Instruction for use: Nurofen Express Neo

Active substance Ibuprofen

ATX code M01AE01 Ibuprofen

Pharmacological group

Non-steroidal anti-inflammatory drug (NSAID) [NSAIDs - Propionic acid derivatives]

Nosological classification (ICD-10)

G43 Migraine

The pain of migraine, Migraine, hemiplegic migraine, Migraine headache, A migraine attack, Continuous headache, hemicranias

J06 Acute upper respiratory infections of multiple and unspecified

Frequent colds viral diseases, Infections of the upper respiratory tract, Acute respiratory disease influenza character, for colds Pain, Acute colds,Cold, respiratory infection,Seasonal colds, Pain in infectious and inflammatory diseases of the upper respiratory tract, Bacterial infections of the upper respiratory tract, Bacterial respiratory infections, Viral disease of the respiratory tract, Viral respiratory tract infections, Inflammatory disease of the upper respiratory tract, Inflammation of the upper respiratory tract disease, Inflammation of the upper respiratory tract illness with difficult sputum, Inflammatory airway disease, Secondary infections with colds, Shortness of sputum in acute and chronic respiratory diseases, Upper respiratory tract infection, Infections of the upper respiratory tract, Respiratory Tract Infections, Infections of the respiratory tract and lungs, Infectious-inflammatory diseases of the upper respiratory tract, Infectious-inflammatory diseases of the upper respiratory tract and ENT-organs, Infectious-inflammatory diseases of the upper respiratory tract in children and adults, Infectious-inflammatory diseases of the upper respiratory tract, Infectious inflammation of the airways,respiratory infection, Qatar upper respiratory tract, Catarrh of the upper respiratory tract, Catarrhal disease of the upper respiratory tract, Catarrhal symptoms of the upper respiratory tract, Coughing with a cold, SARS, ARI, ARI with rhinitis phenomena, Acute respiratory infection, Acute infectious and inflammatory disease of the upper respiratory tract, Acute respiratory disease, Sore throat or nose, Respiratory viral infections, Respiratory diseases, Respiratory infections, Recurrent respiratory infections, Secondary infection with influenza, cold in the chest, Feverish condition with flu usitis, acute sinusitis, genyantritis, purulent sinusitis

J11 Influenza, virus not identified

Flu, Influenza in the early stages of the disease, Flu in children, cold in the chest, Begins flu-like condition, Acute disease parainfluenza, parainfluenza, parainfluenza state, influenza epidemics, The pains of the flu, Influenza

K08.8.0 * Painful toothache

Dentinal pain, Dentinal pains, Pain pulpitis, Anesthesia in dentistry, Pain syndromes in dental practice, Pain after removal of tartar, Pain when extracting a tooth, Toothache, Pain after dental interventions

M25.5 Pain in the joint

Arthralgia, Pain syndrome in musculo-articular diseases, Pain syndrome in osteoarthritis, Pain syndrome in osteoarthritis, Pain syndrome in acute inflammatory diseases of the musculoskeletal system, Pain syndrome in chronic inflammatory diseases of the musculoskeletal system, Pain in the joints, Soreness of the joints, Soreness of joints in severe physical exertion, Painful inflammatory joint damage, Painful conditions of the musculoskeletal system, Painful joint conditions, Painful traumatic affection of joints, Pain in the musculoskeletal system, Pain in Shoulder Joints, Pain in the joints, Joint pain, Joint pain with injuries, Musculoskeletal pain, Pain with osteoarthritis, Pain in the pathology of the joints, Pain in rheumatoid arthritis, Pain in chronic degenerative bone diseases, Pain in chronic degenerative joint diseases, Bone-joint pain, Joint pain, Arthritic pain of rheumatic origin, Articular pain syndrome, Joint pain, Rheumatic pain, Rheumatic pains

