Interaction with other drugs. The legal entity in whose name the registration certificate was issued and the manufacturer

INSTRUCTIONS for the use of the medicinal product for medical use

Registration number: P N013012/01-090117

Trade name of the drug: Nurofen ®

International Nonproprietary Name (INN): ibuprofen

Chemical name:(2RS)-2-propionic acid

Dosage form: film-coated tablets

Compound
One film-coated tablet contains the active ingredient - 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%).
*Solvents that have evaporated after the printing process.

Description
Round, biconvex, white or off-white film-coated tablets with black Nurofen imprint on one side of the tablet. On a cross-section of the tablet, the core is white or almost white, the shell is white or almost white.

Pharmacotherapeutic group: non-steroidal anti-inflammatory drug (NSAID).

ATX code: M01AE01

Pharmacological properties
Pharmacodynamics
The mechanism of action of ibuprofen, a derivative of propionic acid from the group of non-steroidal anti-inflammatory drugs (NSAIDs), is due to inhibition of the synthesis of prostaglandins - mediators of pain, inflammation and hyperthermic reaction. Indiscriminately blocks cyclooxygenase 1 (COX-1) and cyclooxygenase 2 (COX-2), as a result of which it inhibits the synthesis of prostaglandins. It has a rapid, targeted effect against pain (analgesic), antipyretic and anti-inflammatory effects. In addition, ibuprofen reversibly inhibits platelet aggregation. The analgesic effect of the drug lasts up to 8 hours.

Pharmacokinetics
Absorption is high, quickly and almost completely absorbed from the gastrointestinal tract (GIT). After taking the drug on an empty stomach, the maximum concentration (Cmax) of ibuprofen in the blood plasma is achieved after 45 minutes. Taking the drug with food can increase the time to reach maximum concentration (TCmax) to 1-2 hours. Communication with blood plasma proteins - 90%. Slowly penetrates into the joint cavity, lingers in the synovial fluid, creating higher concentrations in it than in the blood plasma. Lower concentrations of ibuprofen are found in cerebrospinal fluid compared to blood plasma. After absorption, about 60% of the pharmacologically inactive R-form is slowly transformed into the active S-form. Metabolized in the liver. The half-life (T1/2) is 2 hours. It is excreted by the kidneys (no more than 1% unchanged) and, to a lesser extent, with bile.
In limited studies, ibuprofen has been found in breast milk at very low concentrations.

Indications for use

Contraindications

• Hypersensitivity to ibuprofen or any of the components included in the drug.
• Complete or incomplete combination of bronchial asthma, recurrent polyposis of the nose and paranasal sinuses and intolerance to acetylsalicylic acid or other NSAIDs (including a history).
• Erosive and ulcerative diseases of the gastrointestinal tract (including gastric and duodenal ulcers, 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).
• A history of bleeding or perforation of a gastrointestinal ulcer caused by the use of NSAIDs.
• Severe heart failure (NYHA class IV - New York Heart Association classification)
• Severe liver failure or active liver disease.
• Severe renal failure (creatinine clearance< 30 мл/мин), подтвержденная гиперкалиемия.
• Decompensated heart failure; period after coronary artery bypass surgery.
• Cerebrovascular or other bleeding.
• Fructose intolerance, glucose-galactose malabsorption, sucrase-isomaltase deficiency.
• Hemophilia and other bleeding disorders (including hypocoagulation), hemorrhagic diathesis.
• Pregnancy (III trimester).
• Children's age up to 6 years.

Carefully
If you have the conditions listed in this section, you should consult a doctor before using the drug.
Concomitant use of other NSAIDs, a history of a single episode of gastric and duodenal ulcers or gastrointestinal ulcerative bleeding; gastritis, enteritis, colitis, the presence of Helicobacter pylori infection, ulcerative colitis; bronchial asthma or allergic diseases in the acute stage or in history - bronchospasm may develop; systemic lupus erythematosus or mixed connective tissue disease (Sharpe's syndrome) - increased risk of aseptic meningitis; chicken pox; renal failure, including dehydration (creatinine clearance 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 mellitus, peripheral arterial disease, smoking, frequent alcohol consumption, concomitant use of medications that may increase the risk of ulcers or bleeding, in particular oral glucocorticosteroids (including prednisone ), anticoagulants (including warfarin), selective serotonin reuptake inhibitors (including citalopram, fluoxetine, paroxetine, sertraline) or antiplatelet agents (including acetylsalicylic acid, clopidogrel), pregnancy I-II trimester, breastfeeding period, elderly age, age under 12 years.

Use during pregnancy and breastfeeding
The use of the drug is contraindicated in the third trimester of pregnancy. You should avoid using the drug in the first and second trimesters of pregnancy; if you need to take the drug, you should consult your doctor. There is evidence that ibuprofen can pass into breast milk in small quantities without any adverse effects on the health of the nursing infant, so there is usually no need to stop breastfeeding when taken for a short period of time. If long-term use of the drug is necessary, you should consult a doctor to decide whether to stop breastfeeding for the period of use of the drug.

