Nurofen overdose in a child and an adult - symptoms, consequences, side effects. Nurofen instructions for use, contraindications, side effects, reviews Can the liver increase from taking nurofen

Nurofen is an analgesic and anti-inflammatory drug, especially used to reduce high temperatures in children. Available in various forms: tablets, including effervescent, capsules, suspension, suppositories. The use of the drug according to the instructions eliminates the possibility of overdose and intoxication.

Application of the drug

Nurofen is a registered trademark owned by pharmacological drug from the group of non-hormonal non-steroidal anti-inflammatory drugs (NSAIDs). It has a strong analgesic and anti-inflammatory effect.

The active substance, ibuprofen, is a derivative of propionic acid. It inhibits the formation and development of substances that cause inflammation in the body, and, according to some studies, stimulates the production of its own interferons. Begins to act within 10 minutes after ingestion. Pain relief lasts up to 8 hours .

Indications for use:

• temperature for colds and infectious diseases;
• toothache;
• menstrual pain;
• pain in muscles, bones and joints, arthritis, sciatica, rheumatism;
• migraine;
• gout;
• ankylosing spondylitis;
• pain in malignant tumors.
• others inflammatory processes various etiologies.

Side effects of Nurofen

With prolonged (more than 10 days) administration, a manifestation is possible side effects. These include:

• Digestive system: nausea, vomiting, anorexia, heartburn, flatulence, diarrhea (diarrhea) or constipation, discomfort in the gastrointestinal tract, dryness and discomfort in the mouth, stomatitis, pancreatitis, in especially severe cases - hepatitis.
• Nervous system: headache, insomnia or, conversely, drowsiness, dizziness, depression, agitation, confusion, hallucinations.
• Sense organs: reversible ocular neuritis optic nerve, loss of clarity of vision, feeling of dryness in the eyes, swelling of the eyelids; hearing loss, noise or ringing in the ears.
• Cardiovascular system: tachycardia, arrhythmia, increased pressure.
• Genitourinary system: nephritis, acute renal failure, polyuria cystitis.
• Hematopoietic system: anemia, thromboembolism, agranulocytosis, leukopenia.
• Allergic reactions: itching, urticaria, rash, angioedema, possible anaphylactic shock, fever, epidermal necrolysis (Lyell's syndrome), allergic rhinitis, eosinophelia.
• Respiratory organs: spasm in the bronchi, shortness of breath.

Causes of poisoning

Maximum daily dose for an adult - 1.6-2.4 g. Children can be given no more than 30 mg of Nurofen per 1 kg of body weight per day. It should be noted that it is quite difficult to get an overdose: for this you need to drink an amount of the drug that exceeds the norm several times. For an adult, this figure will be from 5-7 g, depending on body weight, for a child, 150 mg / kg is enough.

It is necessary to take the remedy strictly according to the instructions.

In addition to exceeding the dosage, the cause of intoxication can be the use of an expired drug or the presence of certain contraindications, including:

• stomach ulcer and duodenum;
• ulcerative colitis;
• heart failure;
• hypertension;
• children's age up to 6 years;
• pregnancy (starting from the third trimester);
• hypersensitivity to ibuprofen and other components of the drug.

Signs of an overdose

Overdose and poisoning is manifested by the following symptoms:

• abdominal pain, nausea and vomiting;
• decline blood pressure;
• drowsiness, lethargy;
• nystagmus, doubling of objects in the eyes;
• headache;
• violation of the heart rhythm (tachycardia, arrhythmia, bradycardia);
• spasm of masticatory muscles;
• depression.

Signs of an overdose in severe form:

• drop in blood pH (metabolic acidosis);
• acute form of renal failure;
• atrial fibrillation;
• in especially severe cases - coma, respiratory arrest and death are possible.

When the first signs of poisoning appear, especially in a child, a pregnant woman or an elderly person, it is necessary to urgently consult a doctor. Self-medication in this case is deadly.

Treatment and recovery after intoxication

In case of poisoning, before the arrival of specialists, it is necessary to provide the patient with first aid, which consists of the following actions:

1. Gastric lavage. This procedure should be carried out if no more than 1 hour has passed since the moment of poisoning. A few grains of potassium permanganate must be dissolved in a liter of water until a slightly pink hue is obtained. Give the victim to drink the resulting liquid, and then provoke vomiting. Repeat several times. This treatment is not suitable for children under 4 years of age. To wash the stomach, the child should be taken to the hospital.
2. Reception of an adsorbent. The adsorbent absorbs the drug that has entered the intestine, preventing its penetration into the blood and distribution along with it throughout the body. The patient can take Enterol, Enterosgel, activated carbon, Smecta or any other similar sorbent.
3. Drinking large amounts of liquid. In case of drug poisoning, doctors advise drinking a lot to minimize the drug content in the blood. It is best to solder the patient with plain water mixed with a pinch of salt, or mineral water with a high alkali content (without gas).

Health care

1. In a hospital, a patient with an overdose of Nurofen is prescribed droppers with glucose, sodium bicarbonate and electrolytic fluid.
2. At the same time, diuretics are prescribed to speed up the elimination of the toxic substance.
3. In case of breathing problems, an artificial lung ventilation apparatus is connected; in case of heart problems, special antiarrhythmic drugs are administered intravenously.

