Nurofen for children from 6 years old pills 8 pcs
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Active ingredients
Ibuprofen
Release form
Pills
Composition
Ibuprofen 200 mg; Excipients: croscarmellose sodium - 30 mg, sodium lauryl sulfate - 0.5 mg, sodium citrate dihydrate - 43.5 mg, stearic acid - 2 mg, colloidal silicon dioxide - 1 mg; shell composition: carmellose sodium - 0.7 mg, talc - 33 mg, acacia gum - 0.6 mg, sucrose - 116.1 mg, titanium dioxide - 1.4 mg, macrogol 6000 - 0.2 mg, black ink [Opacode S-1-277001] (shellac - 28.225%, iron dye black oxide (E172) - 24.65%, propylene glycol - 1.3%, isopropanol * - 0.55%, butanol * - 9.75%, ethanol * - 32.275%, purified water * - 3.25%).
Pharmacological effect
NSAIDs. It has a quick directional effect against pain (analgesic), antipyretic and anti-inflammatory effect. The mechanism of action of ibuprofen, a derivative of propionic acid, is due to inhibition of the synthesis of prostaglandins - mediators of pain, inflammation and hyperthermic reaction. Indiscriminately blocks COX-1 and COX-2, thereby inhibiting the synthesis of prostaglandins. In addition, ibuprofen reversibly inhibits platelet aggregation. The analgesic effect of the drug lasts up to 8 h.
Pharmacokinetics
Absorption - high, fast 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 after 45 minutes. Taking the drug with food can increase the time to reach Cmax up to 1-2 hours; Binding to plasma proteins - 90%. Slowly penetrates into the cavity of the joints, lingers in the synovial fluid, creating in it greater concentrations than in the blood plasma. In the cerebrospinal fluid, lower concentrations of ibuprofen are found compared to blood plasma.; In limited studies, ibuprofen was detected in breast milk at very low concentrations. . Metabolized in the liver. Excreted by the kidneys (in unchanged form - no more than 1%) and, to a lesser extent, with bile. T1 / 2 - 2 h.
Indications
- headache; - migraine; - toothache; - neuralgia; - myalgia; - back pain; - rheumatic pains; - pain in the joints; - Algomenorrhea; - Fever with flu and ARVI.
Contraindications
- a complete or incomplete combination of asthma, recurrent nasal polyposis and paranasal sinuses, and intolerance to acetylsalicylic acid or other NSAIDs (includingin history); - erosive and ulcerative diseases of the gastrointestinal tract (including gastric ulcer and duodenal ulcer, Crohn's disease, ulcerative colitis) or ulcerative bleeding in the active phase or in history (two or more confirmed episodes of peptic ulcer or ulcerative bleeding); - Bleeding or perforation of the gastrointestinal ulcer in history, provoked by the use of NSAIDs; - severe liver failure or liver disease in the active phase; - renal failure severe severity (CC <30 ml / min); - confirmed hyperkalemia; - decompensated heart failure; - the period after coronary artery bypass surgery; - cerebrovascular or other bleeding; - hemophilia and other bleeding disorders (including hypocoagulation); - hemorrhagic diathesis; - III trimester of pregnancy; - children's age up to 6 years; - fructose intolerance, glucose-galactose malabsorption, sucrase-isomaltase deficiency; - Hypersensitivity to ibuprofen and other components of the drug. With caution should be prescribed the drug with the simultaneous use of other NSAIDs; history of a single episode of gastric ulcer and duodenal ulcer and duodenal ulcer or ulcerative hemorrhage of the gastrointestinal tract; gastritis, enteritis, colitis, Helicobacter pylori infection, ulcerative colitis; bronchial asthma or allergic diseases in the acute stage or in the anamnesis (the development of bronchospasm is possible); systemic lupus erythematosus or mixed connective tissue disease (Sharpe syndrome) - an increased risk of aseptic meningitis; renal failure, incl. with dehydration (CC less than 30-60 ml / min), nephrotic syndrome; liver failure, liver cirrhosis with portal hypertension, hyperbilirubinemia; arterial hypertension and / or heart failure, cerebrovascular diseases; blood diseases of unknown etiology (leukopenia and anemia); severe somatic diseases; dyslipidemia / hyperlipidemia; diabetes; peripheral artery diseases; simultaneous use of drugs that can increase the risk of ulcers or bleeding, in particular, GCS for oral administration (including prednisolone), anticoagulants (includingwarfarin), selective serotonin reuptake inhibitors (including citalopram, fluoxetine, paroxetine, sertraline) or antiplatelet agents (including acetylsalicylic acid, clopidogrel); in the I and II trimesters of pregnancy, the period of breastfeeding; elderly patients, patients under the age of 12 years; when smoking, frequent use of alcohol.