M35.3 Rheumatic polymyalgia

Pseudoarthritis rhizomelic, Rheumatic polymyalgia, Pain syndrome in rheumatic diseases, Muscle pain with rheumatism, Extra-articular rheumatism, Extra-articular rheumatic syndrome, Extra-articular rheumatic diseases, Extra-articular rheumatic soft tissue injury, Extra-articular forms of rheumatism, Rheumatic soft tissue damage, Rheumatism of soft tissues, Rheumatic diseases of soft tissues, Rheumatic diseases of the periarticular soft tissues, Rheumatic affections of soft tissues, Rheumatic collagen diseases

M54 Dorsalgia

Pain in the back area, Pain in the spine, Back pain, Pain in different parts of the spine, Backache, Painful pain syndrome in the spine, Pain in the musculoskeletal system

M54.5 Pain below the back

Pain in the lower back, Lumbar pain, Lumbalia, Painful conditions of the spinal column, Back pain, Lower Back Pain Syndrome

M79.1 Myalgia

Myofascial pain syndromes ,Pain syndrome in musculo-articular diseases, Pain syndrome in chronic inflammatory diseases of the musculoskeletal system, Pain in the muscles, Tenderness of muscles, Muscular soreness in severe physical exertion, Painful conditions of the musculoskeletal system, Pain in the musculoskeletal system, Pain in the muscles, Pain at rest, Muscle aches, Muscle pain, Musculoskeletal pain, Myalgia, Muscle pain, Muscle pain at rest, Muscle pain, Muscular pain of non-rheumatic origin, Muscle pain of rheumatic origin, Acute muscle pain, Rheumatic pain, Rheumatic pains, Myofascial syndrome, Fibromyalgia

M79.2 Neurology and neuritis, unspecified

Pain syndrome with neuralgia, Brachialgia, Occipital and intercostal neuralgia, Neuralgia, Neuralgic pain, Neuralgia, Neuralgia of intercostal nerves,Neuralgia of the posterior tibial nerve, Neuritis, Neuritis traumatic, Neuritis, Neurological Pain Syndromes, Neurological contractures with spasms, Acute neuritis, Peripheral neuritis,Post-traumatic neuralgia,Severe pain of a neurogenic nature, Chronic neuritis, Essential neuralgia

N94.0 Pain in the middle of the menstrual cycle

Algomenorea, Painful menstruation, Menalgia, Pain in menstruation

N94.6 Dysmenorrhea Unspecified

Pain during menstruation, Functional disorders of the menstrual cycle, Menstrual cramps, Emmeniopathy, Pain during menstruation, Painful menstrual irregularities, algomenorrhea, algomenoreya, Pain smooth muscle spasm, Pain spasm of smooth muscles (renal and biliary colic, intestinal spasms, dysmenorrhea), Pain spasm of smooth muscles of internal organs (kidney and biliary colic, intestinal spasms, dysmenorrhea), Disalgomenoreya, dysmenorrhea, Dysmenorrhea (essential) (Exfoliative), menstrual disorder, menstruation painful, metrorrhagia, Violation of the menstrual cycle, Menstrual irregularities, Prolaktinzavisimoe menstrual disorders, Prolaktinzavisimoe menstrual dysfunction, Pain spasm of smooth muscles of internal organs, Spasmodic dysmenorrhea, Primary disalgomenoreya

R50.0 Fever with chills

High fever, Heat, Chills, elevated temperature, hyperthermia, Prolonged fever, Feverish syndrome, Fervescence, Increased body temperature in infectious and inflammatory diseases, fever Symptoms, febrile syndrome, Febrile state, Fever, Fever in infectious and inflammatory diseases, Fever with SARS, Fever with cold, Fever for colds, febrility, Feverish condition with flu, Feverish state in infectious and inflammatory diseases , Feverish state of infectious diseases and in the postoperative period, Feverish condition for colds, Febrile of different genesis, Feverish syndrome on the background of infectious diseases, Feverish syndrome in infectious and inflammatory diseases, Feverish syndrome with colds, Feverish syndrome of different genesis, Increased temperature for colds, Increased temperature at catarrhal and infectious and inflammatory diseases, Increased body temperature in cold, etc., Increased body temperature in cold and other infectious and inflammatory diseases, Increased body temperature in cold and other infectious and inflammatory diseases, Fever during pregnancy, Fever with thrombocytopenia, Febrile reaction in blood transfusion