There is no specific antidote specifically for Nurofen.

To recover from poisoning, you should follow a special diet consisting of vegetables, fruits, cereals and dairy products.

Why Nurofen is dangerous - the consequences of long-term use of the drug

Nurofen, like any medicine, should be taken exclusively according to the instructions, which clearly spell out the maximum terms of admission. Otherwise, it can cause significant harm to health. The main complications arising from long-term use of the drug:

1. Erosion of the stomach and duodenum. It is especially dangerous for the health of children: as a result of disruption of the gastrointestinal tract, the child's body will not absorb useful material necessary for his proper development and growth. This will inevitably lead to chronic diseases and weakening of the immune system.
2. Destruction of hepatocytes (liver cells) and the development of chronic hepatitis. The most dangerous thing in this situation is the risk of toxic hepatitis, which is incurable at its last stage.
3. Inflammatory diseases of the kidneys blood vessels and renal tissue, nephritis.
4. Chronical bronchitis.
5. Allergic reactions.

Particular attention should be paid to the drug subcategory Nurofen plus. The active ingredient in its composition, in addition to ibuprofen, is codeine. It is an analgesic with antitussive, analgesic and mild narcotic effect. With prolonged use, addiction develops akin to drug habits.

Measures to prevent poisoning

You can avoid intoxication of the body if you follow the appropriate preventive measures:

• precisely observe the dosage, especially in children - depending on body weight;
• immediately dispose of expired products;
• do not take the drug with broken packaging, as open air harms it;
• be sure to remove the medicine out of the reach of the child. Nurofen syrup is sweet, the packaging is bright and attractive, which can attract children's attention;
• to exclude damage to the gastrointestinal tract, if possible, use Nurofen for children in candles.

Instructions for use:

Nurofen - medicinal product belonging to the group of non-steroidal anti-inflammatory drugs (NSAIDs).

Pharmacological action of Nurofen

The active ingredient in Nurofen is ibuprofen, a derivative of phenylpropionic acid. When taken orally, it inhibits the formation of prostaglandins - substances that cause an inflammatory reaction in the human body (the so-called inflammatory mediators), due to which an anti-inflammatory, analgesic and antipyretic effect occurs.

There are reviews about Nurofen by researchers, indicating that it stimulates the production of the body's own interferon, a substance that is one of the main factors of immunity. Thus, one of the additional actions of ibuprofen is the stimulation of immunity, which makes the use of Nurofen justified in the treatment of viral infections.

Release form

Nurofen is available in the form of sugar-coated tablets, effervescent tablets, rectal suppositories and suspension for children with strawberry or orange flavor.

Composition of Nurofen tablets: each coated tablet contains 200 mg of ibuprofen and excipients: sucrose, talc, silicon dioxide, titanium dioxide, stearic acid, opacode, gum, croscarmellose sodium, sodium lauryl sulfate, sodium citrate, macrogol 6000.

Tablets are issued on 6 and 12 pieces in the blister.

The composition of Nurofen in effervescent tablets: 200 mg of ibuprofen and excipients: sucrose, saccharin, sorbitol, potassium carbonate, citric acid, sodium saccharin.

Effervescent tablets available in tubes of 10 pcs.

The composition of Nurofen in the form of a suspension: contains 100 mg of ibuprofen per 5 ml of suspension, as well as excipients: water, glycerol, maltitol syrup, citric acid, sodium citrate, sodium chloride, sodium saccharinate, gum, domifen bromide, strawberry or orange flavor.

Rectal suppositories Nurofen, composition: ibuprofen 60mg, excipient - solid fat. Available in blister packs of 5, 2 blisters per pack.

Nurofen suspension is available in 100 ml polyethylene bottles, equipped with a child protection mechanism, the kit includes a special dispenser with which the suspension is removed from the bottle.

Nurofen's analogs

Nurofen analogues are non-steroidal anti-inflammatory drugs, active substance which ibuprofen serves: Advil, Apo-Ibuprofen, Bartel drags ibuprofen, Bolinet lingval, Bonifen, Bren, Brufen, Burana, Dolgit, Ibupron, Ibuprofen, Ibuprofen, Ibuprofen Lannacher, Ibuprofen Nycomed, Ibuprofen-Teva, Ibuprofon, Ibusan, Ipren, Markofen , MIG 200, Motrin, MIG 200, Profen, Profinal, Reumafen, Solpaflex.

Indications for use

The use of Nurofen is indicated in the treatment of diseases of a rheumatic nature, as well as to relieve inflammation, fever and pain. Used in the composition complex therapy for the treatment of the following conditions:

• Rheumatoid arthritis;
• Rheumatism;
• Spondylitis and spondylitis, including ankylosing;
• Osteoarthritis;
• Gout;
• Bursitis;
• Myositis;
• Radiculitis;
• Neuritis;
• neuralgia;
• Myalgia;
• Intensive pain syndrome with injuries of any origin and post-traumatic conditions;
• Algodysmenorrhea;
• Toothache;
• Headache;
• seasonal viral infectious diseases accompanied by general malaise, fever and aching muscles and joints;
• Diseases of ENT organs and others inflammatory diseases accompanied by intense pain.

According to reviews, Nurofen in pediatric practice is effective as an antipyretic for colds and fever caused by teething.

