They occupy a strong leading position in the pharmaceutical markets around the world. These complex effects have antipyretic, anti-inflammatory and analgesic effects on the human body. One of these medicines is Ibuprom. The instruction regulates it as a very effective remedy for a wide variety of diseases.
"Ibuprom" is a phenylpropionic acid derivative. The mechanism of influence is based on the suppression of the activity of COX (an enzyme, a precursor of prostaglandins, which in turn dominate the processes of pathogenesis, the development of pain and febrile sensations). Moreover, the drug is characterized by non-selective inhibition of cyclooxygenase, ie, "Ibuprom" equally suppresses the activity of both isoforms of this enzyme - COX-1 and COX-2.
The analgesic effect of the drug "Ibuprom" instructions for use stipulates two mechanisms - peripheral and central. Pevy manifests itself indirectly through inhibition of the production of prostaglandins. The influence of the second mechanism (central) is to suppress the production of the same prostaglandins in the central and peripheral regions of the NA. Due to a decrease in the lipid physiologically active substances present in the inflammation focus, the sensitivity of the receptors' perception of chemical stimuli decreases. In the hypothalamus in the center of thermoregulation, suppression of prostaglandin synthesis leads to a decrease in body temperature during febrile conditions.
In addition, Ibuprom tablets (the instructions for the drug contain such information) to some extent suppress platelet aggregation (adhesion).
Ibuprofen is the main active ingredient of Ibuprom. As auxiliary components, one can name crospovidone, silicon dioxide, polyethylene glycol and a number of other substances (gelatin, starch, vegetable oil, sucrose, etc.).
There are several forms in which the medication is offered to consumers. The drug can be packed in a sachet, in a polyvinyl bottle (50 tablets) or in blisters.
Depending on the volume of the main component in the preparation, one speaks of "Ibuprom" (200 mg of ibuprofen in one tablet) or of the drug "Ibuprom Max" (400 mg of ibuprofen). However, this is not all. About such a variety as "Ibuprom Sprint Caps", the instruction says that the drug is produced in capsules with a dose of 200 mg of the main active ingredient in each. "Ibuprom Extra" is also offered to patients in capsules, the volume of the main component in each is 400 mg. About Ibuprom Sinus, the instruction says that one tablet contains 200 mg of ibuprofen and 30 mg of pseudoephedrine hydrochloride.
A description of all the symptoms, when a positive effect is obtained, contains instructions for such a remedy as Ibuprom tablets. The composition (analogues of the drug with the same active substance will have approximately the same effect) suggests that the drug will give a positive result in the treatment of diseases such as any problems of an inflammatory-degenerative nature in the spine and joints. Arthritis (rheumatoid, rheumatic, psoriatic), osteoarthritis, ankylosing spondylitis are no exception. Prescribe "Ibuprom" for inflammation of soft tissues and musculoskeletal system caused by injuries, radiculitis, bursitis, tendinitis. In addition, the medication is able to cope with headache and toothache, with neuralgia, myalgia, with pain syndrome in infectious and inflammatory diseases of the ENT organs. Health workers practice the appointment of "Ibuprom" in febrile conditions to reduce body temperature, with painful sensations of mild or moderate moderation and unclear origin.
"Ibuprom Sinus" (synonym - "Ibuprom Sprint Caps") is usually prescribed to provide analgesic, anti-inflammatory and antipyretic effects, as well as to reduce swelling of the mucous membranes of the nose and its paranasal sinuses. That is, the drug will be effective in the symptomatic treatment of colds, acute respiratory infections and flu, accompanied by headache, sore throat and muscles, high body temperature and inflammation of the mucous membranes of the nose and paranasal sinuses.
"Ibuprom" (tablets) instructions for use recommends prescribing individually for each patient, depending on the intensity of the clinical manifestations of the disease. The standard regimen for this drug is a single dose in a volume of 200 to 800 mg at intervals of 3-4 times during the day. For small patients, the dosage is selected depending on body weight - 20-40 mg per kilogram of weight (this is the daily volume), divided into several doses throughout the day. The course of therapy usually lasts from 2 to 3 weeks. The maximum permissible dose per day for an adult patient is 2.4 g. It is taken during or after a meal and washed down with a small amount of liquid. It is undesirable to divide the tablet into parts.
"Ibuprom Max" is taken regardless of food, and it is required to drink it with a sufficient volume of water. It is undesirable to crush the tablet into parts.
As for Ibuprom Sprint Caps, for patients over 12 years of age, a single dose is 1-2 capsules every 4-6 hours. Take it with meals or after. For people, there is no need to specially select the dose, except in cases of pronounced insufficiency of the functioning of the kidneys and liver.
"Ibuprom Extra" instruction recommends taking 1 capsule every 4 hours (we are talking about patients over 12 years old), but no more than 3 capsules during the day. The medication is taken after meals, not chewed. For elderly patients, there is no need to specifically select the dose.
"Ibuprom Sinus" is taken before meals 1-2 tablets and washed down with water. Frequency - every 4-6 hours. The maximum per day is permissible to take 6 tablets.
"Ibuprom" (tablets) instructions for use prohibit taking those who have hypersensitivity to ibuprofen or any auxiliary components of the drug. It is unacceptable to prescribe a medication to patients suffering from lesions of the digestive tract of an erosive and ulcerative nature (especially in the exacerbation phase). Treatment with "Ibuprom" is also prohibited in the presence and in some diseases of the optic nerve. Deviations in the functioning of the hematopoietic system are also grounds for refusing to use any funds from the NSAID group. It is not practiced to prescribe this drug to those patients who have severe disorders in the functioning of the kidneys and liver.
It is inadmissible to prescribe and use "Ibuprom" in parallel with other medicines from the non-steroidal group.
As for the drug "Ibuprom Max", the instructions for use prohibit taking pills with the same problems as "Ibuprom" itself.
"Ibuprom Extra", in addition to all the above described contraindications, is not prescribed if patients have hemorrhagic diathesis, with cardiac insufficiency. Also, you can not take this drug in case of violation of dehydration of the body, provoked by vomiting, diarrhea, or the use of insufficient fluid.
The drug "Ibuprom Sinus" has all of the above-mentioned contraindications. In addition, it is not used for bronchial asthma, diabetes mellitus, with an increased level of thyroid hormones (hyperthyroidism). A contraindication is the presence in patients of pheochromocytoma (neoplasms in the tissues of the adrenal glands), hyperplasia (adenoma) of the prostate gland.
How is Ibuprom tolerated? The instruction contains information about the possibility of the development of some side effects from different systems and organs while taking this remedy. The greatest number of reactions to the use of this NSAID is observed from the gastrointestinal tract. Patients talk about nausea, vomiting, epigastric discomfort, the development of anorexia and ulcerative erosive lesions of the mucous membranes of the digestive tract.
From the side of the central nervous system, headaches, dizziness, agitation, abnormalities in the processes of sleep and visual perception are often observed. Possible reactions from the hematopoietic system when taking the medication for a long period - anemia, thrombocytopenia, agranulocytosis.
Various allergic manifestations to Ibuprom are possible. Tablets (the instruction contains such information) can provoke the appearance of a rash, the development of Quincke's edema. In very rare cases, the appearance of aseptic meningitis is possible (people with autoimmune diseases are most susceptible to such a reaction), bronchospastic syndrome. As local manifestations, patients report burning and tingling sensations on the skin, hyperemia.
"Ibuprom Sinus", in addition to all of the above, can cause shortness of breath, tachycardia, increased blood pressure, hyperhidrosis.
In case of an overdose with drugs such as "Ibuprom" and "Ibuprom Max", the instructions for use inform about the possible development of nausea and vomiting, pain in the epigastrium. Also, in such a situation, drowsiness may occur, headache and dizziness may be felt, a decrease in blood pressure and the development of arrhythmias may occur. In severe situations, symptoms of metabolic acidosis appear, loss of consciousness may occur with impaired respiratory function.
In case of an overdose of Ibuprom Sprint Caps, in addition to all of the above, there is a likelihood of disorientation, convulsions, coma. Liver dysfunction is possible. In patients suffering from bronchial asthma, the course of the disease may worsen.
Long-term use of the drug "Ibuprom Sinus" can cause pathological changes in the blood, such as hemolytic anemia (increased breakdown of red blood cells), granulocytopenia (decrease in the number of granulocytes), thrombocytopenia (decrease in platelet count).
"Ibuprom" instruction recommends taking with caution to those who have concomitant diseases of the liver, kidneys, chronic heart failure. If, before starting therapy, the patient has dyspeptic symptoms, or the patient has just undergone surgery, it is also necessary to start treatment with Ibuprom with great caution. A history of information about bleeding of any nature, about diseases of the digestive tract, allergic manifestations associated with treatment with non-steroidal anti-inflammatory drugs should also be a reason for careful attention to the patient's condition.