Directions for use and doses

Adults and children over 12 years of age: 1 tablet (200 mg) orally up to 3-4 times a day. The tablets should be taken with water. To achieve a faster therapeutic effect in adults, the dose can be increased to 2 tablets (400 mg) up to 3 times a day.

Children from 6 to 12 years old: 1 tablet (200 mg) up to 3-4 times a day; The drug can only be taken if the child weighs more than 20 kg. The interval between taking tablets should be at least 6 hours. The maximum daily dose for adults is 1200 mg (6 tablets). Maximum daily dose for children from 6 to 18 years of age: 800 mg (4 tablets). If symptoms persist or worsen after taking the drug for 2-3 days, you should stop treatment and consult a doctor.

Side effect

Elderly people experience an increased incidence of adverse reactions with NSAID use, especially gastrointestinal bleeding and perforation, in some cases fatal. Side effects are predominantly dose-dependent. The following adverse reactions were observed with short-term use of ibuprofen in doses not exceeding 1200 mg/day (6 tablets).

When treating chronic conditions and with long-term use, other adverse reactions may occur.

The frequency of adverse reactions was assessed based on the following criteria: very frequent (≥ 1/10), frequent (≥ 1/100 to< 1/10), нечастые (от ≥ 1/1000 до < 1/100), редкие (от ≥ 1/10 000 до < 1/1000), очень редкие (< 1/10 000), частота неизвестна (данных для оценки частоты недостаточно).

Blood and lymphatic system disorders

• Very rare: hematopoietic disorders (anemia, leukopenia, aplastic anemia, hemolytic anemia, thrombocytopenia, pancytopenia, agranulocytosis). The first symptoms of such disorders are fever, sore throat, superficial oral ulcers, flu-like symptoms, severe weakness, nosebleeds and subcutaneous hemorrhages, bleeding and bruising of unknown etiology.

Immune system disorders

• Uncommon: hypersensitivity reactions - nonspecific allergic reactions and anaphylactic reactions, reactions from the respiratory tract (bronchial asthma, including its exacerbation, bronchospasm, shortness of breath, dyspnea), skin reactions (itching, urticaria, purpura, Quincke's edema, exfoliative and bullous dermatoses , including toxic epidermal necrolysis (Lyell's syndrome), Stevens-Johnson syndrome, erythema multiforme), allergic rhinitis, eosinophilia.
• Very rare: severe hypersensitivity reactions, including swelling of the face, tongue and larynx, shortness of breath, tachycardia, hypotension (anaphylaxis, angioedema or severe anaphylactic shock).

Gastrointestinal disorders

• Uncommon: abdominal pain, nausea, dyspepsia (including heartburn, bloating).
• Rare: diarrhea, flatulence, constipation, vomiting.
• Very rare: peptic ulcer, perforation or gastrointestinal bleeding, melena, hematemesis, in some cases fatal, especially in elderly patients, ulcerative stomatitis, gastritis.
• Frequency unknown: exacerbation of colitis and Crohn's disease.

Disorders of the liver and biliary tract

• Very rare: liver dysfunction, increased activity of liver transaminases, hepatitis and jaundice.

Renal and urinary tract disorders

• Very rare: acute renal failure (compensated and decompensated), especially with long-term use, in combination with an increase in the concentration of urea in the blood plasma and the appearance of edema, hematuria and proteinuria, nephritic syndrome, nephrotic syndrome, papillary necrosis, interstitial nephritis, cystitis.

Nervous system disorders

• Uncommon: headache.
• Very rare: aseptic meningitis.
  Cardiovascular disorders
• Frequency unknown: heart failure, peripheral edema, with long-term use there is an increased risk of thrombotic complications (for example, myocardial infarction), increased blood pressure.

Disorders of the respiratory system and mediastinal organs

• Frequency unknown: bronchial asthma, bronchospasm, shortness of breath.

Laboratory indicators

• hematocrit or hemoglobin (may decrease)
• bleeding time (may increase)
• plasma glucose concentration (may decrease)
• creatinine clearance (may decrease)
• plasma creatinine concentration (may increase)
• activity of “liver” transaminases (may increase)

If side effects occur, you should stop taking the drug and consult a doctor.