Instructions for use Nurofen

The use of Nurofen depends on the age of the patient.

The daily dose of the drug for persons over 12 years of age is 1200 mg. It is desirable to divide the daily dose into 3-4 doses, usually 200 mg per dose (less as possible), in case of urgent need and with the consent of the doctor, a single dose at the beginning of therapy can be increased to 400 mg.

According to the instructions, Nurofen is prescribed for children aged 6 to 12 years at a dosage of not more than 200 mg 3-4 times a day. Between doses of the drug requires a time interval of at least 6 hours. The maximum allowable daily dose is 900 mg.

Following Nurofen's instructions, it is advisable to take sugar-coated tablets after meals with plenty of water. Effervescent tablets are dissolved in a glass of water with a volume of 200-250 ml.

Nurofen in suppositories is available for children aged 3 months to 2 years, a single dose is set at the rate of 5-10 mg per 1 kg of the child's weight, taken 3-4 times a day. The maximum allowable daily dose is determined at the rate of 30 mg per 1 kg of the child's weight.

According to the instructions, Nurofen in suspension is recommended in the following dosage:

• From 3 to 6 months - 2.5 ml up to 3 times a day;
• From 6 to 12 months - 2.5 ml 3-4 times a day;
• From 1 to 3 years - 5 ml 3 times a day;
• From 4 to 6 years - 7.5 ml 3-4 times a day;
• From 7 to 9 years - 10 ml 3 times a day;
• From 10 to 12 years - 15 ml 3 times a day.

The Nurofen instructions contain an indication of the inadmissibility of self-use of the drug for treatment lasting more than 3 days. If after 3 days after the start of the use of Nurofen the symptoms of the disease have not decreased, you should call a doctor who will give recommendations regarding the further use of the drug.

Fedor Katasonov

GMS Pediatrician I hate to repeat what other respected doctors have already written so many times, but the principle of writing posts for Pediatrics is simple: I answer the request. If the number of identical questions (gaps in the knowledge of parents) exceeds a critical mass, this gives rise to a post. Therefore - a post about fever. Pardon his banality. Please save it somewhere and remember next time before asking me one of these questions.

How to measure temperature?

I prefer a contact electronic thermometer, which is placed under the arm. After he squeaks, he must be held for another 3-4 minutes, but few people know about this, because they do not read the instructions. After that, the readings will be approximately equal to those on the standard - a mercury thermometer. Non-contact thermometers and measurement in the mouth and in anus I do not recommend.

Why measure temperature?

The measurement is primarily of diagnostic value. We have a slightly different approach to conditions where the temperature is above or below the conditional limit of 38 degrees Celsius. Since most fevers in our latitudes go away on their own within 3 days, in the absence of threatening symptoms, I recommend observation within 72 hours after the first rise in temperature above 38. If after this period it again rises above 38, a doctor's examination is necessary to decide whether whether it is a protracted virus (and we continue to observe) or more aggressive intervention is required. Thus, we measure the temperature to determine the tactics of treatment, but not to resolve the issue of fever.

How do you decide if you need to lower the temperature?

The answer is simple, regardless of the cause of the temperature. It doesn't matter if it's due to an infection or a post-vaccination reaction or teething or other causes. We lower the temperature when the child is unwell. There is nothing so useful in a rise in temperature that it is tolerated, and nothing so harmful that it is necessary to take medicine when feeling normal. Therefore, when solving the issue of fever reduction, we look not at the thermometer, but at the child. If he is unwell, he is breathing heavily, lethargic, his muscles or his head hurt - you even lower 37.8. But if you can't catch up with a 38.8 kid to give him medicine, then there's no need for it.

How to lower the temperature?

Since only parents of small children ask this question, I will not write about drugs for older children. Toddlers have only three home remedies to lower their temperature: the physical method, paracetamol (acetaminophen), and ibuprofen.

If the child’s arms and legs are warm, they should be undressed, hung with wet towels, wiped with water at room temperature, wrapped in a wet handkerchief, or even put in a cool shower. To give or not to give at the same time the medicine is your choice, you have the right to give and wait. (You can also give the medicine and not use the physical method.) Depends on the level of your panic and the behavior of the child. Small children cool themselves perfectly, sometimes it is enough just to free them from clothes.

If the hands and feet are cold - a vasospasm has begun - the physical method is not recommended, and only medicines remain here.

What form of the drug to use?

It's not very important. Syrups with paracetamol (Panadol, Calpol, Tylenol, etc.) or ibuprofen (Nurofen, Advil) are easier to dose. Suppositories (Panadol, Efferalgan, Cefecon with paracetamol or Nurofen with ibuprofen) are good when the child cannot drink the syrup (vomiting, allergy to supplements). It seems to me that it is enough to have paracetamol suppositories at home for low temperatures (up to 39) and Nurofen syrup for more pronounced fevers.

How to dose them?