R51 Headache

Pain in the head, Cephalgia, Pain with sinusitis, Pain in the back of the head, Painful headache, Headache of vasomotor genesis, Headache of vasomotor origin, Headache with vasomotor disorders, Headache, Neurological headache, Serial headache

R52.9 Unspecified Pain

Pain after cholecystectomy, Pain shooting, Non-malignant pain, Obstetric and gynecological pain, Pain syndrome, Pain in the postoperative period, Pain in the postoperative period after orthopedic surgery, Pain of inflammatory genesis, Pain than cancer genesis, Pain syndrome after diagnostic procedures, Pain after surgery Diagnostic, Pain after surgery, Pain after orthopedic surgery, Pain after injuries, Pain after the removal of hemorrhoids, Pain at the non-rheumatic inflammation of nature, Pain in inflammatory lesions of the peripheral nervous system, Pain in diabetic neuropathy, Pain in acute inflammatory diseases of the musculoskeletal system, Pain when the tendon pathology, Pain smooth muscle spasm, Pain spasm of smooth muscles (renal and biliary colic, intestinal spasms, dysmenorrhea), Pain spasm of smooth muscles of internal organs, Pain spasm of smooth muscles of internal organs (kidney and biliary colic, intestinal spasms, dysmenorrhea), Pain in trauma syndrome, Pain with injuries and after surgical interventions, Pain in chronic inflammatory diseases of the musculoskeletal system, Pain with duodenal ulcer, Pain syndrome in gastric ulcer, Pain syndrome in gastric ulcer and duodenal ulcer, pain, Pain during menstruation, pain syndromes, painful condition, Painful foot fatigue, Sore gums when wearing dentures, Soreness of the cranial nerves exit points, Painful menstrual irregularities, Painful dressings, Painful muscle spasm, Painful teeth growth, Melosalgia, Pain in the area of the surgical wound, Pain in the postoperative period, Pain in the body, Pain after diagnostic procedures, Pain after orthopedic surgery, Pain after surgery, The pains of the flu, Pain in diabetic polyneuropathy, Pain for burns, Pain during sexual intercourse, Pain during diagnostic procedures, Pain during therapeutic procedures, for colds Pain, Pain in sinusitis, Pain in trauma, Pain traumatic, The pain in the postoperative period, Pain after diagnostic procedures, The pain after sclerotherapy, Pain after surgery, postoperative Pain, Pain postoperative and posttraumatic, posttraumatic pain, Pain when swallowing, Pain in infectious and inflammatory diseases of the upper respiratory tract, The pain of burns, The pain in traumatic muscle injury, Pain in trauma, The pain of tooth extraction, The pain of traumatic origin, Pain caused by spasm of smooth muscles, Expressed pain syndrome, Expressed pain syndrome, traumatic origin, Postoperative pain, Post-traumatic pain, Post-traumatic pain syndrome, Torpid pain, Traumatic pain, Traumatic pain, Mild pain, Moderately severe pain, Moderate pain, Polyarthralgia with polymyositis

Composition

Tablets, coated with a coating.

active substance:

ibuprofen sodium dihydrate 256 mg

(equivalent to ibuprofen 200 mg)

auxiliary substances: croscarmellose sodium - 30 mg; xylitol - 30 mg; MCC - 30 mg; magnesium stearate - 8 mg; silicon dioxide colloidal - 2 mg

sheath: carmellose sodium - 0.5 mg; talc - 24 mg; acacia gum - 0,8 mg; sucrose - 93.1 mg; titanium dioxide (E171) - 1.65 mg; macrogol 6000 - 0.25 mg; black ink (Opakod 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%, water * - 3.25%)

* Solvents evaporated after the printing process

Description of dosage form

Round biconvex tablets covered with a white sheath, with a black "N" overprint on one side of the tablet.

pharmachologic effect

Pharmacological action - anti-inflammatory, antipyretic, analgesic.