Overdose
In children, overdose symptoms may occur after taking a dose exceeding 400 mg/kg body weight. In adults, the dose-dependent effect of overdose is less pronounced. The half-life of the drug in case of overdose is 1.5-3 hours.
Symptoms: nausea, vomiting, epigastric pain or, less commonly, diarrhea, tinnitus, headache and gastrointestinal bleeding. In more severe cases, manifestations from the central nervous system are observed: drowsiness, rarely - agitation, convulsions, disorientation, coma. In cases of severe poisoning, metabolic acidosis and increased prothrombin time, renal failure, liver tissue damage, decreased blood pressure, respiratory depression and cyanosis may develop. In patients with bronchial asthma, exacerbation of this disease is possible.
Treatment: symptomatic, with mandatory maintenance of airway patency, monitoring of ECG and vital signs until the patient’s condition is normalized. Oral use of activated charcoal or gastric lavage is recommended within 1 hour after taking a potentially toxic dose of ibuprofen. If ibuprofen has already been absorbed, an alkaline drink may be prescribed in order to eliminate the acidic derivative of ibuprofen by the kidneys, forced diuresis. Frequent or prolonged seizures should be treated with intravenous diazepam or lorazepam. If bronchial asthma worsens, the use of bronchodilators is recommended.

Interaction with other drugs

• Acetylsalicylic acid: with the exception of low doses of acetylsalicylic acid (no more than 75 mg per day) prescribed by a doctor, since combined use may increase the risk of side effects. With simultaneous use, ibuprofen reduces the anti-inflammatory and antiplatelet effect of acetylsalicylic acid (an increase in the incidence of acute coronary insufficiency in patients receiving small doses of acetylsalicylic acid as an antiplatelet agent is possible after starting ibuprofen).
• Other NSAIDs, in particular selective COX-2 inhibitors: The simultaneous use of two or more drugs from the NSAID group should be avoided due to a possible increased risk of side effects.

Use with caution concomitantly with the following medicinal products
means:

• Anticoagulants and thrombolytic drugs: NSAIDs may enhance the effect of anticoagulants, in particular warfarin and thrombolytic drugs.
• Antihypertensives (ACE inhibitors and angiotensin II antagonists) and diuretics: NSAIDs may reduce the effectiveness of drugs in these groups. In some patients with impaired renal function (eg, dehydrated patients or elderly patients with impaired renal function), coadministration of ACE inhibitors or angiotensin II antagonists and cyclooxygenase inhibitors may lead to a deterioration of renal function, including the development of acute renal failure. (usually reversible). These interactions should be considered in patients taking coxibs concomitantly with ACE inhibitors or angiotensin I antagonists. Therefore, the combined use of the above drugs should be prescribed with caution, especially in the elderly. It is necessary to prevent dehydration in patients, and consider monitoring renal function after initiation of this combination treatment and periodically thereafter. Diuretics and ACE inhibitors may increase the nephrotoxicity of NSAIDs.
• Glucocorticosteroids: increased risk of gastrointestinal ulcers and gastrointestinal bleeding.
• Antiplatelet agents and selective serotonin reuptake inhibitors: increased risk of gastrointestinal bleeding.
• Cardiac glycosides: simultaneous administration of NSAIDs and cardiac glycosides can lead to worsening heart failure, a decrease in glomerular filtration rate and an increase in the concentration of cardiac glycosides in the blood plasma.
• Lithium preparations: There is evidence of the likelihood of an increase in the concentration of lithium in the blood plasma during the use of NSAIDs.
• Methotrexate: There is evidence of the likelihood of an increase in the concentration of methotrexate in the blood plasma during the use of NSAIDs.
• Cyclosporine: increased risk of nephrotoxicity with simultaneous administration of NSAIDs and cyclosporine.
• Mifepristone: NSAIDs should be started no earlier than 8-12 days after taking mifepristone, as NSAIDs may reduce the effectiveness of mifepristone.
• Tacrolimus: When NSAIDs and tacrolimus are co-administered, the risk of nephrotoxicity may increase.
• Zidovudine: Concomitant use of NSAIDs and zidovudine may lead to increased hematotoxicity. There is evidence of an increased risk of hemarthrosis and hematomas in HIV-positive patients with hemophilia who received concomitant treatment with zidovudine and ibuprofen.
• Quinolone antibiotics: in patients receiving concomitant treatment with NSAIDs and quinolone antibiotics, the risk of seizures may increase.
• Myelotoxic drugs: increased hematotoxicity. Cefamandole, cefoperazone, cefotetan, valproic acid, plicamycin: increased incidence of hypoprothrombinemia.
• Medicines that block tubular secretion: decreased excretion and increased plasma concentrations of ibuprofen. Inducers of microsomal oxidation (phenytoin, ethanol, barbiturates, rifampicin, phenyl butazone, tricyclic antidepressants): increased production of hydroxylated active metabolites, increased risk of developing severe intoxications.
• Microsomal oxidation inhibitors: reducing the risk of hepatotoxicity.
• Oral hypoglycemic drugs and insulin, sulfonylurea derivatives: enhancing the effect of drugs.
• Antacids and cholestyramine: decreased absorption.
• Uricosuric drugs: decreased effectiveness of drugs.
• Caffeine: enhancing the analgesic effect.

special instructions
It is recommended to take the drug for the shortest possible course and in the minimum effective dose necessary to eliminate symptoms. If you need to take the drug for more than 10 days, you should consult a doctor.
In patients with bronchial asthma or an allergic disease in the acute stage, as well as in patients with a history of bronchial asthma/allergic disease, the drug may provoke bronchospasm. The use of the drug in patients with systemic lupus erythematosus or mixed connective tissue disease is associated with an increased risk of developing aseptic meningitis.