The easiest way to dose Nurofen: syrup dose (ml) = ½ weight (kg). This is based on a single dose of 10 mg/kg. On the box of Nurofen, however, some nonsense is written about the dosage by age. This is dangerous because children of the same age weigh very differently. Properly dose drugs by weight or body surface area, but not by age. Such a single dose of Nurofen can be given no more than once every 4 hours, but preferably no more than 3 times a day. Paracetamol is dosed at 15 mg/kg, but the instructions for paracetamol preparations are more adequate than for Nurofen. It is quite possible to navigate them. If you dose the most popular syrup - Panadol - you can multiply the child's weight in kg by 0.625. This will give you the amount of ml of syrup for a single dose. The intervals and multiplicity are the same as for Nurofen.

What to do if an hour has passed and the temperature does not drop?

First, evaluate your well-being. If it has improved, the numbers are not important to us. Secondly, even if the temperature has not decreased, the spasm must have gone away, and a physical cooling method can be connected. Thirdly, if the need for antipyretics still remains, 1.5-2 hours after the first, you can give a second drug, for example, Nurofen after Panadol. However, an adequate dose of Nurofen reduces the temperature almost always.

When to call an ambulance?

You don't need to call an ambulance. No isolated rise in temperature is a reason to call ambulance. Isolated means that there are no other threatening symptoms, such as a vague rash, severe shortness of breath, or bulging of the fontanel. Yes, an ambulance can always lower the temperature - with a lytic mixture or a hormone, but there is no need for this and it can be harmful. The drug that forms the basis of the lytic mixture - analgin (metamisole) - is prohibited in children throughout the civilized world. In addition, the ambulance will most likely start to scare you and drag you to the hospital. Fever is not an emergency. If she worries you, lower the temperature and go to the doctor. Or call the doctor at home in a planned manner.

So, should I sit back while the baby has a fever?

Make a delicious drink for your child, sit next to him and read a book.

More interesting:

How to put your baby to sleep without pain. 11 Tips From a Sleep Consultant I'm bored with my baby and he is bored with me. What to do?

How to prepare teenagers for sexual life. 8 important topics

special instructions

When pregnant for a period of 28 weeks, taking Nurofen is contraindicated. At other times, the drug can be taken in cases where the disease of the mother does not allow to do without Nurofen. During the period of breastfeeding breastfeeding must be abandoned for the entire period of treatment with Nurofen.

Children under 3 months old can take Nurofen only under the strict supervision of a pediatrician and with an individual recalculation of the dosage. From 3 months to 6 years, the drug can only be taken in the form of a suspension. From the age of 6, tablet forms of the drug are allowed, subject to the dosage.

Alcohol does not affect the action of Nurofen. The exception is Nurofen-plus. Due to the content of codeine in it, joint intake alcoholic beverages with this drug is not possible. This is due to the possible unpredictable reaction of the body to this substance.

Release form

Release form, drug packaging may vary. On the pharmacy shelves you can find such medicines:

• tablets, capsules for oral administration. Usually they are packed in 10 pieces per blister, the number of such blisters in a carton box can vary from one to two or three;
• Nurofen Plus deserves special attention - these are capsules with a liquid center containing 2 times more active substance than in ordinary tablets;
• Nurofen syrup used in pediatrics: poured into a dark glass bottle, equipped with a dosing syringe, which determines the required amount of medication;
• the gel used for application to the skin is packaged in aluminum tubes, it can have different weights from 30 to 100 g.

Many people wonder if Nurofen is an antibiotic or not. Ibuprofen - the main component of this drug is an anti-inflammatory, non-steroid drugs. It relieves symptoms viral infection, fever and pain, but does not fight bacterial infections, therefore, it does not have antibacterial functions.

Nurofen is quickly absorbed by the walls of the stomach and intestines, almost completely. Already after 45 minutes, its concentration in the blood plasma reaches its maximum. When the medicine is taken with food, peaking may be slower and take one to two hours.

The drug is excreted outside the body through the functioning of the liver and kidneys.

How Nurofen works

Nurofen blocks both fractions of cyclooxygenase (COX-1 and COX-2), which leads to the cessation of the production of prostaglandins (inflammatory mediators). Also, the drug affects the passage of pain impulses through nerve endings with the brain and reduces the threshold of sensitivity to pain and reduces the locally elevated temperature of inflamed tissues. As an additional action, Nurofen reduces tissue swelling, which is caused by inflammation.

Nurofen Plus also contains codeine, which is a narcotic analgesic. It enhances the effect of ibuprofen and also blocks the cough reflex.

As a result of the treatment, the patient feels a noticeable decrease in pain and the restoration of the usual way of life. The volume of active and passive movements in the spine is restored.

drug interaction

When using the drug, it is necessary to take into account the interaction with other drugs:

1. Ibuprofen enhances the side effects of ethanol, estrogens, glucocorticosteroids and mineralocorticoids.
2. Colestyramine and antacids reduce the absorption of ibuprofen.
3. Nurofen increases plasma concentrations of methotrexate, digoxin and lithium preparations.
4. Caffeine enhances the analgesic effect of ibuprofen.
5. With simultaneous use with Nurofen, cefotetan, plicamycin, cefoperazone, valproic acid and cefamandol increase the incidence of hypoprothrombinemia.
6. The simultaneous use of ibuprofen with acetylsalicylic acid and other NSAIDs is not recommended (the antiplatelet and anti-inflammatory effect of the latter decreases), as well as with thrombolytic and anticoagulant drugs (the risk of bleeding increases).
7. Drugs that block tubular secretion increase the concentration of ibuprofen in plasma. Microsomal oxidation inducers (barbiturates, phenylbutazone, phenytoin, tricyclic antidepressants, rifampicin, ethanol) increase the risk of severe hepatotoxic reactions, and microsomal oxidation inhibitors have the opposite effect.
8. Gold preparations and cyclosporine increase the nephrotoxicity of ibuprofen, which in turn increases the plasma concentration of cyclosporine and increases the likelihood of developing a hepatotoxic effect of the latter.
9. Nurofen reduces the natriuretic effect of hydrochlorothiazide and furosemide, the hypotensive effect of vasodilators and the effectiveness of uricosuric agents; enhances the action of fibrinolytics, antiplatelet agents, indirect anticoagulants and oral hypoglycemic agents (insulin and sulfonylurea derivatives).