To avoid unpleasant surprises, it is necessary to constantly monitor the functions of the kidneys and liver, and the picture of peripheral blood during the use of Ibuprom.
Both "Ibuprom" and "Ibuprom Max" instructions do not recommend using in the 3rd trimester of pregnancy. In the 1st and 2nd trimesters, the use of this NSAID is justified only if the expected positive effect for the mother outweighs the possible negative consequences for the child.
Ibuprofen, the main active ingredient of Ibuprom, is excreted in small doses in breast milk, so it can be used during lactation to relieve pain and fever. However, if there is a question about long-term therapy with Ibuprom or the need to take large doses, you should discuss with your doctor the issue of refusing to breastfeed.
The use of "Ibuprom Sinus" during gestation and breastfeeding is generally contraindicated.
Any form of "Ibuprom" ("Ibuprom Max", "Ibuprom Sprint Caps", "Ibuprom Extra") instructions for use prohibit taking in parallel with antihypertensive drugs and diuretics such as furosemide, hydrochlorothiazide, since their therapeutic effect can be significantly reduced.
The use of "Ibuprom" in tandem with antiplatelet and selective serotonin inhibitors increases the risk of GI bleeding. Further, this NSAID can increase the content of glycosides in the blood plasma and, thus, cause an exacerbation of heart failure. "Ibuprom" will enhance the effect of anticoagulants on the human body. For this reason, it is important to regularly monitor blood clotting values, since ibuprofen significantly reduces platelet aggregation.
When used in parallel with and "Methotrexate", the level of these substances in the blood plasma will significantly increase. Tandem with cyclosporine will increase the nephrotoxicity of the latter.
The combination of "Ibuprom" with can cause the development of cardiac arrhythmias. It should also not be taken in tandem with acetylsalicylic acid (aspirin), as there is a possibility of increased negative side effects.
The combination of quinolone antibacterial agents and any NSAIDs (and "Ibuprom" as well) increases the risk of developing convulsive syndrome. And the combination with such a medication as "Zinovudine" increases the risk of developing hemarthrosis and hematomas in HIV-infected patients.
Non-steroidal PVA are serious drugs with, as a rule, a wide range of effects. Therefore, patient reviews about such drugs are always both positive and negative. Ibuprom is no exception.
The majority of people who took the drug were satisfied with its effect. Painful sensations quickly stop and do not remind of themselves for a long time. The drug has proven itself well for painful menstruation, headaches and myositis, for myalgia and neuralgia.
At the same time, there are patients who were dissatisfied with the effect of the drug "Ibuprom". The instruction declares the rapid development of the effect of pain relief, but many consumers did not feel the effect of this drug at all. In addition, many have complained of adverse reactions such as nausea and headaches.
A fairly large group of people complained that Ibuprom did not completely relieve the toothache. Although in this case it is not worth saying that the drug is bad. The fact is that, for example, with acute pulpitis, no pain relievers will help, except for an injection directly into the gum. In the case of a toothache, Ibuprom is an opportunity to get to the dentist as soon as possible without experiencing severe pain.
In any case, NSAIDs are a new generation of anti-relieving and anti-inflammatory drugs that are effective in a very wide range of pathologies. This is the opinion of most consumers and healthcare professionals.
ATX code: M01AE01
International non-proprietary name: Ibuprofen.
Release form: coated tablets 400 mg.
Description: white film-coated tablets, round, with a biconvex surface, with a line.
Composition: each tablet contains: active substance: ibuprofen - 400 mg; Excipients: potato starch, magnesium stearate, calcium stearate, povidone, opadray ΙΙ (contains polyvinyl alcohol, partially hydrolyzed; talc; macrogol 3350; titanium dioxide E 171).
Pharmacotherapeutic group: Non-steroidal anti-inflammatory and antirheumatic drugs. Propionic acid derivatives.
Ibuprofen is used as an analgesic and anti-inflammatory agent in the treatment of rheumatoid arthritis (including juvenile rheumatoid arthritis or Still's disease), ankylosing spondylitis, osteoarthritis, and other non-rheumatoid (seronegative) arthropathies. Ibuprofen is indicated for the treatment of non-rheumatic inflammatory processes in the periarticular tissues, such as frozen shoulder (inflammation of the lining of the joint), bursitis, tendonitis, tendovaginitis, and back pain. Ibuprofen can also be used to relieve pain from soft tissue injuries such as sprains. Ibuprofen is also indicated as a pain reliever for mild to moderate pain in conditions such as dysmenorrhea, toothache or postoperative pain, for symptomatic relief of headaches, including migraines.
- hypersensitivity to ibuprofen or any excipient included in the composition;
- a history of bronchospasm, asthma, urticaria or rhinitis after taking acetylsalicylic acid or other non-steroidal anti-inflammatory drugs (NSAIDs);
- hemorrhagic diathesis or diseases associated with blood clotting disorders;
- disorders of hematopoiesis of unexplained genesis;
- a history of gastrointestinal bleeding or perforation after administration of NSAIDs;
- the presence in the present or past of recurrent peptic ulcer / bleeding (two or more confirmed episodes);
- cerebrovascular bleeding or bleeding of another localization, present at the present time;
- severe liver failure;
- severe renal failure (with a decrease in the glomerular filtration rate less than 30 ml / min);
- severe heart failure (stage IV according to NYHA);
- severe dehydration (caused by vomiting, diarrhea, or insufficient fluid intake);
- III trimester of pregnancy and breastfeeding;
- children under 12 years of age or adolescents weighing less than 40 kg.
Administered orally, preferably between meals. In order to minimize the risks of developing adverse reactions, ibuprofen should be taken in the lowest effective dose and for the shortest period necessary to achieve a clinical effect.
Ibuprofen MAX is prescribed for adults, as well as for children over 12 years old and weighing 40 kg or more.
The dosage regimen is set individually and depends on the indications. Usually, adults and children over 12 years of age (whose body weight is 40 kg or more) are prescribed ibuprofen in an initial dose of 400 mg 1-2 times a day, if necessary, to achieve a therapeutic effect, the dose can be increased to 400 mg 3 times a day. It is not recommended to take more than 3 tablets in 24 hours (1200 mg).
In case of missing the next dose of the drug, it is recommended to take the dose in accordance with the prescribed dosage regimen, without doubling the amount of the drug.
Patients with renal impairment
Based on pharmacokinetic data, dose reduction is not required in patients with mild to moderate renal impairment (creatinine clearance 30–80 ml / min). In severe renal failure (creatinine clearance< 30 мл/мин) назначение ибупрофена противопоказано.
Patients with hepatic impairment
In patients with mild to moderate hepatic impairment, dose reduction is not required (use is contraindicated in severe liver failure).
Elderly patients
No special dose adjustment is required with preserved renal function. However, given that the elderly are at increased risk of serious adverse reactions, it is recommended that the lowest effective therapeutic dose be prescribed for the shortest possible time. During treatment, regular monitoring is necessary to exclude the occurrence of gastrointestinal bleeding. If renal function is impaired, the dosage should be selected individually. If treatment is necessary for more than 7 days, regular monitoring of renal function is required.
Children
Given that the maximum daily dose of ibuprofen in children is 20 mg / kg, it is inappropriate to prescribe ibuprofen in tablets of 400 mg to children and adolescents weighing less than 40 kg and under 12 years of age.
If adults, children and adolescents from 12 to 18 years old require ibuprofen prescription for more than 3 days, or if the symptoms of the disease worsen, you should consult your doctor.
It is a non-steroidal anti-inflammatory agent with analgesic, anti-inflammatory, antipyretic and anti-edema effects. Produced under the trademarks of various companies, the article will focus on the standard (non-retard) tablet form of Ibuprofen.
Pharmacologically, it realizes its effects due to non-selective inhibition of COX-2, blocking the production of inflammatory cytokines.
Pharmacokinetically metabolized to form 3 metabolites, which are excreted by the kidneys. The maximum concentrations are reached after 1 hour, the half-life is 2.5 hours, retard forms can have a half-life of up to 12 hours.
Taking the drug is indicated for:
There are contraindications to the appointment of ibuprofen tablets:
Should be used with caution when:
Ibuprofen is prescribed to patients over 12 years of age orally in tablets of 200 mg 3-4 times a day. The dose can be increased to 400 mg three times a day (table 2) to accelerate the therapeutic effect. When the effect is achieved, the dose of ibuprofen per day should be reduced to 600-800 mg. Ibuprofen is preferably taken after meals.
Attention, the maximum daily dose of the drug is 1200 mg - do not take more than six 200 mg tablets in 24 hours! A repeated dose is taken no more often than four hours later. Without consulting a doctor, taking the drug should not be longer than five days!
Not applicable to patients under 12 years of age without consulting a doctor!