During long-term treatment, monitoring of the peripheral blood picture and the functional state of the liver and kidneys is necessary. When symptoms of gastropathy appear, careful monitoring is indicated, including esophagogastroduodenoscopy, a complete blood count (hemoglobin determination), and a stool test for occult blood. If it is necessary to determine 17-ketosteroids, the drug should be discontinued 48 hours before the study. During the treatment period, ethanol intake is not recommended.

Patients with renal failure should consult a doctor before using the drug, as there is a risk of deterioration in the functional state of the kidneys.

Patients with hypertension, including a history of hypertension and/or chronic heart failure, should consult a physician before using the drug, as the drug may cause fluid retention, increased blood pressure, and edema.
In patients with uncontrolled hypertension, NYHA class II-III congestive heart failure, coronary artery disease, peripheral arterial disease and/or cerebrovascular disease, ibuprofen should be prescribed only after a careful benefit-risk assessment, and high doses of ibuprofen should be avoided (> 2400 mg/day).

The use of NSAIDs in patients with chickenpox may be associated with an increased risk of developing severe purulent complications of infectious and inflammatory diseases of the skin and subcutaneous fat (for example, necrotizing fasciitis). In this regard, it is recommended to avoid using the drug for chickenpox.

Information for women planning pregnancy: the drug suppresses cyclooxygenase and prostaglandin synthesis, affects ovulation, disrupting female reproductive function (reversible after discontinuation of treatment).

Influence on the ability to drive vehicles and machinery.
Patients who experience dizziness, drowsiness, lethargy, or blurred vision while taking ibuprofen should avoid driving or operating machinery.

Release form
Film-coated tablets 200 mg.
6, 8, 10 or 12 tablets per blister (PVC / PVDC / aluminum). One blister (6, 8, 10 or 12 tablets each) or two blisters (6, 8, 10 or 12 tablets each) or 3 blisters (10 or 12 tablets each) or 4 blisters (12 tablets each) or 8 blisters (each 12 tablets) together with instructions for use are placed in a cardboard box.

Storage conditions
Store at a temperature not exceeding 25 °C. Keep out of the reach of children.

Best before date
3 years.
Do not use a drug that has expired.

Vacation conditions
Over the counter.

The legal entity in whose name the registration certificate was issued and the manufacturer

Representative in Russia/Organization receiving consumer complaints
Reckitt Benckiser Healthcare LLC
Russia, 115114, Moscow, Shlyuzovaya embankment, 4

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 oxide black (E172) - 24.65%, propylene glycol - 1.3%, isopropanol* - 0.55%, butanol* - 9.75%, ethanol* - 32.275%, purified water* - 3.25%).
* solvents that have evaporated after the printing process.
White or almost white, film-coated tablets, round, biconvex, with a black overprint "Nurofen" on one side. On a cross-section of the tablet, the core is white or almost white, the shell is white or almost white.

pharmachologic effect

Indications for use

Mode of application

Interaction

Side effect

Contraindications

Use during pregnancy and breastfeeding
The use of the drug is contraindicated in the third trimester of pregnancy. You should avoid using the drug in the first and second trimesters of pregnancy; if you need to take the drug, you should consult your doctor.
There is evidence that ibuprofen can pass into breast milk in small quantities without any adverse effects on the health of the nursing infant, so there is usually no need to stop breastfeeding when used for short periods of time. If long-term use of the drug is necessary, you should consult a doctor to decide whether to stop breastfeeding for the period of use of the drug.

Overdose

special instructions

Nurofen is a non-steroidal anti-inflammatory drug with antipyretic, analgesic, and anti-inflammatory effects. It is actively used for conditions accompanied by fever (infectious diseases), pain of various etiologies, and so on. Nurofen Plus is a fairly powerful pain reliever prescribed to adult patients, thanks to the combination of two active ingredients - codeine and ibuprofen. The following describes how to drink Nurofen for adults and children.

There are a number of medicines of this name on sale, which differ in composition and form.

So in pharmacies there are:

• Nurofen for children;
• Nurofen Ultracap;
• Nurofen;
• Nurofen Forte;
• Nurofen Plus.

Regular Nurofen is produced in the form of tablets containing 200 mg of the main component (ibuprofen). In one package, packaging can vary between 6-24 pcs. Adult effervescent tablets contain 200 mg of ibuprofen. There are 10 pcs in one pack.

Nurofen Ultracap is produced in the form of capsules, packaged in 4-10 pieces. The inner part is liquid and contains 200 mg of ibuprofen (the dose for adults is calculated based on personal data). Nurofen Forte is presented in tablets packaged from 6 to 24 pcs. In 1 piece I take 400 mg of ibuprofen.