Mode of application

Nurofen tablets

Depending on the severity of the disease and its symptoms, Nurofen can be prescribed at a dosage of 200 to 800 g 3-4 times a day. For better absorption and less side effects, Nurofen is recommended to be taken with meals or within 30 minutes after meals. The course of treatment is selected individually, ranging from a single dose for short-term pain, up to 5-10 days for severe exacerbations of chronic processes.

Nurofen in the form of a suspension

Nurofen suspensions are most often prescribed for children (sweet taste, convenient dispenser, small dosages). The calculation of the drug depends on the weight of the patient: 5-10 mg for each kg of the young patient's weight per 1 dose. The maximum daily dosage is 20-30 mg per kg of the patient's weight. At 3-6 months, it is recommended to give 2.5 ml per reception, 1-3 times a day; at 6 months - 1 year - 2.5 ml, 1-4 times a day; at 1-3 years - 5 ml per reception, 1-3 times a day; at 4-6 years old - 7.5 ml up to 3 times a day; at 7-9 years old - 10 ml up to 3 times a day; at 10-12 years old - 15 ml 1-3 times a day. After 12 years - adult dosage, 20-40 ml per reception, up to 3-4 times a day. The course of treatment is from 1 to 10 days. Most often, 5-7 days is enough.

Nurofen Gel

The gel is applied externally, in the projection of the affected area of ​​the spine, in a thin layer, slightly rubbing into the skin, 3-4 times a day. After relief of the condition, the frequency of application can be reduced to 2 times a day. The duration of the course of treatment is usually 10-28 days.

General information

Registration number: P N013012/01–090117. Clinical and pharmacological group: NSAIDs (non-steroidal anti-inflammatory drugs).

Release form, packaging and composition

White, round, biconvex tablet with Nurofen black imprint on one side. Covered with a protective sheath. The packaging is a cardboard block, where there are several foil blisters, each of which contains 10 dragees. detailed instructions on the use of tablets Nurofen 200 mg is attached to each package.

As part of one dragee - 200 mg of ibuprofen - the active substance (in the preparation "Nurofen Forte" - 400 mg, and in "Nurofen Plus" add another 10 mg of codeine). Auxiliary components are also present: silicon dioxide in colloidal form - 1 mg, sodium dodecyl sulfate - 0.5 mg, cetylacetic acid - 2 mg, sodium citric acid - 43.5 mg, croscarmellose sodium - 30 mg.

Additional substances contained in the shell: gum arabic - 0.6 mg, sugar - 116.1 mg, titanium dioxide - 1.4 mg, black dye (shellac - 28, 225%, isopropyl alcohol - 0.55%, water - 3.25%, iron oxide (E-172 - food supplement) - 24.65%, ethyl alcohol - 9.75%, E-1520 - 1.3%, butyl alcohol - 9.75%), cellulose gum - 0.7 mg, talc - 33 mg, polyethylene glycol - 0, 2 mg. Solvents that evaporate after printing.

Pharmacological properties

Nurofen is an anti-inflammatory express agent of a non-hormonal nature. It has an antipyretic and analgesic effect due to the blocking of Cyclooxygenase-1 and 2, due to which the connection of prostaglandins, the so-called pain mediators, is inhibited. It should be noted that ibuprofen (active ingredient) also inhibits platelet aggregation. The medicine works up to 8 hours.

It has high absorption - quickly and almost everything is absorbed from the intestines. If you take the medicine on an empty stomach, the maximum concentration in the blood of the active substance will reach after 3/4 hours. In the case of eating, the time can be increased up to 1.5 hours.

In blood plasma, proteins have a good connection with Nurofen - 90%. The drug is absorbed into all tissues and joint cavities, especially lingering in the synovial fluid, where it reaches its highest concentration. In the liquor it can be found in very small quantities.

Then the tablets are split in the liver and within 4 hours are removed by the kidneys in a natural way.

It is released in pharmacies without a doctor's prescription.

Side effects

The likelihood of side effects is minimal if Nurofen Plus is taken for a short time and at the lowest dose needed to relieve symptoms.

Risk adverse reactions especially perforations and bleeding from gastrointestinal tract, higher in elderly patients. There are known cases of death in this age group.