When taking the drug in children from six to twelve, the following instructions should be observed:
There are a number of possible side effects of Ibuprofen:
From the gastrointestinal tract: abdominal pain, nausea, heartburn, decreased appetite, flatulence, diarrhea, constipation, pancreatitis. Rarely, the appearance of ulceration of the gastrointestinal mucosa, complications in the form of bleeding and perforations. Dryness and pain in the mouth, stomatitis, the appearance of aphthae and ulcers on the oral mucosa.
From the liver: toxic hepatitis.
From the respiratory system: bronchospasm, shortness of breath.
From the senses: ringing in the ears, noise, hearing loss. Toxic damage to the optic nerve, impaired color perception, double vision, scotoma, dryness, eye irritation, edema of the eyelids and conjunctiva.
From the side of the central nervous system: headaches, dizziness, anxiety, insomnia, drowsiness, hallucinations, depression. Rarely - aseptic meningitis (with a history of autoimmune pathologies).
From the CCC side: tachycardia, heart failure, increased blood pressure.
From the urinary system: cystitis, polyuria, nephritis, nephrotic syndrome, acute renal failure.
Allergic reactions are possible: skin rash and itching, rhinitis, Quincke's edema, anaphylactic reactions; dyspnea, fever, eosinophilia.
From the side of the hematopoietic organs: leukopenia, anemia, including aplastic, hemolytic; agranulocytosis, thrombocytopenia, thrombocytopenic purpura.
Other complications: the risk of bleeding - gingival, uterine, hemorrhoidal. Increased perspiration.
Changes in laboratory parameters are possible:
The risk of developing side effects increases in proportion to the duration of therapy.
Attention! If negative effects appear, you should stop taking ibuprofen and contact your doctor!
Symptoms: nausea, vomiting, abdominal pain, lethargy, drowsiness, headache, depression, tinnitus, renal failure, metabolic acidosis, decreased blood pressure, coma, bradycardia, tachycardia, atrial fibrillation and subsequent respiratory arrest.
Treatment: active lavage, sorbents, forced diuresis, symptomatic therapy.
Treatment with ibuprofen should be carried out at the lowest effective dose for the shortest course possible. With long-term treatment, it is necessary to monitor the state of the liver, kidneys, as well as the picture of peripheral blood. When a patient complains of nausea, vomiting and abdominal pain, it is imperative to conduct a thorough examination of the latter - EGDS, OAC and fecal blood test.
If the determination of 17-ketosteroids is required, then the drug should be canceled two days before the study.
Patients while taking the drug, it is advisable to refrain from any activity that requires increased concentration of attention.
Store in a dry place out of reach of children at temp. not higher than 25 ° С. The shelf life is 3 years. Do not use drugs with an expired date!
With the active substance Ibuprofen, such drugs are produced as Advil, Brufen, Artrokam, Bonifen, Burana, Ibuklin, Brustan, Deblok, Ibusan, Nurofen, as well as many others. The drug is very common on the market and is used very often.
Prices vary depending on the manufacturer.
The average price tag is:
You can not use NSAIDs uncontrollably. Consult a healthcare professional for advice, you should read the full instructions before use.
Producer: JSC "Borisov plant of medical preparations" Republic of Belarus
ATC code: M01AE01
Pharm group:
Release form: Solid dosage forms. Pills.
Active ingredient: 200 mg ibuprofen in 1 tablet.
Excipients: potato starch, magnesium stearate, calcium stearate, povidone (polyvinylpyrrolidone), opadry ΙΙ (polyvinyl alcohol, partially hydrolyzed, talc, macrogol 3350, lecithin, titanium dioxide (E 171)).
Pharmacodynamics. A drug of non-steroidal structure, which has a pronounced anti-inflammatory, analgesic, antipyretic and antiplatelet effect.
The mechanism of action is associated with inhibition of the activity of cyclooxygenase I and II types (COX-I selectivity index: COX-II = 5.0-10.0: 1). As a result, the reactions of the arachidonic cascade of eicosanoid synthesis are blocked and the formation of prostaglandins PgE2, PgF22, thromboxane TxA2, and prostacyclin PgI2 is impaired.
Ibuprofen reduces hyperemia, exudation and capillary permeability in the focus of inflammation. It inhibits the activity of hyaluronidase, inhibits the production of ATP, limiting the energy supply of the inflammatory process.
In rheumatic diseases, it has anti-inflammatory and analgesic effects. Eases pain at rest and during movement, reduces morning stiffness and swelling of the joints, improves their function. Full anti-inflammatory effect develops on the 5-7th day of regular use.
In post-traumatic and postoperative inflammatory processes, it quickly relieves both spontaneous pain and pain that occurs during movement. Reduces inflammatory edema in the wound area.
Ibuprofen has an analgesic effect, increases the excitability threshold of pain centers in the thalamus. Interferes with the conduction of pain impulses from extra- and proprioceptive receptors along the beams of Gaulle and Burdach. Reduces the algogenic effect of bradykinin. In the nuclei of the antinociceptive system, ibuprofen enhances the release of kynurenic acid, which inhibits the conduction of pain impulses (due to the effect on AMPA and NMDA receptors), as well as endogenous opiopeptides. Eliminates pains of mild and moderate intensity, which are usually of a somatic nature: pain in muscles, joints, tendons, nerve trunks, headache and toothache.
Reduces elevated body temperature, but does not affect normal body temperature. This is due to the ability of ibuprofen to reduce the activity of the thermosetting center of the hypothalamus, reduce the effect of endogenous pyrogens on it, and enhance heat transfer. The antipyretic effect develops in smaller doses than the anti-inflammatory effect and occurs within 30 minutes after the use of ibuprofen, persisting for 6 hours.
Ibuprofen disrupts the platelet adhesion (aggregation) reaction and leads to some lengthening of the time.
Pharmacokinetics. After intramuscular administration, it is well absorbed. Bioavailability is 80%. The maximum concentration in blood plasma after oral administration on an empty stomach is reached after 0.45-1 hours, when taken after meals - after 2.0-2.5 hours. The maximum concentration in the synovial fluid - after 3 hours. Therapeutic plasma concentration is 10 - 50 mcg / ml, toxic - 100 - 700 mcg / ml. The biological activity of ibuprofen is associated with the S-enantiomer. After absorption, about 60% of the pharmacologically inactive R-form is slowly transformed into the active S-form.
In the blood, it binds reversibly to plasma proteins (about 90-99%). Slowly penetrates into the joint cavity, is retained in the synovial fluid, creating concentrations in it greater than in plasma. The volume of distribution is 0.1 l / kg.
It is metabolized in the liver to form 3 inactive metabolites. 60-90% of the administered dose is excreted by the kidneys in the urine in the form of metabolites, to a lesser extent excreted in the bile. Excretion of unchanged ibuprofen is less than 1%. The half-life of ibuprofen is 2-2.5 hours, the total clearance is 0.75 ± 0.20 ml / min / kg.
In elderly patients, the pharmacokinetics of ibuprofen does not change.
* inflammatory diseases of the musculoskeletal system: (including), ankylosing spondylitis, spondyloarthritis, osteoarthritis;
* degenerative diseases of the musculoskeletal system:;
* diseases of extra-articular tissues:,;
* rheumatic lesions of soft tissues;
* post-traumatic and postoperative pain syndromes, accompanied by inflammation and edema;
* Bare-Lieu syndrome (cervical migraine, vertebral artery syndrome);
* febrile syndrome in acute infectious, infectious and inflammatory diseases;
* postural hypotension when taking antihypertensive drugs;
* as an additional remedy for severe infectious and inflammatory diseases of the upper respiratory tract, pneumonia, pericarditis and pleurisy, occurring with severe pain.
Important! Check out the treatment
Administered orally, preferably between meals.
Adults are prescribed 400-600 mg (2-3 tablets) 3-4 times a day. With rheumatoid arthritis - 800 mg (4 tablets) 3 times a day. With algodismenorrhea appoint 400 - 600 mg (2 - 3 tablets) with an interval of 4 - 6 hours. The maximum single dose is 800 mg (4 tablets), the daily dose is 2400 mg (12 tablets).
Children are prescribed in a dose of 5 - 10 mg / kg / day in 3 - 4 doses. The maximum daily dose of ibuprofen is 20 mg / kg, with juvenile rheumatoid arthritis - up to 40 mg / kg. Children aged 3 - 6 years (body weight 16 - 20 kg) 100 mg (½ tablet) 3 times a day, the maximum daily dose is 300 mg. Children 6 - 9 years old (21 - 30 kg) 100 mg (½ tablet) 4 times a day, the maximum daily dose is 400 mg. Children 9 - 12 years old (31 - 41 kg) 200 mg (1 tablet) 3 times a day, the maximum daily dose is 600 mg. Children over 12 years old (over 41 kg) 200 mg (1 tablet) 4 times a day, the maximum daily dose is 800 mg.
