received joint treatment with zidovudine and ibuprofen. Quinolone antibiotics: in patientsreceiving joint treatment of NSAIDs and nnolonovogo antibiotics, may increase the risk of seizures. Myelotoxic drugs increase the manifestations of the drug hematotoxicity. Caffeine increases the analgesic effect
special instructions
It is recommended to take the drug as short a course as possible and in the minimum effective dose necessary to eliminate symptoms. In patients with bronchial asthma or an allergic disease in the acute phase, as well as in patients with a history of bronchial asthma / allergic disease, the drug can trigger bronchospasm. The use of the drug in patients with systemic lupus erythematosus or a mixed connective tissue disease is associated with an increased risk of aseptic meningitis. During long-term treatment, it is necessary to monitor the pattern of peripheral blood and the functional state of the liver and kidneys. When symptoms of gastropathy appear, a careful monitoring is shown, including esophagogastroduodenoscopy, complete blood count (hemoglobin determination), fecal occult blood test. If necessary, determine the 17-ketosteroids drug should be canceled 48 hours before the study. Ethanol is not recommended during treatment. Patients with renal insufficiency should consult a physician before using the drug, because there is a risk of renal impairment. Patients with arterial hypertension, including. history, and / or chronic heart failure, you should consult with your doctor before using the drug, because the drug can cause fluid retention, increased blood pressure and edema. Effects on the ability to drive vehicles and control mechanismsPatients who notice dizziness, drowsiness, inhibition or visual impairment taking ibuprofen, you should avoid driving vehicles or driving mechanisms.