In general, the incidence of unwanted side effects depends on the dose. The following are the reactions that were observed during short-term therapy with ibuprofen in daily doses of not more than 1200 mg:

• digestive system, liver and biliary tract: infrequently - nausea, dyspeptic disorders, pain in the abdomen; rarely - vomiting, flatulence, diarrhea or constipation; very rarely - ulcerative stomatitis, hematemesis (up to death), tarry stools, peptic ulcer, jaundice, hepatitis, gastritis, gastrointestinal bleeding or perforation, abnormal liver function, increased activity of liver enzymes; frequency unknown - dryness in oral cavity, biliary colic, exacerbation of Crohn's disease and colitis;
• metabolism and nutrition: frequency unknown - loss of appetite;
• respiratory system: frequency unknown - bronchospasm, cough suppression, shortness of breath, bronchial asthma, respiratory depression;
• cardiovascular system: the frequency is unknown - bradycardia, peripheral edema, increased blood pressure, heart failure, thrombotic complications (in case of long-term use);
• urinary system: very rarely - the presence of protein or blood in the urine, cystitis, nephritic syndrome, necrotizing papillitis, acute renal failure, interstitial nephritis, nephrotic syndrome; frequency unknown - violation of the process of urination, renal colic;
• nervous system and psyche: infrequently - headache; very rarely - serous meningitis; frequency unknown - agitation, dizziness, depressed mood, weakness, nightmares, convulsions, confusion, depression of the central nervous system, involuntary muscle movements, hallucinations, increased intracranial pressure, drug dependence;
• sense organs: frequency unknown - diplopia, vestibular dizziness, blurred vision;
• musculoskeletal system: frequency unknown - muscle stiffness;
• skin and subcutaneous tissues: infrequently - skin rash; very rarely - severe skin reactions; frequency unknown - flushing of blood to the skin;
• immune system: infrequently - bronchospasm, dyspnea, exacerbation bronchial asthma, shortness of breath, nettle rash, pruritus, dermatoses, angioedema, eosinophilia, nonspecific anaphylactic and allergic reactions, allergic rhinitis; very rarely - tachycardia, drop in blood pressure, anaphylactic shock;
• hematopoietic system: very rarely - various disorders of the hematopoietic process (agranulocytosis, anemia, leukopenia, thrombocytopenia, hemolytic and aplastic anemia, pancytopenia);
• general disorders: very rare - low temperature body, edema, hyperhidrosis, fatigue, irritability, restlessness;
• laboratory studies: an increase in bleeding time, an increase in the activity of liver enzymes, a decrease in hematocrit or hemoglobin, an increase in plasma creatinine concentration, a decrease in blood glucose levels.

What does Nurofen help with?

There are many indications for use this tool. However, in all cases, the dosage and treatment regimen can vary greatly. Most often, the composition is used to treat pain and fever. However, there may be more reasons for your doctor to prescribe this medicine for you. Learn more about Nurofen. What can he heal?

In the heat. From the temperature "Nurofen" helps quite quickly. At the same time, syrups and liquid capsules are preferable, since the effect of them is faster.

An adult with a fever should take one capsule or drink about 15 milliliters of baby syrup. Within half an hour, the effect of the treatment will be noticeable. From the temperature of "Nurofen" is applied no more than three days. If after that you do not feel better, then you should re-consult a doctor and take some tests.

For flu and colds. Excellent remedy "Nurofen" from the flu. The drug eliminates the symptoms that become painful for the patient. These include bone ache, muscle pain, throbbing in the temples, and photophobia.

You can take Nurofen for colds for no more than three days. At the same time, it is allowed to drink up to 3-4 tablets per day. It is worth dividing the portion into equal parts and taking at regular intervals. The drug is also an anti-inflammatory agent. That is why it not only has an antipyretic and analgesic effect, but also fights the source of infection.

For pain in bones and muscles. The drug in the form of a gel and ointment perfectly eliminates pain. It is used for sprains, after bruises. It is worth noting that before using the substance, you must make sure that there is no fracture.

For athletes, Nurofen gel will help get rid of pain and discomfort associated with prolonged exercise. Apply the composition in a thin layer, gently rubbing into the skin. The drug begins to act almost instantly. The frequency of use of the gel can be up to 4 times a day with an interval of six hours. The course of treatment lasts from several days to two weeks. If after this period of time there is no improvement, then you should contact the doctors.

Periodic pain in women. The drug copes well with menstrual pain. It is also widely used in postoperative period. During surgical interventions on the reproductive organs, women are prescribed a course of the drug for prophylactic purposes. In this case, you need to take 1-2 tablets 2-4 times a day for five days.

Breastfeeding women can use the children's form of the drug. In this case, it is necessary to calculate the minimum dosage of the drug and take it.

Indications and contraindications

Nurofen, the annotation to which contains an exhaustive list of indications for use, can be purchased at any pharmacy. This medicine is used to get rid of pain of various localization and relief of inflammatory processes.

Indications for the use of the drug:

• headache;
• migraine-like pain;
• toothache (caused by teething, caries or removal);
• periodic menstrual female ailments;
• joint and muscle pain that occurs after injury or sprains;
• rheumatism;
• fever body;
• neuralgia of a different nature;
• back pain (due to radicular osteochondrosis syndrome).