As an antipyretic, it is prescribed at a body temperature of more than 38.5 ° C (in patients with a history of febrile seizures - at a temperature of more than 37.5 ° C). If the body temperature exceeds 39.2 ° C, it is prescribed at the rate of 10 mg / kg, at a temperature below 39.2 ° C - at a dose of 5 mg / kg.
Pregnancy. The use of ibuprofen during pregnancy is possible only in cases where the expected benefit to the mother outweighs the potential risk to the fetus. The drug should be prescribed in the minimum effective dose. The use of ibuprofen in the third trimester of pregnancy is not recommended due to possible suppression of uterine contractility and premature closure of the ductus arteriosus in the fetus.
Lactation period. Ibuprofen passes into breast milk, therefore, when it is used during lactation, it is necessary to provide for the termination of breastfeeding for the entire period of treatment.
Persons with gastrointestinal tract pathology. During the use of ibuprofen, careful medical supervision is necessary for patients who have complaints from the gastrointestinal tract, a history of ulcerative lesions of the gastrointestinal tract, as well as Crohn's disease. Against the background of the use of ibuprofen, this group of patients may develop (for the first time or again) or ulceration / perforation of the gastrointestinal tract, which may not be accompanied by precursor symptoms. In all such cases, the drug should be discontinued.
Persons with pathology of the blood system. Ibuprofen temporarily inhibits platelet aggregation, therefore, in patients with impaired hemostasis, careful monitoring of appropriate laboratory parameters is necessary. With prolonged use of ibuprofen, systematic monitoring of peripheral blood is shown.
Persons with liver disease. During the use of ibuprofen, a transient increase in the activity of liver enzymes is possible. With prolonged therapy with ibuprofen, laboratory monitoring of liver function is indicated as a precautionary measure. If functional disorders persist or worsen, as well as if clinical manifestations of other liver damage occur, ibuprofen should be canceled. It should be remembered that against the background of the use of ibuprofen, it can occur without prodromal manifestations.
Persons with pathology of the cardiovascular system. Since prostaglandins play an important role in maintaining normal renal blood flow, special care is required when using ibuprofen in patients with impaired renal function and chronic congestive heart failure, in those receiving diuretics, as well as in patients with a significant decrease in circulating plasma volume (for example, in period before and after massive surgical interventions). In all these cases, monitoring of renal function is recommended as a precautionary measure. Discontinuation of the drug usually results in the restoration of renal function to its original level.
Impact on laboratory parameters. If it is necessary to determine 17-ketosteroids in urine, ibuprofen should be discontinued 48 hours before the analysis.
Influence on the ability to drive vehicles and control mechanisms. During the period of ibuprofen use, it is necessary to refrain from all types of activities that require increased attention, quick mental and motor reactions.
Cherry and currant juice, sugar syrup increase the absorption rate of ibuprofen.
To reduce the risk of developing adverse events from the gastrointestinal tract, the minimum effective dose should be used in the smallest possible short course.
* skin allergic reactions, angioedema, exudative erythema multiforme (Stevens-Johnson syndrome), toxic epidermal necrolysis (Lyell's syndrome), aseptic,.
* increased sweating.
Ibuprofen can increase plasma concentrations of methotrexate, lithium and digoxin when used concomitantly with these drugs.
Ibuprofen, like other nonsteroidal anti-inflammatory drugs (NSAIDs), can reduce the effect of diuretics, calcium channel blockers, ACE inhibitors and other antihypertensive drugs, which is associated with impaired synthesis of prostaglandins in the kidneys. Simultaneous use with potassium-sparing diuretics can lead to an increase in the level of potassium in the blood (if necessary, such a combination of drugs should monitor the level of potassium in the plasma).
There are reports of an increased risk of bleeding in the case of the combined use of ibuprofen and anticoagulants, fibrinolytic drugs.
When used together with antidepressants, barbiturates, zixorin, rifampicin, phenylbutazone, phenytoin, the risk of severe intoxication increases due to an increase in the production of hydroxylated active metabolites of ibuprofen.
Ibuprofen enhances the sugar-reducing efficacy of oral hypoglycemic agents, which requires dose adjustment of these drugs while using ibuprofen.
Glucocorticoid and mineralocorticoid hormones, colchicine enhance the anti-inflammatory effect of ibuprofen and increase the risk of developing gastrointestinal tract damage.
When used together with cefamandol, cefoperazone, cefotetan, valproic acid and plikamycin, the risk of developing hypoprothrombinmia increases.
Cyclosporine and gold preparations increase the nephrotoxic effect of ibuprofen.
Ibuprofen enhances the undesirable effects of estrogens when used together.
Ibuprofen weakens the effectiveness of the uricosuric action of anti-gout agents.
Cholestyramine slows down the absorption of ibuprofen.
Caffeine enhances the analgesic effect of ibuprofen.
Ibuprofen increases the toxicity of ethanol.
When used together, acetylsalicylic acid weakens the effect of ibuprofen and increases its toxicity, this is due to the displacement of ibuprofen from the connection with proteins and its metabolism with the formation of toxic hydroxylated metabolites.
* deficiency of glucose-6-phosphate dehydrogenase;
* hypersensitivity to ibuprofen;
* erosive and ulcerative lesions of the gastrointestinal tract in the acute phase;
* gastrointestinal bleeding;
* "Aspirin" asthma and "aspirin" triad;
* hemorrhagic diathesis (von Willebrand disease, thrombocytopenic purpura,), hypoprothrombinemia,;
* deficiency of vitamin K;
* pregnancy in the third trimester and lactation;
* diseases of the optic nerve, scotoma, amblyopia, color vision disorders;
* children under 3 years old.
Symptoms: The typical clinical picture does not develop with an overdose of ibuprofen. Abdominal pain, nausea, vomiting, dizziness, lethargy, drowsiness, depression, headache, hypotension, heart rhythm disturbances, respiratory depression are possible.
Treatment: assistance measures include discontinuation of the drug, supportive and symptomatic therapy aimed at eliminating the violations that have arisen, and correcting the acid-base state. It is possible to carry out with the simultaneous appointment of an alkaline drink, activated carbon, to reduce the reabsorption of ibuprofen. There is no specific antidote. effective only within an hour after taking the drug.
In a place protected from light and moisture, at a temperature not exceeding 25 ºС. Keep out of the reach of children. Shelf life is 3 years. Do not use after the expiration date.
Over the counter
10 tablets in a blister strip, in a package No. 10 x 3, No. 10 x 5.
Ibuprofen is one of the most prominent representatives of non-steroidal anti-inflammatory drugs (NSAIDs). The drug has pronounced analgesic and anti-inflammatory properties, which, given the etiological diversity of pain, finds the widest therapeutic application. By blocking cyclooxygenase, ibuprofen thereby knocks the soil out from under the feet of pain mediators prostaglandins, for the synthesis of which this particular enzyme is needed. The drug does not leave alone another mediator of pain and inflammation - bradykinin, reducing its secretion and inhibiting its activity. The anti-inflammatory effect of ibuprofen is manifested in a decrease in the permeability of the walls of blood vessels, stimulation of microcirculation, and an effect on the energy supply of the inflammation process. Another positive property of ibuprofen is its ability to lower body temperature by reducing the excitability of the diencephalon responsible for heat regulation. The severity of the antipyretic effect is determined by the dose of the drug and the initial body temperature of the patient. Ibuprofen is also inherent in all NSAIDs antithrombotic action.
The wide range of use and "working" of ibuprofen predetermines the variety of forms of its release: tablets, suppositories (for children), ointment, gel, oral suspension (for children).
Long-term use of ibuprofen in maximum permissible doses increases the risk of side effects, which, unfortunately, are common to all NSAIDs and are, to some extent, the price to pay for their effectiveness. Ibuprofen is used as part of symptomatic treatment, eliminating the signs of the disease, but not its cause. This is a certain degree of danger: the drug can mask the growing infectious process. In this regard, if an infection is suspected, the condition of the patient using ibuprofen should be monitored with particular care, incl. observe the blood picture and the functional state of the liver.
Ibuprofen in the form of a gel or ointment should be applied carefully, being careful not to get into open areas of damage. Especially carefully it is necessary to use the external forms of the drug in the area of the eyes and mucous membranes. The syrup and suppositories have been specially designed for children. In this age group of patients, the drug is used mainly as an antipyretic.
The drug belongs to non-steroidal anti-inflammatory drugs (NSAIDs). It has analgesic, antipyretic and anti-inflammatory effects. Blocks COG1 and COG2 indiscriminately.
The mechanism of action of ibuprofen is due to inhibition of the synthesis of prostaglandins - mediators of pain, inflammation and hyperthermic reaction.