The manufacturer produces children's Nurofen in the form of a syrup suspension. Vials of medicine have a volume of 50-150 ml; the drug is packaged at the factory in 5 ml portions (8-16 sachets per package). The medicine can also come with a dosing spoon (5 and 2.5 ml) or a dosing syringe. The children's medicine contains ibuprofen 100 mg. Rectal suppositories contain 60 mg of ibuprofen.

Nurofen Plus is packaged in blister packs. The number of tablets varies. The composition contains 10 mg of codeine phosphate and 200 mg of ibuprofen. Nurofen gel (5% concentration) is sold in tubes from 20 to 100 g. 1 g of gel contains 50 mg of ibuprofen.

Action and properties of the drug

The main effects of ibuprofen:

• analgesic;
• antipyretic;
• anti-inflammatory.

The active components help inhibit the synthesis of prostaglandins, which are mediators of heat, inflammation and pain. The duration of the influence of the main substance from the moment of a single use or use of the product lasts approximately 8 hours, which depends on the drugs used in parallel, medications and on the characteristics of a particular organism.

Efficiency of drug forms

Nurofen Ultracap contains the main component in liquid equivalent. The capsules are developed using modern technologies, so ibuprofen enters the body more quickly, beginning to be absorbed and providing the required effect in an accelerated manner. The shape and size make it easier for adults to take the medicine.

Effervescent Nurofen tablets, which must first be dissolved in a certain amount of water, also differ in their speed of action. Taking only the prepared solution promotes faster absorption. This type of medicine is distinguished by its rapid solubility, pleasant taste and speed of absorption into the body.

Children's Nurofen syrup is produced for children. Applicable from 3 months to 12 years. The composition does not contain potential allergens such as dyes or alcohol, which ensures the relative safety of taking the product even by infants. The drug has a pleasant fruity taste, which makes it easier for children to take.

Nurofen gel can only be used topically, that is, externally. Upon completion of application, it immediately begins to act on the source of inflammation, relieving unpleasant symptoms, including pain and swelling. The absorption process is quick and the gel leaves no traces on clothes. Clinical studies have shown high effectiveness in statistics when it is necessary to eliminate back pain in the shortest possible time. There are almost no smells.

Nurofen Plus has a combined composition with an analgesic bias, relieving spasms in a short time from the moment of use of the drug. This increased effectiveness and speed of action is due to the combination of ibuprofen and codeine. The latter belongs to the group of opioid receptor antagonists, being an opium alkaloid. In addition to the analgesic effect, there is also an antitussive effect. Is an ibuprofen booster.

Nurofen tablets and other forms are used as an antipyretic drug:

• influenza and ARVI;
• childhood infections;
• post-vaccination reactions;
• other febrile conditions arising from infectious diseases of various types.

This type of medicine is also used as a pain reliever.

How is an analgesic used for:

• neuralgia;
• arthralgia;
• pain caused by injuries;
• back pain;
• migraine;
• sore throat or ears;
• myalgia;
• toothache;
• algodismenorrhea;
• headache;
• other types of pain.

Nurofen is taken for headaches caused by various reasons: from colds, flu and migraines. The tablet form is used in the treatment of toothache, joint pain, muscle pain, and menstrual pain. The drug actively fights the symptoms of flu and colds.

Effervescent tablets are used for dental pain, headaches, back pain, migraines, periodic pain in women, and so on. This type of remedy helps to quickly relieve fever and symptoms of infectious diseases. Nurofen capsules help with pain of various origins. Forte can eliminate pain in muscles, teeth, and head. The medicine is effective for neuralgia, myalgia, and fever.

When treating children, Nurofen syrup is used. It will not only quickly relieve fever, but will also eliminate pain caused by infection or other reasons. Helps with post-vaccination reactions, during teething, eliminates the main symptoms of flu and colds. It will relieve pain of various types, if it is part of the symptoms of an infectious disease such as ARVI. The suspension (syrup) is effective if used from 3 months to 12 years. The dosage of Nurofen for adolescents is taken as for adults.

Nurofen gel is used topically for pain caused by injuries or degenerative joint and muscle diseases. It relieves not only pain, but also swelling, reducing inflammation in the affected area. The sooner the remedy is used, the sooner the symptoms will be relieved.

When to take Nurofen

For headaches, the dosage of Nurofen for children and adults is according to the instructions or prescription of the doctor. Efficiency is higher if you use the product immediately after the development of the first symptoms. Timely administration helps reduce the duration of pain intensity during migraine. According to clinical studies, a significant reduction in pain during a migraine attack occurs approximately an hour after using the drug.

Algodismenorrhea, which is also called periodic pain in women, is easily relieved with the tablet form of Nurofen. It should be taken until the peak of pain is reached. If it is already strong enough, then it is better to take Nurofen Plus.