Pharmacodynamics

The mechanism of action of ibuprofen, a derivative of propionic acid from the group of NSAIDs, is due to inhibition of the synthesis of PG mediators of pain, inflammation and hyperthermia. Non-selectively blocks COX-1 and COX-2, which inhibits the synthesis of PG. Has a quick directional action against pain (analgesic), antipyretic and anti-inflammatory action. In addition, ibuprofen reversibly inhibits platelet aggregation.

Pharmacokinetics

Absorption is high, quickly and almost completely absorbed from the digestive tract. After taking 2 tablets. of the drug on an empty stomach ibuprofen is detected in blood plasma after 15 minutes, Cmax ibuprofen in blood plasma is reached after 30-35 minutes, which is twice as fast as after taking an equivalent dose of Nurofen®, in the form of a tablet coated with a coating, 200 mg. Taking the drug with food can increase Tmax. The connection with blood plasma proteins is more than 90%, T1 / 2 - 2 hours Slowly penetrates into the joint cavity, is retained in the synovial fluid, creating in it greater concentrations than in the blood plasma. After absorption, about 60% of the pharmacologically inactive R-form is slowly transformed into an active S-form. It is metabolized in the liver. It is excreted by the kidneys (in an unchanged form not more than 1%) and to a lesser extent with bile.

In the elderly, there were no significant differences in the pharmacokinetic profile of the drug compared to younger people.

In limited studies, ibuprofen was found in breast milk in very low concentrations.

Indications

headache;

migraine;

toothache;

painful menstruation;

neuralgia;

back pain, muscle, rheumatic pain, joint pain;

feverish conditions with influenza and colds.

Contraindications

hypersensitivity to ibuprofen or any of the components included in the formulation;

complete or incomplete combination of bronchial asthma, recurrent nasal polyposis and paranasal sinuses and intolerance to acetylsalicylic acid or other NSAIDs (including in anamnesis);

erosive and ulcerative diseases of the digestive tract in the stage of exacerbation (including peptic ulcer of stomach and duodenal ulcer, Crohn's disease, ulcerative colitis) or ulcerative bleeding in the active phase or anamnesis (two or more confirmed episodes of peptic ulcer or ulcer bleeding);

bleeding or perforation of a gastrointestinal ulcer in an anamnesis, provoked by NSAID application;

renal failure of severe degree (Cl creatinine <30 ml / min), confirmed hyperkalemia;

Decompensated heart failure; period after aortocoronary shunting;

cerebrovascular or other bleeding;

intolerance to fructose, glucose-galactose malabsorption, insufficiency of sucrose-isomaltase;

hemophilia and other disorders of blood clotting (including hypocoagulation), hemorrhagic diathesis;

pregnancy (III trimester);

children under 12 years.

With caution: in the presence of conditions specified in this section, before using the drug should consult a doctor - the simultaneous intake of other NSAIDs; presence in the anamnesis of a single episode of peptic ulcer of stomach or ulcerous bleeding of the gastrointestinal tract; gastritis, enteritis, colitis, the presence of Helicobacter pylori infection, ulcerative colitis; A bronchial asthma or allergic diseases in a stage of an exacerbation or in the anamnesis - development of a bronchospasm is possible; systemic lupus erythematosus or mixed connective tissue disease (Sharpe's syndrome) increased risk of aseptic meningitis; renal failure, incl. when dehydrated (Cl creatinine less than 30-60 ml / min); nephrotic syndrome; liver failure; cirrhosis of the liver with portal hypertension; hyperbilirubinemia; arterial hypertension and / or heart failure; cerebrovascular diseases; blood diseases of unclear etiology (leukopenia and anemia); severe physical illness; dyslipidemia / hyperlipidemia; diabetes; diseases of peripheral arteries; smoking; frequent use of alcohol; phenylketonuria or intolerance to phenylalanine; concurrent use of drugs that may increase the risk of ulcers or bleeding, in particular oral GCS (including prednisolone), anticoagulants (including warfarin), SSRIs (including citalopram, fluoxetine, paroxetine, sertraline ) or antiplatelet agents (including acetylsalicylic acid, clopidogrel); pregnancy, I-II trimester; the period of breastfeeding; elderly age.