Absorption - high, quickly and almost completely absorbed from the gastrointestinal tract. C max of ibuprofen in plasma is achieved within 1-2 hours after taking the drug. Communication with plasma proteins is more than 90%, T 1/2 - 2 hours. Slowly penetrates into the joint cavity, lingers in the synovial tissue, creating higher concentrations in it than in plasma. After absorption, about 60% of the pharmacologically inactive R-form is slowly transformed into the active S-form. Metabolized. It is excreted by the kidneys (not more than 1% unchanged) and, to a lesser extent, with bile.
Film-coated tablets from light pink to pink, round, biconvex; the cross section shows two layers: the core is white and the shell is from light pink to pink.
| 1 tab. | |
| ibuprofen | 200 mg |
Excipients: potato starch 38 mg, magnesium stearate 2 mg, colloidal silicon dioxide (aerosil) 3.35 mg, vanillin 1.5 mcg, beeswax 20 mcg, food gelatin 320 mcg, dye azorubin 8.5 mcg, magnesium hydroxycarbonate 39.57 mg, wheat flour 17.37 mg , low molecular weight povidone 1.5 mg, sucrose 144.96 mg, titanium dioxide 2.9 mg.
10 pieces. - contour cell packings.
10 pieces. - contour cell packaging (2) - cardboard packs.
10 pieces. - contour cell packaging (5) - cardboard packs.
Ibuprofen is prescribed for adults and children over 12 years of age by mouth, in tablets of 200 mg 3-4 times a day. To achieve a quick therapeutic effect, the dose can be increased to 400 mg (2 tablets) 3 times a day. When the therapeutic effect is achieved, the daily dose of the drug is reduced to 600-800 mg. The morning dose is taken before meals with a sufficient amount of water (for faster absorption of the drug). The remaining doses are taken throughout the day after meals.
The maximum daily dose is 1200 mg (do not exceed 6 tablets in 24 hours). A repeated dose should be taken no more often than after 4 hours. The duration of the drug use without consulting a doctor is not more than 5 days.
Do not use in children under 12 years of age without consulting a doctor.
Children from 6 to 12 years old: 1 tablet no more than 4 times a day; the drug can be used only if the child's body weight is more than 20 kg. The interval between taking the tablets is at least 6 hours (daily dose is not more than 30 mg / kg).
Symptoms: abdominal pain, nausea, vomiting, lethargy, drowsiness, depression, headache, tinnitus, metabolic acidosis, coma, acute renal failure, decreased blood pressure, bradycardia, tachycardia, atrial fibrillation, respiratory arrest.
Treatment: gastric lavage (only within 1 hour after ingestion), activated charcoal, alkaline drinking, forced diuresis, symptomatic therapy.
Simultaneous administration of ibuprofen with acetylsalicylic acid and other NSAIDs is not recommended. With the simultaneous appointment of ibuprofen, it 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). When administered with anticoagulant and thrombolytic drugs (alteplase, streptokinase, urokinase), the risk of bleeding increases at the same time. Concomitant use with serotonin reuptake inhibitors (citalopram, fluoxetine, paroxetine, sertraline) increases the risk of serious gastrointestinal bleeding.
Cefamandol, cephaperazone, cefotetan, valproic acid, plikamycin, increase the incidence of hypoprothrombinemia. Cyclosporine and gold preparations increase the effect of ibuprofen on the synthesis of prostaglandins in the kidneys, which is manifested by an increase in nephrotoxicity. Ibuprofen increases the plasma concentration of cyclosporine and the likelihood of developing its hepatotoxic effects. Drugs that block tubular secretion reduce excretion and increase the plasma concentration of ibuprofen. Microsomal oxidation inducers (phenytoin, ethanol, barbiturates, rifampicin, phenylbutazone, tricyclic antidepressants) increase the production of hydroxylated active metabolites, increasing the risk of severe intoxication. Inhibitors of microsomal oxidation - reduce the risk of hepatotoxic effects. Reduces the hypotensive activity of vasodilators, natriuretic and diuretic activity in furosemide and hydrochlorothiazide. Reduces the effectiveness of uricosuric drugs, enhances the effect of indirect anticoagulants, antiplatelet agents, fibrinolytics (increasing the risk of hemorrhagic disorders), enhances the ulcerogenic effect with bleeding of mineralocorticosteroids, glucocorticosteroids, colchicine, estrogens, ethanol. Enhances the effect of oral hypoglycemic drugs and insulin, sulfonylurea derivatives. Antacids and cholestyramine reduce absorption. Increases the concentration in the blood of digoxin, lithium preparations, methotrexate. Caffeine enhances the analgesic effect.
Gastrointestinal tract (GIT): NSAID gastropathy (abdominal pain, nausea, vomiting, heartburn, loss of appetite, diarrhea, flatulence, constipation; rarely - ulceration of the gastrointestinal mucosa, which in some cases is complicated by perforation and bleeding); irritation or dryness of the oral mucosa, pain in the mouth, ulceration of the gingival mucosa, aphthous stomatitis, pancreatitis.
Hepato-biliary system: hepatitis.
Respiratory system: shortness of breath, bronchospasm.
Sense organs: hearing impairment: hearing loss, ringing or tinnitus; visual impairments: toxic damage to the optic nerve, blurred vision or double vision, scotoma, dryness and irritation of the eyes, edema of the conjunctiva and eyelids (allergic genesis).
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).
Cardiovascular system: heart failure, tachycardia, increased blood pressure.
Urinary system: acute renal failure, allergic nephritis, nephrotic syndrome (edema), polyuria, cystitis.
Allergic reactions: skin rash (usually erythematous or urticaria), pruritus, Quincke's edema, anaphylactoid reactions, anaphylactic shock, bronchospasm or dyspnea, fever, exudative erythema multiforme (including Stevens-Johnson syndrome), toxic epidermal syndrome , eosinophilia, allergic rhinitis.
Hematopoietic organs: anemia (including hemolytic, aplastic), thrombocytopenia and thrombocytopenic purpura, agranulocytosis, leukopenia.
Others: increased sweating.
The risk of ulceration of the mucous membrane of the gastrointestinal tract, bleeding (gastrointestinal, gingival, uterine, hemorrhoidal), visual impairment (color vision disorders, scotoma, amblyopia) increases with prolonged use in high doses.
Laboratory indicators:
If side effects appear, you should stop taking the drug and consult a doctor.
Carefully. Elderly age, heart failure, arterial hypertension, ischemic heart disease, cerebrovascular disease, dyslipidemia, diabetes mellitus, peripheral arterial disease, smoking, frequent alcohol consumption, cirrhosis of the liver with portal hypertension, hepatic and / or renal failure with creatinine clearance less than 60 ml / mines, nephrotic syndrome, hyperbilirubinemia, gastric ulcer and duodenal ulcer (in history), H. pylori infection, gastritis, enteritis, colitis, blood diseases of unknown etiology (leukopenia and anemia), lactation period, prolonged use of NSAIDs, severe somatic diseases , simultaneous administration of oral corticosteroids (including prednisone), anticoagulants (including warfarin), antiplatelet agents (including acetylsalicylic acid, clopidogrel), selective serotonin reuptake inhibitors (including citalopram, fluoxetine, paroxetine, sertraline).
Contraindicated in pregnancy. Use with caution during lactation.
Contraindicated in severe liver failure or active liver disease.
Contraindicated in progressive kidney disease, severe renal failure with creatinine clearance less than 30 ml / min.
Contraindicated in children under 6 years of age. Do not use in children under 12 years of age without consulting a doctor.
Treatment with the drug should be carried out in the minimum effective dose, the minimum possible short course. During long-term treatment, it is necessary to monitor the peripheral blood picture and the functional state of the liver and kidneys. When symptoms of gastropathy appear, careful monitoring is shown, including esophagogastroduodenoscopy, general blood count (hemoglobin determination), and fecal occult blood test.
If it is necessary to determine 17-ketosteroids, the drug should be discontinued 48 hours before the study.
Patients should refrain from all types of activities that require increased attention, quick mental and motor reactions. During the period of treatment, it is not recommended to take ethanol.
Pain is a defense reaction of the body and a signal to a person that something is most likely going wrong inside. But sometimes it is unbearable to endure it, and besides, it is often not necessary. There are many modern drugs that can quickly stop pain attacks. One of them is "Ibuprofen" (400 mg), the instructions for use of which recommend taking it to relieve discomfort in a variety of diseases.
There is a large class of drugs that belong to non-steroidal anti-inflammatory drugs. They relieve pain and have an antipyretic effect. Also, these drugs reduce the severity of the inflammatory process, and the effect of them is quite quick. One of these drugs is Ibuprofen (400 mg). Instructions for use recommend taking it for pain of various natures and elevated body temperature.