Back pain, lumbago, muscle pain, sports injuries, fibrositis, arthritis, rheumatic are treated with Nurofen. The best effect is shown for acute or aching pain. In such cases, the drug brings noticeable relief in a short time, while simultaneously providing an anti-inflammatory effect. Nurofen Plus is used for rheumatic and muscle pain.

Nurofen is taken based on the patient’s age and body weight. For children, the volume of syrup is calculated according to the age table, which is in the instructions and on the packaging of the drug. The adult version involves the use of Nurofen according to the instructions, taking into account the weight. How to take Nurofen is indicated in the instructions, although the attending physician is able, at his own discretion, to adjust the regimen for using the drug.

Children's Nurofen

The dosage of Nurofen for children depends largely not only on the age, but also on the patient’s body weight. Per 1 kg of body weight, about 5-10 mg of the substance is expected. This volume is given 3-4 times a day. But the daily volume should not exceed 30 mg/kg. Before taking the syrup, you need to shake it thoroughly. To calculate the dose, use either a measuring spoon or a special syringe that comes with the medicine.

• six months to a year, 2.5 ml up to 4 times a day (maximum 200 mg per day);
• 1-3 years 5 ml (maximum 300 mg per day);
• 4-6 years, 7.5 ml (no more than 450 mg per day);
• 7-9 years old, 10 ml (no more than 600 mg per day);
• 10-12 years: 15 mg (not more than 900 mg per day).

How often can children over 3 months take the medicine is written in the instructions. Starting from a year, the medication is taken a maximum of 3 times a day, every 7-8 hours. If symptoms appear after immunization, then the dose of Nurofen prescribed in the instructions is given once for up to a year. For children over one year old, the same dosage is assumed (2.5 ml), but it is allowed to take another 2.5 ml if necessary after 6 hours.

The use of suppositories (Nurofen suppositories) is carried out rectally. For fever and pain, patients weighing from 5.5 to 8 kg (approximately 3 to 9 months) use 1 suppository per day three times maximum every 6 hours. Patients weighing from 8 to 12.5 kg (about 9 months) use Nurofen in suppositories 4 times. During postimmunization, 1 suppository is used once for children under one year old and twice every 6 hours for children over one year old. It is necessary to differentiate Nurofen suppositories for adults from children, since the dosage of ibuprofen is different for them.

Important! The drug is used without prescription by a specialist for no longer than 3 days in case of fever, and also for no longer than 5 days as an analgesic. If symptoms continue to persist, it is recommended to consult a doctor for a diagnosis or change of remedy.

Nurofen for adults

Nurofen tablets, capsules and other forms of the drug are prescribed for adults, dividing the daily dose into 4 doses. It is assumed to take 200 mg at a time. The effervescent form should be dissolved in 200 ml of still water. To achieve the effect more quickly, the dose is doubled. For children and adolescents, the daily maximum was 1000 mg. It cannot be exceeded. For adults, the daily maximum was 1200 mg. If symptoms persist for 3 days or there is a clear deterioration, consult a specialist.

Gel Nurofen is prescribed exclusively from 12 years of age. The daily maximum was 50-125 mg, which in volume is expressed as 4-10 cm of medicine squeezed out of the tube. Rub in until absorbed. Re-application is provided no earlier than after 5 hours. The composition is used no more than 4 times per day. If after a month there is no improvement, then use of the drug is discontinued.

Toothache and pain that occurs after surgical intervention can be relieved with any form of medication except for the gel. In addition to the analgesic effect, there is also an anti-inflammatory effect, which, in addition to the feeling of discomfort, reduces swelling. If the patient classifies the pain as very severe, then the dose for adults is not increased, and the medication is changed to Nurofen Plus.

The manifestation of negative reactions during an overdose develops extremely rarely, but if they make themselves felt, you should consult a doctor.

• bradycardia, tachycardia;
• decreased blood pressure, accompanied by noise, ringing in the ears, headaches and even migraines;
• epigastric pain, nausea, which is accompanied by vomiting or retching;
• coma;
• respiratory arrest;
• metabolic acidosis;
• lethargic, drowsy state;
• constriction of the pupil;
• acute renal failure;
• atrial fibrillation.

The last point applies more to Nurofen Plus. In such situations, you need to call an ambulance. Treatment consists of gastric lavage (effective in the first hour after taking an excess dose of the drug), the use of adsorbents such as activated carbon, white carbon, Enteros-gel, Polysorb MP, and so on. The patient is given an alkaline drink. Then treatment is carried out according to the existing symptoms. For shortness of breath, asphyxia and depressed breathing, naloxone is used. An overdose of the gel has not been observed to this day.

Contraindications

Nurofen for adults and children has factors that are contraindications for use that cannot be ignored.