Use during pregnancy and lactation
Use of the drug in the III trimester of pregnancy is contraindicated. The use of the drug in the first and second trimesters of pregnancy should be avoided; if necessary, you should consult a doctor.; There is evidence that ibuprofen in small amounts can penetrate into breast milk without any negative consequences for the health of the infant, therefore usually short-term use of the need to stop breastfeeding does not occur. If necessary, long-term use of the drug should consult a doctor to decide whether to stop breastfeeding for the period of use of the drug.
Dosage and administration
The drug is taken orally. Tablets should be taken with water. Patients with hypersensitivity of the stomach are advised to take the drug with meals.; The drug is intended only for short-term use.; Adults and children over 12 years old are prescribed 1 tab. (200 mg) up to 3-4 times / day. To achieve a faster therapeutic effect in adults, the dose can be increased to 2 tab. (400 mg) up to 3 times / day; For children aged 6 to 12 years, 1 tab. (200 mg) up to 3-4 times / day; The drug can only be prescribed to children with body weight more than 20 kg. The interval between taking the pill should be at least 6 hours. The maximum daily dose for adults is 1200 mg (6 tab.). The maximum daily dose for children aged 6 to 18 years is 800 mg (4 tab.). If the symptoms persist or worsen with the use of the drug for 2-3 days, you should stop the treatment and consult a doctor.
Side effects
The risk of side effects can be minimized if the drug is taken in a short course, at the minimum effective dose needed to eliminate the symptoms.in some cases with a fatal outcome.; Side effects are predominantly dose-dependent.; The following side effects were observed with short-term use of ibuprofen in doses not exceeding 1200 mg / day (6 tab.). In the treatment of chronic conditions and long-term use, other adverse reactions may occur.; The incidence of adverse reactions was estimated based on the following criteria: very often (≥1 / 10), often (from ≥1 / 100 to <1/10), infrequently (from ≥1 / 1000 to <1/100), rarely (from ≥1 / 10 000 to <1/1000), very rarely (<1/10 000), the frequency is unknown (data on frequency estimates are not available); Co side of the hematopoietic system: very rarely - hematopoietic disorders (anemia, leukopenia, aplastic anemia, hemolytic anemia, thrombocytopenia, pancytopenia, agrana otsitoz). The first symptoms of such disorders are fever, sore throat, superficial oral ulcers, flu-like symptoms, severe weakness, nosebleeds and subcutaneous hemorrhages, hemorrhages and hemorrhages of unknown etiology.; From the immune system: rarely - hypersensitivity reactions (nonspecific allergic reactions and anaphylactic reactions), reactions of the respiratory tract (bronchial asthma, including its exacerbation, bronchospasm, shortness of breath, dyspnea), skin reactions (itching, urticaria, purpura, edema K vinca, exfoliative and bullous dermatoses, including toxic epidermal necrolysis (Lyell's syndrome), Stevens-Johnson syndrome, erythema multiforme), allergic rhinitis, eosinophilia; very rarely - severe hypersensitivity reactions, including swelling of the face, tongue and larynx, shortness of breath, tachycardia, arterial hypotension (anaphylaxis, angioedema or severe anaphylactic shock). From the gastrointestinal tract: rarely - abdominal pain, nausea, dyspepsia (including heartburn, bloating belly); rarely - diarrhea, flatulence, constipation, vomiting; very rarely - peptic ulcer, perforation or gastrointestinal bleeding, melena, hematemesis, in some cases with a fatal outcome, especially in elderly patients, ulcerative stomatitis, gastritis; frequency is unknown - exacerbation of colitis and Crohn's disease.; From the side of the liver and biliary tract: very rarely - abnormal liver function,increased activity of hepatic transaminases, hepatitis and jaundice. From the urinary system: very rarely - acute renal failure (compensated and decompensated) especially with prolonged use, combined with increased concentration of urea in the blood plasma and the appearance of edema, hematuria and proteinuria, nephritic syndrome , nephrotic syndrome, papillary necrosis, interstitial nephritis, cystitis. From the nervous system: infrequently - headache; very rarely - aseptic meningitis. From the side of the cardiovascular system: frequency unknown - heart failure, peripheral edema, with prolonged use increased risk of thrombotic complications (eg myocardial infarction), increased blood pressure. From the respiratory system: frequency unknown - bronchial asthma, bronchospasm, shortness of breath.; Laboratory indicators: hematocrit or hemoglobin may decrease; bleeding time may increase; plasma glucose concentration may decrease; QC may decrease; plasma creatinine concentration may increase; Hepatic transaminase activity may increase. If you experience side effects, you should stop taking the drug and consult a doctor.