The remedy belongs to fast-acting medicines that relieve symptoms, but, unfortunately, do not eliminate the causes of the disease. Therefore, most often "Ibuprofen" is included in the complex therapy of various diseases. It allows a person to endure the healing process much easier due to the fact that the clinical picture against the background of his reception becomes less pronounced. In parallel with it, an etiotropic treatment is prescribed, that is, one that affects the true nature of the disease.
The first thing that catches your eye when you open the package of the drug "Ibuprofen" (400 mg) - instructions for use. The composition of the preparation is as follows:
Each tablet has a special feature that makes it possible to divide the medication into 2 equal halves. This is very convenient when you need to take, say, 200 or 600 mg of ibuprofen at the same time.
Funds with prolonged use, unfortunately, negatively affect the mucous membrane of the digestive system, this also applies to the drug "Ibuprofen". Instructions for use of the tablet (400 mg) are recommended to be taken after meals so that the stomach does not succumb to the irritating effect of the drug.
During inflammation, prostaglandins (physiologically active substances) are actively formed in the tissues, the increased level of which brings pain to a person. The reaction of their synthesis is accelerated by the enzymes cyclooxygenases of the 1st and 2nd type (COX-1 and COX-2).
Non-steroidal anti-inflammatory drugs inhibit the formation of these catalysts, and the amount of prostaglandins decreases rapidly, since the reaction is not so intense. This mechanism of action has Ibuprofen (400 mg). Instructions for use, the description of the drug in pharmaceutical directories indicate that the agent effectively eliminates pain, relieves inflammation and lowers the overall body temperature. The maximum concentration of the active substance is observed 1-2 hours after taking the tablet inside. The drug is excreted from the body mainly with urine, and in the body it accumulates in the plasma and periarticular fluid.
Ibuprofen is available in different doses and dosage forms. It is available in syrups, tablets, suspensions and capsules. But if we consider "Ibuprofen" (400 mg), the instructions for use of which assumes oral administration, then in this dosage it is available only in tablets. This type of medicine has certain advantages:
The use of tablets does not require the participation of medical personnel (as is the case with injections, for example) and the observance of the conditions of sterility. Ibuprofen tablets are medium-sized and easy to swallow with a little water.
The most comprehensive document, which describes the indications for the use of the drug "Ibuprofen" - instructions for use. Tablets (400 mg) are usually prescribed to a patient with the following symptoms and diseases:
The agent can be used as part of complex therapy in patients with It reduces the amount of protein in the urine and reduces the intensity of pain. The medicine helps to reduce the discomfort in the postoperative period, although it cannot act as the only analgesic in this case.
Tablets with this dosage are available under the following trade names:
There is also a quality drug of domestic production "Ibuprofen Hemofarm" (400 mg). The instructions for use assumes its use according to the following scheme:
These recommendations are standard for taking ibuprofen 400 mg tablets from any manufacturer. To reduce the temperature, the amount of the drug is calculated based on the patient's weight. If the mark on the thermometer has reached 39.2, you need to drink the remedy at a ratio of 10 mg / kg of a person's weight (if the value is less, then 5 mg / kg of the patient's body weight is enough).
Not all people can safely use Ibuprofen tablets (400 mg). Instructions for use contraindications indicate the following:
During lactation, ibuprofen passes into breast milk, but in very low doses. Cancellation of natural feeding of a newborn due to the appointment of this drug to the mother is only necessary in those cases when the woman will have long-term drug therapy.
Before treatment, it is advisable to find out such information about the "Ibuprofen" (400 mg): instructions for use, release form and contraindications. But it is important to read about the safe doses of the medicine, because exceeding them can lead to sad consequences. It is important to maintain a minimum interval of 6 hours between doses of the remedy; it is not worth drinking these pills more often because of the high risk of side effects on the body. The daily dose of the drug in any case should not exceed 2.4 g.
Symptoms of taking too much medication:
There is no specific counteracting agent, therefore, if alarming symptoms occur, the patient needs to rinse the stomach, provide fresh air and immediately call an ambulance.
Not all medicines are compatible with each other. They can increase the side effects of each other or weaken their effectiveness. The drug "Ibuprofen" (400 mg) is no exception in this regard. The instructions for use warn that the medicine should not be taken with such medicines:
When treating with the drug, alcohol should not be consumed, since this combination leads to an undesirable side effect of Ibuprofen and enhances the harmful effects of alcoholic beverages.
active substance: ibuprofen;
1 tablet contains 400 mg ibuprofen
Excipients: core: lactose monohydrate, povidone, starch corn talc sodium croscarmellose; magnesium stearate silicon dioxide colloidal
shell: sucrose, talc, corn starch, titanium dioxide (E 171), carnauba wax, white wax.
Film-coated tablets.
Basic physical and chemical properties: white, oblong, sugar-coated tablets convex on both sides.
Non-steroidal anti-inflammatory drugs. Propionic acid derivatives.
ATX code М01А Е01.
Pharmacological.
Ibuprofen is an NSAID (NSAID) derivative of propionic acid that targets pain, fever and inflammation by inhibiting the synthesis of prostaglandins, which mediate pain and inflammation. In addition, ibuprofen reversibly inhibits platelet aggregation.
Pharmacokinetics.
Ibuprofen is well absorbed in the gastrointestinal tract and binds to blood plasma proteins. The maximum concentration in serum is determined 45 minutes after application (in the case of fasting). When this drug is taken with meals, peak levels are observed 1-2 hours after ingestion. Ibuprofen is metabolized in the liver, excreted by the kidneys unchanged or as metabolites. The half-life is about 2:00. In elderly patients, there are no significant differences in the pharmacokinetic profile.
Symptomatic treatment of headache, including migraine, toothache, dysmenorrhea (menstrual pain), neuralgia, back pain, joint pain, muscle pain, rheumatic pain, and symptoms of colds and flu.
Ibuprofen, like other NSAIDs, should not be used in combination with:
Ibuprofen should be used with caution in combination with the following drugs:
anticoagulants NSAIDs can enhance the effect of anticoagulants such as warfarin;
antihypertensive drugs (ACE inhibitors and angiotensin II antagonists) and diuretics: NSAIDs can reduce the effect of these drugs. Diuretics may increase the risk of nephrotoxic effects of NSAIDs
corticosteroids: increased risk of ulceration and bleeding in the gastrointestinal tract;
antiplatelet agents and selective serotonin reuptake inhibitors: increased risk of gastrointestinal bleeding
cardiac glycosides: NSAIDs can increase cardiac dysfunction, decrease renal glomerular filtration function, and increase plasma glycoside levels
lithium: there is evidence of a potential increase in plasma lithium levels
methotrexate: there is a possibility of an increase in the level of methotrexate in the blood plasma
cyclosporine: increased risk of nephrotoxicity;
mifepristone: NSAIDs should not be used earlier than 8-12 days after using mifepristone, as they can reduce its effectiveness;
tacrolimus: the risk of nephrotoxicity may increase with the simultaneous use of NSAIDs with tacrolimus;
zidovudine: increased risk of hematological toxicity with the combined use of zidovudine and NSAIDs. There is evidence of an increased risk of hemarthrosis and hematoma in HIV-infected patients with hemophilia in the case of concomitant treatment with zidovudine and ibuprofen;
quinolone antibiotics: in patients taking ibuprofen and quinolone antibiotics at the same time, there may be an increased risk of seizures;
sulfonylurea and phenytoin preparations: it is possible to enhance the effect.
Side effects associated with ibuprofen can be minimized by using the lowest effective dose necessary to treat symptoms for a short period of time.
In elderly patients, there is an increased frequency of adverse reactions to NSAIDs, especially gastrointestinal bleeding and perforation, which can be fatal.
Effects on the respiratory system.
In patients with bronchial asthma or allergic diseases, or have a history of these diseases, bronchospasm may occur.
Other NSAIDs.
The simultaneous use of ibuprofen with other NSAIDs, including selective COX-2 inhibitors, should be avoided, as this increases the risk of adverse reactions.
Systemic lupus erythematosus and mixed connective tissue disease.
Ibuprofen should be used with caution in systemic lupus erythematosus and mixed connective tissue disease for an increased risk of aseptic meningitis.
Influence on the cardiovascular and cerebrovascular system.
Patients with a history of hypertension and / or heart failure should begin treatment with caution (consultation with a doctor is required), since cases of fluid retention, hypertension and edema have been reported with ibuprofen therapy, like other NSAIDs.
Clinical study data and epidemiological data indicate that the use of ibuprofen, especially in high doses (2400 mg per day), as well as long-term use, can lead to a slight increase in the risk of developing arterial thrombotic complications (for example, myocardial infarction or stroke). In general, epidemiological data do not suggest that a low dose of ibuprofen (eg, ≤ 1200 mg per day) may increase the risk of myocardial infarction.