These include:

• hypersensitivity;
• traumatic brain injuries and consequences of such injuries;
• increased intracranial pressure;
• dysfunction of the vestibular apparatus, hearing impairment;
• respiratory failure;
• up to 6 years for tablet form;
• up to 12 for gel, capsules, effervescent tablets and Nurofen Plus;
• up to 3 months for any form of the drug;
• hyperkalemia;
• deficiency of glucose-phosphate dehydrodenase;
• Visual impairment, complex ophthalmological diseases, pathologies;
• allergic reactions caused by taking the medicine;
• gastrointestinal ulcer in the acute phase;
• hemophilia, leukopenia, hypocoagulation;
• active liver disease;
• impaired kidney function;
• severe heart disease;
• heart surgery, bypass surgery;
• chronic constipation;
• lactation period, pregnancy in the 3rd trimester;
• for Nurofen Plus – pregnancy from beginning to end.

The drug is prescribed with caution to people with helicobacteriosis, enteritis, colitis, gastritis, gastrointestinal ulcers, hyperbilirubinemia, diabetes mellitus, polyps on the nasal mucosa, diseases of the liver, heart, blood, kidneys, and severe somatic conditions. Also, intake is limited or reduced to an effective minimum if there have been allergic reactions to the drug such as rhinitis, urticaria, rhinitis, bronchial asthma, and so on. The dosage is limited/reduced for adults with dys- or hyperlipidemia, cerebrovascular diseases, diseases of the peripheral arteries, and thyroid gland.

Take with extreme caution with glucocorticoids, anticoagulants, antiplatelet agents and other similar drugs, as well as if NSAIDs are used for a sufficiently long period. Elderly people use the minimum daily dose of the drug whenever possible. Smoking and frequent consumption of alcoholic beverages while taking medications is not recommended.

Hypersensitivity to ibuprofen or any of the components included in the drug. complete or incomplete combination of bronchial asthma, recurrent nasal polyposis and paranasal sinuses, and intolerance to acetylsalicylic acid or other NSAIDs (including a history). erosive and ulcerative diseases of the gastrointestinal tract (including gastric and duodenal ulcers, 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). a history of bleeding or perforation of a gastrointestinal ulcer caused by the use of NSAIDs. severe liver failure or active liver disease. severe renal failure (Cl creatinine

Use during pregnancy and breastfeeding

The use of the drug is contraindicated in the third trimester of pregnancy. You should avoid using the drug in the first and second trimesters of pregnancy; if you need to take the drug, you should consult your doctor. There is evidence that ibuprofen can pass into breast milk in small quantities without any adverse effects on the health of the nursing infant, so there is usually no need to stop breastfeeding when taken for a short period of time. If long-term use of the drug is necessary, you should consult a doctor to decide whether to stop breastfeeding for the period of use of the drug.

Directions for use and doses

Inside, with water. Patients with hypersensitivity of the stomach are recommended to take the drug with meals. For short term use only. Before taking the drug, you should carefully read the instructions. Adults and children over 12 years of age: 1 tablet orally. (200 mg) up to 3-4 times a day. To achieve a faster therapeutic effect in adults, the dose can be increased to 2 tablets. (400 mg) up to 3 times a day. Children from 6 to 12 years old: 1 tablet. (200 mg) up to 3-4 times a day. The drug can only be taken if the child weighs more than 20 kg. The interval between taking tablets should be at least 6 hours. The maximum daily dose for adults is 1200 mg (6 tablets). The maximum daily dose for children from 6 to 18 years is 800 mg (4 tables). If symptoms persist or worsen after taking the drug for 2-3 days, you should stop 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 required to eliminate symptoms. Elderly people experience an increased incidence of adverse reactions with NSAID use, especially gastrointestinal bleeding and perforation, in some cases fatal. Side effects are predominantly dose-dependent. The following adverse reactions were observed with short-term use of ibuprofen in doses not exceeding 1200 mg/day (Table 6). When treating chronic conditions and long-term use, other adverse reactions may occur. The incidence of adverse reactions was assessed based on the following criteria: very often (≥ .1/10). often (from ≥ .1/100 to

special instructions

The risk of side effects can be minimized if the drug is taken in a short course, at the minimum effective dose required to eliminate symptoms. Elderly people experience an increased incidence of adverse reactions with NSAID use, especially gastrointestinal bleeding and perforation, in some cases fatal. Side effects are predominantly dose-dependent. The following adverse reactions were observed with short-term use of ibuprofen in doses not exceeding 1200 mg/day (Table 6). When treating chronic conditions and long-term use, other adverse reactions may occur. The incidence of adverse reactions was assessed based on the following criteria: very often (≥ .1/10). often (from ≥ .1/100 to

Certificates

pharmachologic effect

A nonspecific anti-inflammatory drug that is produced from phenylpropionic acid. This medicine exhibits pronounced analgesic, antipyretic and anti-inflammatory effects, which are associated with inhibition of prostaglandin synthesis by blocking the cyclooxygenase enzyme.

After ingestion, the drug is quickly absorbed in the digestive system, binds to plasma proteins, after which it slowly penetrates into the joint cavities, into the synovial fluid, where it creates very high concentrations, much higher than in plasma.