Contraindications for admission:

• ulcerative stomatitis;
• ulcers of the stomach and duodenum;
• chronic peptic ulcer;
• perforation of the ulcer, which happened earlier;
• intolerance to the active substance, or aspirin;
• situations of development of acute coronary insufficiency, other severe pathologies from the cardiovascular system;
• insufficiency of the functioning of the liver and kidneys;
• first and last trimesters of pregnancy;
• lactation period;
• polyps in the nasal cavity;
• frequent bronchial obstruction, other problems with the patient's breathing;
• the presence of bronchial asthma;
• children's age up to six years (for tablets and capsules);
• stroke and hemorrhagic vasculitis;
• blood clotting disorders;
• recent surgical interventions in the aorta or other large blood vessels.

Only after consulting a doctor and under his control, the drug is used in the presence of such conditions:

• pregnancy period from 14 to 28 weeks;
• ischemia of the heart;
• diabetes;
• the use of drugs from the group of glucocorticosteroids (prednisolone);
• chronic diseases of the gastrointestinal tract associated with a high tendency to form erosive lesions of the mucous membranes;
• elevated blood pressure;
• reduced lipid levels in blood serum;
• the presence of minimal suspicion of gastric bleeding.

Mode of application

When should I take Nurofen before or after food? To determine the intricacies of treatment with this drug, you need to familiarize yourself with the annotation that is attached to each of its dosage forms.

How to use Nurofen:

• drink after meals;
• tablets do not need to be chewed, they are swallowed whole;
• you can drink the drug with water or milk, this will reduce the irritating moment for the mucous membrane of the digestive tract;
• the specific amount of the drug is determined individually by a specialist;
• according to the recommendations, to get rid of pain, the pill is taken once;
• when a decrease in body temperature is required, the drug is allowed to take one capsule of 200 mg, no more than four times a day (between each dose it is necessary to maintain an interval of 4 to 6 hours);
• with strong painful sensations Nurofen drink one tablet 2 to 4 times a day (the duration of such therapy should not exceed 3-5 days).

Use during pregnancy and lactation

1. Pregnant women in the first 12 weeks are not recommended to use any medications, including Nurofen. In the course of studies, it was found that against the background of drug therapy in the first trimester of pregnancy in the fetus, the risk of developing a "cleft lip" or "cleft palate" increases.
2. In the second trimester of pregnancy, drug therapy is possible only if there are vital indications in the case when the benefit to the woman far outweighs the likely complications for the fetus. Treatment is carried out under the strict supervision of a doctor.
3. In the third trimester of pregnancy, treatment with Ibuprofen is prohibited, as the risk of developing abnormalities in the hematopoietic system of the fetus, impaired renal function of the fetus or newborn, and the risk of birth bleeding in a woman increases.

Since Ibuprofen passes into breast milk, the use of Nurofen during breastfeeding is not recommended in order not to harm the baby. If treatment is necessary, the patient should stop lactation.

Side effects

When using Nurofen for 2-3 days, side effects, according to reviews, are practically not observed. With prolonged use of tablets, the following are possible:

• Anorexia, flatulence, nausea, vomiting, constipation, epigastric discomfort, heartburn, diarrhea, erosive and ulcerative lesions of the gastrointestinal tract, pancreatitis, dryness and pain in the oral mucosa, abdominal pain, stomatitis, irritation and ulceration of the gums, aphthous hepatitis;
• headache, dizziness, drowsiness or insomnia, depression or agitation, hallucinations, confusion;
• Increased blood pressure, heart failure, tachycardia;
• Blurred vision, dry and irritated eyes, diplopia, hearing loss;
• Acute renal failure, cystitis, nephritis, polyuria;
• Shortness of breath, bronchospasm;
• Anemia, agranulocytosis, leukopenia, thrombocytopenic purpura, thrombocytopenia;
• Allergic reactions.

With external use of Nurofen, a burning sensation, tingling and redness at the site of application of the gel are possible, with increased sensitivity - bronchospasm, allergic reactions.

Composition and form of drug production

The main active ingredient of this drug is ibuprofen. In addition, the medicine contains additional components. However, their number and type depend on the form of release of the product.

At present, the consumer can purchase several different types drugs "Nurofen". From what they help, you will learn further. The most common tablet form. These are conventional solid pills and capsules containing a liquid substance. The manufacturer also produces ointment and gel for external use. In addition, you can find products for children that are in the form of syrup and rectal suppositories.

special instructions

Before you start using the drug, read the special instructions:

1. During the treatment period, ethanol is not recommended.
2. 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.
3. 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 use the drug for more than 10 days, you should consult a doctor.
4. During long-term treatment, it is necessary to control the picture of peripheral blood and the functional state of the liver and kidneys.
5. Use of the drug in patients with systemic lupus erythematosus or mixed disease connective tissue associated with increased risk development of aseptic meningitis.
6. If it is necessary to determine 17-ketosteroids, the drug should be discontinued 48 hours before the study.
7. When symptoms of gastropathy appear, careful monitoring is indicated, including esophagogastroduodenoscopy, general analysis blood (hemoglobin determination), fecal occult blood test.
8. Patients with hypertension, incl. in history, and / or chronic heart failure, it is necessary to consult a doctor before using the drug, since the drug can cause fluid retention, increased blood pressure and edema.
9. Patients with renal insufficiency should consult a doctor before using the drug, as there is a risk of deterioration in the functional state of the kidneys.
10. The use of NSAIDs in patients with chicken pox may be associated with an increased risk of developing severe purulent complications of infectious and inflammatory diseases and subcutaneous fat (for example, necrotizing fasciitis). In this regard, it is recommended to avoid the use of the drug for chicken pox.
11. Patients with uncontrolled arterial 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 assessment of the benefit/risk ratio, and high doses of ibuprofen (≥2400 mg/day) should be avoided.
12. Women planning pregnancy should be aware that the drug inhibits COX and prostaglandin synthesis, affects ovulation, disrupting female reproductive function (reversible after discontinuation of treatment).