Effects on the kidneys.
Risk of renal failure due to impaired renal function.
Effects on the liver.
Liver dysfunction.
Effects on fertility in women.
There is limited evidence that drugs that inhibit cyclooxygenase / prostaglandin synthesis can interfere with ovulation. This process is reversed after stopping treatment.
Effect on the gastrointestinal tract.
NSAIDs should be used with caution in patients with a history of gastrointestinal diseases (ulcerative colitis, Crohn's disease), as their condition may worsen.
There have been reports of cases of gastrointestinal bleeding, perforation, ulcers, which can be fatal, that occurred at any stage of treatment with NSAIDs, regardless of the presence of warning symptoms or the presence of severe gastrointestinal disorders in the history.
The risk of gastrointestinal bleeding, perforation or ulceration increases with increasing doses of NSAIDs in patients with a history of peptic ulcer disease, especially complicated by bleeding or perforation, and in the elderly. These patients should start treatment with low doses.
Patients with a history of gastrointestinal toxicity, especially elderly patients, should report any unusual symptoms from the gastrointestinal tract (especially gastrointestinal bleeding), in particular at the beginning of treatment.
Caution should be exercised when treating patients concurrently taking drugs that may increase the risk of ulceration or bleeding, such as oral corticosteroids, anticoagulants (eg warfarin), selective serotonin reuptake inhibitors, or antiplatelet agents (eg aspirin).
In case of gastrointestinal bleeding or ulceration in patients receiving ibuprofen, treatment should be stopped immediately.
Very rarely, against the background of the use of NSAIDs, severe forms of skin reactions can occur, which can be fatal, including exfoliative dermatitis, Stevens-Johnson syndrome and toxic epidermal necrolysis. The risk of such reactions is highest at the beginning of therapy, in most cases, such reactions began within the first month of treatment. At the first sign of a skin rash, pathological changes in the mucous membranes, or any other sign of hypersensitivity, ibuprofen should be discontinued.
Since the drug contains lactose, patients with rare hereditary diseases such as galactose intolerance, Lapp lactase deficiency or impaired glucose-galactose malabsorption should not take this drug.
Since the drug contains sucrose, patients with rare hereditary fructose intolerance, glucose-galactose malabsorption syndrome or sucrose-isomaltase deficiency should not use this drug.
Application during pregnancy or lactation.
Suppression of prostaglandin synthesis can adversely affect pregnancy and / or embryo / fetal development. Data from epidemiological studies indicate an increased risk of miscarriage, congenital malformations after the use of inhibitors of prostaglandin synthesis at an early stage of pregnancy. The risk is thought to increase with dose and duration of therapy. NSAIDs should not be taken in the first two trimesters of pregnancy or during childbirth, unless the potential benefit to the patient outweighs the potential risk to the fetus. In the third trimester of pregnancy, with the use of any inhibitors of prostaglandin synthesis, such effects on the fetus as cardiopulmonary toxicity (premature closure of the ductus arteriosus of the fetus with pulmonary hypertension) and impaired renal function, which can progress to renal failure with manifestation of oligohydramnios, are possible. Ibuprofen is contraindicated in the third trimester of pregnancy due to the possibility of inhibition of the contractile function of the uterus, which can lead to an increase in the duration of labor with a tendency to increased bleeding in the mother and child, even with the use of low doses.
In studies, a small amount of ibuprofen has been found in breast milk. If possible, NSAIDs are not recommended for use during breastfeeding.
The ability to influence the reaction rate when driving or operating other mechanisms.
With a short-term intake of the drug, there is no need for preventive measures. Provided that it is used according to the recommended doses and duration of treatment, the drug does not affect the reaction rate when driving or operating other mechanisms. Patients who experience dizziness, drowsiness, disorientation or visual impairment while taking NSAIDs should refuse to drive vehicles or operate machinery.
For short-term use, regardless of food intake.
Adults and children over 12 years old: 1 tablet every 4-6 hours. Drink the tablets with water. Do not exceed 3 tablets in a 24 hour period. The maximum daily dose is 1200 mg.
The minimum effective dose should be used for the shortest possible period necessary to relieve symptoms. If necessary, use the drug for more than 10 days, if the symptoms do not disappear or worsen, the patient should consult a doctor.
Elderly patients do not need special dosing.
Patients with mild to moderate renal and hepatic impairment do not require dose adjustment.
Do not use in children under 12 years of age.
The use of the drug in children at a dose of 400 mg / kg can lead to symptoms of intoxication. In adults, the dose effect is less pronounced. The half-life for overdose is 1.5-3 hours.
Symptoms... In most patients, the use of a clinically significant amount of NSAIDs caused only nausea, vomiting, epigastric pain, or, less commonly, diarrhea. Tinnitus, headache, and gastrointestinal bleeding may also occur. In severe poisoning, toxic damage to the central nervous system is observed, manifests itself as drowsiness, sometimes an agitated state and disorientation or coma. Sometimes patients develop seizures. In more severe poisoning, metabolic acidosis and an increase in PT / INR may occur (probably through interaction with blood clotting factors circulating in the bloodstream). Acute renal failure and liver damage may occur. Patients with bronchial asthma may experience an exacerbation of asthma.
Treatment... Treatment should be symptomatic and supportive and include airway management and monitoring of cardiac function and vital signs until the patient is normalized. Oral administration of activated charcoal is recommended within 1:00 after the application of a potentially toxic dose of the drug. For frequent or prolonged muscle spasms, treatment should be given by intravenous diazepam or lorazepam. In the case of bronchial asthma, bronchodilators should be used.
The following adverse reactions have been observed with short-term use of ibuprofen at doses not exceeding 1200 mg / day. In the treatment of chronic diseases and with prolonged use, other adverse reactions may occur.
Adverse reactions associated with the use of ibuprofen, classified by organ systems and frequency. Frequency is defined as follows: very often ≥1 / 10; often: ≥1 / 100 and<1/10; нечасто ≥1 / 1000 и <1/100; редко ≥1 / 10000 и <1/1000; очень редко <1/10000, частота неизвестна (невозможно оценить частоту по имеющимся данным).
On the part of the blood and lymphatic system.
Very rare: impaired hematopoiesis 1.
From the immune system.
Infrequently, hypersensitivity reactions accompanied by urticaria and itching 2. Very rare: severe hypersensitivity reactions, the symptoms of which may include edema of the face, tongue and larynx, shortness of breath, tachycardia, arterial hypotension (anaphylaxis, angioedema or severe shock) 2.
From the nervous system.
Uncommon: headache. Very rare aseptic meningitis 3.
On the part of the cardiovascular system.
Frequency unknown: heart failure, edema 4.
From the vascular system.
Frequency unknown: arterial hypertension 4.
From the respiratory tract and mediastinal organs .
Frequency not known: airway reactivity including asthma, bronchospasm or shortness of breath 2.
From the digestive system.
Uncommon: abdominal pain, nausea, dyspepsia 5. Rarely diarrhea, flatulence, constipation, vomiting. Very rare: gastric ulcer and duodenal ulcer, gastrointestinal perforation or gastrointestinal bleeding, melena, bloody vomiting 6; ulcerative stomatitis, gastritis. Frequency unknown: exacerbation of colitis and Crohn's disease 7.
From the liver.
Very rare: impaired liver function.
On the part of the skin and subcutaneous tissue.
Uncommon: various types of skin rashes 2. Very rare bullous reactions including Stevens-Johnson syndrome, erythema multiforme and toxic epidermal necrolysis 2.
On the part of the kidneys and urinary system.
Very rarely, acute renal impairment 8.
Laboratory research.
Very rare: decreased hemoglobin levels.
Description of selected adverse reactions
1 Includes anemia, leukopenia, thrombocytopenia, pancytopenia, and agranulocytosis. The first signs of such disorders are fever, sore throat, superficial mouth ulcers, flu-like symptoms, severe wasting, bleeding, and hematomas of unknown etiology.
2 Hypersensitivity reactions may include: (a) nonspecific allergic reactions and anaphylaxis, (b) airway reactivity, including asthma, exacerbation of asthma, bronchospasm and shortness of breath, or (c) various forms of skin reactions, including pruritus, urticaria, purpura, angioedema , and less often - exfoliative and bullous dermatosis, including toxic epidermal necrolysis, Stevens-Johnson syndrome and erythema multiforme.
3 The pathogenic mechanism of drug-induced aseptic meningitis has not been elucidated. The available data on aseptic meningitis associated with the use of NSAIDs indicate a hypersensitivity reaction (through a temporary connection with the drug intake and the disappearance of symptoms after drug withdrawal). In patients with autoimmune diseases (systemic lupus erythematosus and mixed connective tissue disease), isolated cases of symptoms of aseptic meningitis (stiff neck, headache, nausea, vomiting, fever and loss) were observed.