Application of Nurofen

Effectively eliminates algia of various localizations and genesis: headache, toothache, migraine, back pain, pain due to algodismenorrhea, neuralgia and myalgia.

Used to reduce body temperature during fever caused by acute respiratory viral infections of various origins.

Side effects of Nurofen

At the beginning of therapy, side effects usually do not appear for 2-3 days. With long-term use of Nurofen, symptoms such as dyspeptic syndrome with nausea, vomiting, heartburn, anorexia, diarrhea, constipation, and flatulence are likely to occur. Erosive and ulcerative lesions of the gastrointestinal tract and bleeding may occur.

CNS and PNS disorders may occur - headache, fatigue or agitation, dizziness, sleep disturbances, depression, hallucinations, confusion. Very rarely, aseptic meningitis can develop in patients with a history of autoimmune diseases.

In patients with cardiovascular disorders, heart failure may occur, but tachycardia and arterial hypertension are most often diagnosed.

Rarely, dysfunction of the sensory organs occurs, which is expressed in the development of reversible toxic optic neuritis, blurred vision, diplopia, dryness or irritation of the eyes. Swelling of the conjunctiva may begin, and hearing may decrease. Nurofen may cause noise and ringing in the ears.

In severe cases, the development of nephrotic syndrome, acute renal failure, cystitis, nephritis or polyuria is likely.

Possible hematopoietic disorders - anemia, thrombocytopenia, leukopenia, thrombocytopenic purpura and agranulocytosis.

The development of allergic reactions begins with skin rash and itching, urticaria, and allergic rhinitis. In severe cases - Quincke's edema up to anaphylactic shock. Sometimes an elevated temperature is recorded, exudative erythema multiforme, toxic epidermal necrolysis occurs, and eosinophilia occurs in the blood.

Patients may complain of heavy breathing, shortness of breath and bronchospasms, and increased sweating.

Contraindications

Not used in the treatment of children under 6 years of age and weighing less than 20 kilograms. It is prohibited to use during the third trimester of pregnancy and during breastfeeding. Contraindication is the presence of hypersensitivity to the drug.

For the following diseases, treatment is not indicated, because: can lead to serious complications:

severe heart failure, severe stage of hypertension;

Nurofen is contraindicated if there are severe renal and liver dysfunctions;

erosive and ulcerative diseases of the gastrointestinal tract in the period of exacerbation: erosive gastritis, peptic ulcer, ulcerative colitis, duodenal and gastric ulcer, Crohn's disease;

bronchial asthma of “aspirin” origin, rhinitis and urticaria caused by taking salicylates, NSAIDs, in particular acetylsalicylic acid;

hemorrhagic diathesis;

scotoma, optic nerve diseases, amblyopia, color vision impairment;

deficiency of glucose-6-phosphate dehydrogenase;

leukopenia;

hemophilia;

hypocoagulation;

hearing impairment, vestibular apparatus functions.

It is prescribed with extreme caution for all diseases of the digestive tract, bleeding, kidney and liver diseases, diseases of the circulatory system of unknown etiology, autoimmune diseases, pregnancy in the 1st and 2nd trimesters, and children aged 6 to 12 years.

special instructions

At the first appearance of side effects, you should immediately contact your doctor to adjust the treatment regimen. If side effects persist for up to 3 days, then it is advisable to discontinue Nurofen.

Before laboratory testing of the level of 17-ketosteroids, the medication is discontinued 2 days before the expected test.

Drinking alcohol is strictly prohibited during treatment.

If treatment is carried out using effervescent tablets, then patients on a hypopotassium diet should take into account that one tablet contains 1530 mg of potassium carbonate.

In addition, the tablets contain 40 mg of sodium saccharinate and 376 mg of sorbitol, which, accordingly, should be taken into account by patients with diabetes mellitus and fructose intolerance.

If the course of treatment involves long-term use, then it is necessary to monitor the clinical picture of the blood, monitor the functioning of the gastrointestinal tract, liver and kidneys. If signs of gastropathy occur, an esophagogastroduodenoscopy, stool test for occult blood and blood test for hemoglobin content are urgently indicated.

Due to the possible development of central nervous system disorders during treatment with Nurofen, you should stop driving vehicles and performing activities that require a lot of attention.

Storage conditions for Nurofen

The medicine should be stored at temperatures up to 25°C, for no more than 3 years.

Is a medicine. A doctor's consultation is required.

Compound

Mode of application

The medicine is used to treat children and adults.

The treatment regimen for patients over 12 years of age (children) and adults involves taking Nurofen orally 3-4 times a day, 1 tablet (200 mg). To quickly achieve a clinical effect on the first day of treatment, start with 400 mg - 3 times a day.

The dosage of the medicine for children 6-12 years old does not exceed 200 mg, no more than 4 times a day. Do not use to treat children whose body weight is less than 20 kilograms.