Overdose
In children, symptoms of overdose may occur after taking the drug in a dose exceeding 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. In patients with bronchial asthma, this disease may be exacerbated. 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. With the worsening of bronchial asthma, the 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 acetylsalicylic acid in low doses (not more than 75 mg / day) prescribed by a doctor, since 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 acetylsalicylic acid in small doses as an antiplatelet agent after starting ibuprofen); Other NSAIDs, in particular, selective COX- 2: the simultaneous use of two or more drugs from the group of NSAIDs should be avoided due to the possible increase in the risk of side effects. C o caution should be used simultaneously with the following drugs.; Anticoagulants and thrombolytic drugs: NSAIDs may enhance the effect of anticoagulants, in particular, warfarin and thrombolytic drugs. . 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 receptor antagonists and COX inhibiting agents can lead to deterioration of renal function, including the development of acute renal failure (usually reversible). These interactions should be considered in patients taking Coxibs simultaneously with ACE inhibitors or angiotensin II receptor antagonists. In this regard, the combined use of the above funds should be prescribed with caution, especially in the elderly.It is necessary to prevent dehydration in patients, as well as to consider the possibility of monitoring renal 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 gastrointestinal ulcers and gastrointestinal bleeding.; Antiplatelet agents and selective serotonin reuptake inhibitors: an increased risk of gastrointestinal bleeding.; Cardiac glycosides: simultaneous administration of NSAIDs and cardiac glycosides can lead to aggravation of heart failure, a decrease in the glomerular filtration rate and an increase in the concentration of cardiac glycosides in the blood plasma.; Lithium preparations: essentially There are data on the likelihood of increasing the concentration of lithium in the blood plasma against the background of the use of NSAIDs; Methotrexate: there is evidence of the likelihood of increasing the concentration of methotrexate in the blood plasma against the background of the use of NSAIDs; Cyclosporin: an increased risk of nephrotoxicity with the simultaneous appointment of NSAIDs and cyclosporine; NSAIDs should be started no earlier than 8-12 days after taking mifepristone, since NSAIDs may decrease the effectiveness of mifepristone.; Tacrolimus: while simultaneously prescribing NSAIDs and tacrolimus may increase ix nephrotoxicity risk; Zidovudine. concurrent use of NSAIDs and zidovudine could result in increased 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: patients who receive joint treatment of NSAIDs and quinolone antibiotics may increase the risk of seizures. Myelotoxic drugs : increased hematotoxicity.; Cefamandol, cefoperazone, cefotetan, valproic acid, plicamycin: an increase in the frequency of development of hypoprothrombinemia.; Drugs, blocks inhibiting tubular secretion: reduction of excretion and increase in plasma concentration of ibuprofen.; Inductors of microsomal oxidation (phenytoin, ethanol, barbiturates, rifampicin, phenylbutazone, tricyclic antidepressants): an increase in the production of hydroxylated active metabolites,increasing the risk of severe intoxication.; Microsomal oxidation inhibitors: reducing the risk of hepatotoxic action.; Oral hypoglycemic drugs and insulin, sulfonylurea derivatives: enhancing the effects of drugs. Antacids and colestiramine: reducing absorption.; increased analgesic effect.
special instructions
It is recommended to take the drug in the shortest possible course and in the minimum effective dose necessary to eliminate the symptoms. If it is necessary to use the drug for more than 10 days, it is necessary to consult a doctor. In patients with bronchial asthma or an allergic disease in the acute stage, as well as in patients with bronchial asthma / allergic disease in the history of the drug may provoke bronchospasm. systemic lupus erythematosus or mixed connective tissue disease is associated with an increased risk of aseptic meningitis. During long-term treatment, control of the peripheral pattern is necessary blood and functional status of the liver and kidneys. When symptoms of gastropathy occur, careful monitoring is provided, including esophagogastroduodenoscopy, complete blood count (hemoglobin determination), fecal occult blood test; research.; During the period of treatment is not recommended ethanol.; Patients with renal insufficiency should consult with your doctor before using the drug, because there is a risk of deterioration the functional state of the kidneys.; Patients with hypertension, incl. 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.; Women planning pregnancy should take into account that the drug suppresses COX and prostaglandin synthesis, affects ovulation, disrupting female reproductive function (reversible after discontinuation of treatment); Effect on the ability to drive vehicles and control mechanisms; Patients who notice dizziness, drowsiness, congestion dix, or visual disturbances while taking ibuprofen, should avoid driving vehicles or machinery control.