pregnancy and lactation

Contraindicated use of the drug in the III trimester of pregnancy. You should avoid the use of the drug in the I-II trimesters of pregnancy, if necessary, you should consult a doctor.

There is evidence that ibuprofen in small amounts can penetrate into breast milk without any negative consequences for the health of the infant, so it usually does not occur with short-term admission of the need to stop breastfeeding. If it is necessary to take the drug for a long time, you should consult a doctor to resolve the issue of stopping breastfeeding for the period of drug use.

Side effects

The risk of side effects can be minimized if you take the drug with a short course, at the lowest effective dose needed to eliminate the symptoms.

In elderly people, there is an increased incidence of adverse reactions when NSAIDs are used, especially gastrointestinal bleeding and perforations, in some cases fatal. Side effects are predominantly dose-dependent. In particular, the risk of developing gastrointestinal bleeding depends on the range of doses and duration of treatment.

The following adverse reactions were noted with a short-term intake of ibuprofen in doses not exceeding 1200 mg / day (3 tablets). In the treatment of chronic conditions and prolonged use, other side reactions may occur.

The frequency of occurrence of adverse reactions was estimated on the basis of the following criteria; very often (≥1 / 10); often (from ≥1 / 100 to <1/10); infrequently (from ≥1 / 1000 to <1/100); rarely (from ≥1 / 10000 to <1/1000); very rarely (<1/10000); frequency is unknown (there is no data on frequency estimation).

On the part of the blood and lymphatic system: very rarely - hemopoiesis disorders (anemia, leukopenia, aplastic anemia, hemolytic anemia, thrombocytopenia, pancytopenia, agranulocytosis). The first symptoms of such disorders are fever, sore throat, superficial ulcers in the mouth, flu-like symptoms, severe weakness, nosebleeds and subcutaneous hemorrhages, bleeding and bruising of unknown etiology.

From the side of the immune system: infrequently - hypersensitivity reactions - nonspecific allergic reactions and anaphylactic reactions, respiratory tract reactions (bronchial asthma, including its aggravation, bronchospasm, dyspnea, 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 rarely - severe hypersensitivity reactions, incl. swelling of the face, tongue and larynx, dyspnea, tachycardia, arterial hypotension (anaphylaxis, Quincke's edema or severe anaphylactic shock).

From the gastrointestinal tract: infrequently - abdominal pain, nausea, dyspepsia (including heartburn, bloating); rarely - diarrhea, flatulence, constipation, vomiting; very rarely - peptic ulcer, perforation or gastrointestinal bleeding, melena, bloody vomiting, in some cases fatal, especially in elderly patients, ulcerative stomatitis, gastritis; frequency unknown - exacerbation of colitis and Crohn's disease.

From the liver and bile ducts: very rarely - violations of the liver, increased activity of hepatic transaminases, hepatitis and jaundice.

On the part of the kidneys and urinary tracts: very rarely - acute renal failure (compensated and decompensated), especially with prolonged use, in combination with increased urea concentration in the blood plasma and the appearance of edema, hematuria and proteinuria, nephritic syndrome, nephrotic syndrome, papillary necrosis, interstitial nephritis, cystitis.

From the nervous system: infrequently - a headache; very rarely - aseptic meningitis.

On the part of the CAS: the frequency is unknown - heart failure, peripheral edema, with prolonged use increased risk of thrombotic complications (eg myocardial infarction), increased blood pressure.

On the part of the respiratory system and mediastinal organs: the frequency is unknown - bronchial asthma, bronchospasm, dyspnea.