Store in original packaging at a temperature not exceeding 30 ° C.
Keep out of the reach of children.
Film-coated tablets, No. 6, No. 12, No. 24 (12 × 2) in blisters, No. 24 in vials, in a cardboard box.
Instructions for the medical use of the drug
NSAIDs, a derivative of phenylpropionic acid. It has anti-inflammatory, analgesic and antipyretic effects.
The mechanism of action is associated with inhibition of the activity of COX, the main enzyme of the metabolism of arachidonic acid, which is a precursor of prostaglandins, which play a major role in the pathogenesis of inflammation, pain and fever. The analgesic effect is due to both a peripheral (indirectly, through suppression of prostaglandin synthesis) and a central mechanism (due to inhibition of prostaglandin synthesis in the central and peripheral nervous system). Suppresses platelet aggregation.
When applied externally, it has anti-inflammatory and analgesic effects. Reduces morning stiffness, increases the range of motion in the joints.
Inflammatory and degenerative diseases of the joints and spine (including rheumatic and rheumatoid arthritis, ankylosing spondylitis, osteoarthritis), articular syndrome during exacerbation of gout, psoriatic arthritis, tendinitis, bursitis, sciatica, traumatic inflammation of soft tissues and musculoskeletal system.
Neuralgia, myalgia, pain syndrome in infectious and inflammatory diseases of the upper respiratory tract, adnexitis, algomenorrhea, headache and toothache.
Fever in infectious and inflammatory diseases.
Film-coated tablets 400 mg; blister packaging 12 pack of cardboard 1,2;
Film-coated tablets 400 mg; blister packaging 6 pack of cardboard 1,2;
Non-selectively inhibits COX-1 and COX-2, reduces the synthesis of PG.
The anti-inflammatory effect is associated with a decrease in vascular permeability, an improvement in microcirculation, a decrease in the release of inflammatory mediators (PG, kinins, LT) from cells and a suppression of the energy supply of the inflammatory process.
The analgesic effect is due to a decrease in the intensity of inflammation, a decrease in the production of bradykinin and its algogenicity.
In rheumatoid arthritis, it affects mainly the exudative and partly the proliferative components of the inflammatory response, has a rapid and pronounced analgesic effect, reduces swelling, morning stiffness and limited mobility in the joints.
A decrease in the excitability of the heat-regulating centers of the diencephalon results in antipyretic action.
The severity of the antipyretic effect depends on the initial body temperature and dose.
With a single dose, the effect lasts up to 8 hours.
In primary dysmenorrhea, it reduces intrauterine pressure and frequency of uterine contractions. Reversibly inhibits platelet aggregation.
When taken orally, ibuprofen is almost completely absorbed from the gastrointestinal tract. Simultaneous food intake slows down the rate of absorption. Metabolized in the liver (90%). T1 / 2 is 2-3 hours.
80% of the dose is excreted in the urine mainly in the form of metabolites (70%), 10% - unchanged; 20% is excreted through the intestines as metabolites.
Ibuprofen should not be used during the third trimester of pregnancy. Use in the I and II trimesters of pregnancy is justified only in cases where the expected benefit to the mother outweighs the possible harm to the fetus.
Ibuprofen is excreted in small amounts in breast milk. Application during lactation for pain and fever is possible. If you need long-term use or use in high doses (more than 800 mg /), you should decide on the termination of breastfeeding.
Erosive and ulcerative lesions of the gastrointestinal tract in the acute phase, diseases of the optic nerve, "aspirin triad", hematopoiesis disorders, severe renal and / or liver dysfunctions; hypersensitivity to ibuprofen.
From the digestive system: often - nausea, anorexia, vomiting, epigastric discomfort, diarrhea; development of erosive and ulcerative lesions of the gastrointestinal tract is possible; rarely - bleeding from the gastrointestinal tract; with prolonged use, liver dysfunctions are possible.
From the side of the central nervous system and peripheral nervous system: often - headache, dizziness, sleep disturbances, agitation, visual disturbances.
From the hematopoietic system: with prolonged use, anemia, thrombocytopenia, agranulocytosis are possible.
From the urinary system: with prolonged use, renal dysfunction is possible.
Allergic reactions: often - skin rash, Quincke's edema; rarely - aseptic meningitis (more often in patients with autoimmune diseases), bronchospastic syndrome.
Local reactions: when applied externally, skin hyperemia, a burning sensation or tingling sensation are possible.
Set individually, depending on the nosological form of the disease, the severity of clinical manifestations. When taken orally or rectally for adults, a single dose is 200-800 mg, the frequency of administration is 3-4 times / day; for children - 20-40 mg / kg / day. in several steps.
Applied externally for 2-3 weeks.
The maximum daily dose for adults when taken by mouth or rectally is 2.4 g.
Symptoms: abdominal pain, nausea, vomiting, lethargy, drowsiness, depression, headache, tinnitus, metabolic acidosis, coma, acute renal failure, hypotension, bradycardia, tachycardia, atrial fibrillation, and respiratory arrest.
Treatment: gastric lavage (only within the first hour after ingestion), activated charcoal (to reduce absorption), alkaline drinking, forced diuresis and symptomatic therapy (correction of acid base balance, blood pressure, gastrointestinal bleeding).
With the simultaneous use of ibuprofen reduces the effect of antihypertensive drugs (ACE inhibitors, beta-blockers), diuretics (furosemide, hypothiazide).
With simultaneous use with anticoagulants, their effect may be enhanced.
With simultaneous use with GCS, the risk of developing side effects from the gastrointestinal tract increases.
With the simultaneous use of ibuprofen, indirect anticoagulants (acenocoumarol), hydantoin derivatives (phenytoin), oral hypoglycemic drugs, sulfonylurea derivatives can be displaced from compounds with blood plasma proteins.
With simultaneous use with amlodipine, a slight decrease in the antihypertensive effect of amlodipine is possible; with acetylsalicylic acid - the concentration of ibuprofen in the blood plasma decreases; with baclofen - a case of intensification of the toxic effect of baclofen is described.
With simultaneous use with warfarin, an increase in bleeding time is possible, microhematuria, hematomas were also observed; with hydrochlorothiazide - a slight decrease in the antihypertensive effect of hydrochlorothiazide is possible; with captopril - it is possible to reduce the antihypertensive effect of captopril; with cholestyramine - a moderately pronounced decrease in the absorption of ibuprofen.
With simultaneous use with lithium carbonate, the concentration of lithium in the blood plasma increases.
With simultaneous use with magnesium hydroxide, the initial absorption of ibuprofen increases; with methotrexate - the toxicity of methotrexate increases.
Treatment should be carried out in the minimum effective dose, the smallest possible short course. During long-term treatment, it is necessary to monitor the peripheral blood picture and the functional state of the liver and kidneys.
Given the possibility of the development of NSAID gastropathy, it is prescribed with caution to the elderly, with a history of stomach ulcers and other gastrointestinal diseases, gastrointestinal bleeding, with simultaneous therapy with glucocorticoids, other NSAIDs and for long-term therapy. When symptoms of gastropathy appear, careful monitoring is shown (including esophagogastroduodenoscopy, blood test with determination of hemoglobin, hematocrit, fecal occult blood test). To prevent the development of NSAID gastropathy, it is recommended to combine it with PGE (misoprostol).
It is prescribed with caution to patients with impaired liver and kidney function (regular monitoring of the level of bilirubin, transaminases, creatinine, kidney concentration), arterial hypertension and chronic heart failure (daily monitoring of diuresis, body weight, blood pressure). If visual impairment occurs, the dose should be reduced or the drug should be discontinued.
Cannot be applied to an open wound surface, damaged skin; avoid getting the cream, gel or ointment in the eyes and mucous membranes.
It is used with caution in case of concomitant liver and kidney diseases, chronic heart failure, with dyspeptic symptoms before starting treatment, immediately after surgical interventions, with indications of a history of bleeding from the gastrointestinal tract and gastrointestinal diseases, allergic reactions associated with taking NSAIDs.
In the course of treatment, systematic monitoring of the functions of the liver and kidneys, and the picture of peripheral blood is necessary.
Do not apply topically to damaged skin areas.
** The Medication Guide is intended solely for informational purposes. For more information, please refer to the manufacturer's annotation. Do not self-medicate; before using the drug Ibuprom Max, you should consult a doctor. EUROLAB is not responsible for the consequences caused by the use of the information posted on the portal. Any information on the site does not replace the consultation of a doctor and cannot serve as a guarantee of the positive effect of the drug.
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** Attention! The information provided in this medication guide is intended for medical professionals and should not be used as a basis for self-medication. The description of the drug Ibuprom Max is given for information purposes only and is not intended to prescribe treatment without the participation of a doctor. Patients need a specialist consultation!
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