Laboratory parameters: hematocrit or Hb (may decrease); bleeding time (may increase); the concentration of glucose in the blood plasma (may decrease); clearance of creatinine (may decrease); plasma concentration of creatinine (may increase); activity of hepatic transaminases (may increase).

If side effects occur, stop taking the medication and consult a doctor.

Interaction

The simultaneous use of ibuprofen with the following drugs should be avoided

Acetylsalicylic acid: with the exception of low doses of acetylsalicylic acid (not more than 75 mg / day) prescribed by the doctor, as joint application may increase the risk of side effects. With simultaneous use, ibuprofen reduces the anti-inflammatory and antiplatelet effect of acetylsalicylic acid (possibly an increase in the incidence of acute coronary insufficiency in patients receiving small doses of acetylsalicylic acid as an antiplatelet agent after taking ibuprofen).

Other NSAIDs, in particular selective COX-2 inhibitors: simultaneous use of two or more drugs from the NSAID group should be avoided because of the possible increase in the risk of side effects.

Use with caution at the same time as the following drugs

Anticoagulants and thrombolytic drugs: NSAIDs can enhance the effect of anticoagulants, in particular warfarin and thrombolytic drugs.

Antihypertensives (ACE inhibitors and ARA II) and diuretics: NSAIDs may reduce the effectiveness of the drugs of these groups. In some patients with impaired renal function (eg in patients with dehydration or elderly patients with impaired renal function) concomitant administration of ACE inhibitors or ARA II inhibitors and COX-inhibiting agents can lead to impaired 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 ARA II. In this regard, the joint use of the above-mentioned remedies should be administered with caution, especially for the elderly. It is necessary to prevent dehydration in patients, and also to consider the possibility of monitoring renal function after the beginning of such combined treatment and periodically - in the future.

Diuretics and ACE inhibitors: may increase the nephrotoxicity of NSAIDs.

SCS: increased risk of gastrointestinal ulcers and gastrointestinal bleeding.

Antiaggregants and SSRIs: an increased risk of gastrointestinal bleeding.

Cardiac glycosides: simultaneous administration of NSAIDs and cardiac glycosides may lead to worsening of heart failure, a decrease in glomerular filtration rate and an increase in the concentration of cardiac glycosides in blood plasma.

Lithium preparations: there are data on the probability of an increase in the concentration of lithium in blood plasma against the background of NSAIDs.

Methotrexate: There are data on the probability of increasing the concentration of methotrexate in the blood plasma against the background 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, because NSAIDs may reduce the effectiveness of mifepristone.

Tacrolimus: with simultaneous administration of NSAIDs and tacrolimus, an increased risk of nephrotoxicity may occur.

Zidovudine: simultaneous use of NSAIDs and zidovudine may lead to an increase in hematotoxicity. There is evidence of an increased risk of hemarthrosis and hematoma in HIV-positive patients with hemophilia who received co-treatment with zidovudine and ibuprofen.

Antibiotics of the quinolone series: in patients receiving co-treatment with NSAIDs and quinolone antibiotics, an increased risk of seizures is possible.

Myelotoxic drugs: increased hematotoxicity.

Cefamandol, cefoperazone, cefotetan, valproic acid, plikamycin: an increase in the frequency of hypoprothrombinemia.

Drugs that block tubular secretion: reduced elimination and increased plasma concentrations of ibuprofen.

Inductors of microsomal oxidation (phenytoin, ethanol, barbiturates, rifampicin, phenylbutazone, tricyclic antidepressants): increase in the production of hydroxylated active metabolites, increased risk of severe intoxication.

Inhibitors of microsomal oxidation: a reduction in the risk of hepatotoxic action.

Oral hypoglycemic drugs and insulin, derivatives of sulfonylureas: enhancing the effect of drugs.

Antacids and colostiramia: decreased absorption.

Urikozuricheskie drugs: a decrease in the effectiveness of drugs.

Caffeine: increased analgesic effect.

Dosing and Administration

Inside, after eating. Read the instructions carefully before taking the drug. Only for short-term use.

Adults and children over 12 years of age - 1 table. (200 mg) 3-4 times a day.

Tablets should be washed down with water. The interval between doses of the drug should be at least 4 hours.

To achieve a more rapid therapeutic effect in adults, the dose can be increased to 2 tablets. (400 mg) up to 3 times a day.

Do not take more than 6 tablets. for 24 hours. The maximum daily dose is 1200 mg.

The maximum daily dose for children 12-17 years is 1000 mg. If the symptoms persist or worsen during 2-3 days, stop treatment and consult a doctor. If you need to take the drug for more than 10 days, you need to see a doctor.

Overdose

In children, overdose symptoms may occur after taking a dose exceeding 400 mg / kg. In adults, the dose-dependent effect of an overdose is less pronounced. T1 / 2 of the drug with an overdose is 1.5-3 hours.

Symptoms: nausea, vomiting, pain in the epigastric region or less often - diarrhea, tinnitus, headache and gastrointestinal bleeding. In more severe cases, there are manifestations from the side of the central nervous system: drowsiness, rarely - excitation, convulsions, disorientation, coma. In cases of severe poisoning, metabolic acidosis and increased PV, renal failure, damage to liver tissue, decreased blood pressure, respiratory depression and cyanosis may develop. Patients with bronchial asthma may exacerbate this disease.

Treatment: symptomatic, with mandatory provision of airway patency, monitoring of ECG and basic indicators of vital activity, up to the normalization of the patient's condition. Recommended oral administration of activated charcoal or gastric lavage for 1 hour after taking a potentially toxic dose of ibuprofen. If ibuprofen has already been absorbed, an alkaline drink may be prescribed to excrete the acid derivative ibuprofen by the kidneys, forced diuresis. Frequent or prolonged seizures should be quenched in / in the administration of diazepam or lorazepam. When bronchial asthma worsens, the use of bronchodilators is recommended.

special instructions

It is recommended to take the drug as short a course as possible and at the minimum effective dose necessary to eliminate symptoms. In patients with bronchial asthma or allergic disease in the acute stage, as well as in patients with an anamnesis of bronchial asthma / allergic disease, the drug can provoke bronchospasm.

The use of the drug in patients with systemic lupus erythematosus or a mixed disease of connective tissue is associated with an increased risk of developing aseptic meningitis.

During long-term treatment, control of the peripheral blood picture and the functional state of the liver and kidneys is necessary. When symptoms of gastropathy appear, careful monitoring including esophagogastroduodenoscopy, a general blood test (Hb determination), and a fecal occult blood test are shown. If it is necessary to determine 17-ketosteroids, the drug should be discontinued 48 hours before the test.

During the period of treatment, ethanol is not recommended.

Patients with renal insufficiency should consult with a doctor before using the drug, since there is a risk of impairment of the functional state of the kidneys.

Patients with hypertension, incl. in an anamnesis, and / or CHF, it is necessary to consult a doctor before using the drug, since the drug can cause fluid retention, increased blood pressure and swelling.

Information for women planning pregnancy: these drugs suppress COX and GH synthesis, affect ovulation, disrupting female reproductive function (reversible after withdrawal of treatment).

Influence on the ability to drive vehicles, mechanisms. Patients who report dizziness, drowsiness, blockage, or visual impairment when taking ibuprofen should avoid driving motor vehicles or controlling mechanisms.

Form of issue

The tablets covered with a cover, 200 mg. By 6 or 12 tables. in the blister (PVC / PVDC / aluminum). For 1 or 2 bl. (6 or 12 tables) are placed in a cardboard box.

Conditions of leave from pharmacies

Without recipe.

storage conditions

In a dry place, at a temperature of no higher than 25 ° C.

Keep out of the reach of children.

Shelf life Nurofen

2 years.

Do not use after the expiry date printed on the package.