Release form and composition

Nurofen tablets can be found in two packaging options - in silver-colored boxes and in orange boxes, on which there is an inscription "from 6 years old". Both of these drugs are small white tablets with a round shape. Their sweet shell has a black Nurofen inscription on one side.

The composition of the tablets is the same - the main component is a dose of 200 mg. Sodium citrate and sodium lauryl sulfate, as well as stearic acid, croscarmellose sodium and silicon dioxide are added to it to form the core of the drug. For the manufacture of the shell, sucrose, macrogol 6000, acacia gum, talc, titanium dioxide and carmellose sodium are used.

Tablets are placed in blisters of 6, 8, 10 or 12 pieces, and in one pack there can be from one to eight blisters, so there are silver packages on sale containing from 6 to 96 tablets. As for Nurofen in orange boxes, inside such a pack there is only 1 blister with 8 tablets.

Side effect

The incidence of adverse reactions was estimated based on the following criteria: very frequent (≥ 1/10), frequent (≥ 1/100 to 1/10000), frequency unknown (frequency cannot be determined based on the available data).

The following adverse reactions have been observed with short-term use of ibuprofen at a dose not exceeding 500 mg / day. In the treatment of chronic conditions and with prolonged use, other adverse reactions may occur.

– Immune system disorders

Frequency unknown: hypersensitivity reactions - nonspecific allergic reactions and anaphylactic reactions, side effects respiratory tract(bronchial asthma, including its exacerbation, bronchospasm, shortness of breath, dyspnea), skin reactions (itching, urticaria, purpura, angioedema, exfoliative and bullous dermatoses, including toxic epidermal necrolysis (Lyell's syndrome), Stevens-Johnson syndrome, erythema multiforme).

- Disorders of the gastrointestinal tract

Frequency unknown: abdominal pain, dyspepsia.

– Renal and urinary tract disorders

Frequency unknown: impaired renal function.

If side effects occur, stop using the drug immediately and consult a doctor.

Instructions for use

Reception scheme:

The drug is given to the child to swallow and drink with plain water. To reduce the risk of negative effects of Nurofen on digestive system, taking the tablet is recommended during or immediately after a meal.
A single dosage for patients over 6 years old is one tablet, and children over 12 years old can be given 2 tablets at once, but the maximum dosage for patients 6-18 years old is 4 tablets per day.
The medicine is usually prescribed three times with a break between doses of 8 hours, but if necessary, Nurofen can be given 4 times a day, that is, every 6 hours

Breaks of less than six hours between two tablets are not recommended.
With regard to the duration of administration, it is important to know that Nurofen tablets are prescribed only as a short-term treatment for symptoms such as pain and fever. Usually such a medication is used only 1-3 days to eliminate symptoms.

If there is no improvement after 2-3 days of taking it, you should consult your doctor.

Compound

Description of the dosage form

Coated tablets: round, biconvex, white or off-white film-coated with a black overprint "Nurofen" on one side of the tablet.

On the cross section of the tablet - the core is white or almost white, the shell is white or almost white.

pharmachologic effect

Pharmacodynamics

The mechanism of action of ibuprofen, a propionic acid derivative from the NSAID group, is due to the inhibition of the synthesis of PG - mediators of pain, inflammation and hyperthermic reaction. Indiscriminately blocks COX-1 and COX-2, as a result of which it inhibits the synthesis of PG. It has a fast directed action against pain (pain reliever), antipyretic and anti-inflammatory. In addition, ibuprofen reversibly inhibits platelet aggregation. The analgesic effect of the drug lasts up to 8 hours.

Pharmacokinetics

Absorption - high, quickly and almost completely absorbed from the gastrointestinal tract. After taking the drug on an empty stomach, Cmax ibuprofen in plasma is reached after 45 minutes. Taking the drug with food can increase Tmax up to 1-2 hours.

Communication with blood plasma proteins - 90%. It slowly penetrates into the joint cavity, lingers in the synovial fluid, creating higher concentrations in it than in the blood plasma. In the cerebrospinal fluid, lower concentrations of ibuprofen are found compared to blood plasma. After absorption, about 60% of the pharmacologically inactive R-form is slowly transformed into the active S-form. It is metabolized in the liver.

T1 / 2 - 2 hours. Excreted in the urine (unchanged, no more than 1%) and to a lesser extent with bile. In limited studies, ibuprofen has been found in breast milk at very low concentrations.

Nurofen ® indications

headache;

toothache;

painful menstruation;

neuralgia;

backache;

muscle pain;

rheumatic pain;

pain in the joints;

febrile conditions with influenza and colds.

Contraindications

hypersensitivity to ibuprofen or any of the components that make up 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 history);

erosive and ulcerative diseases of the gastrointestinal tract (including peptic ulcer of the stomach and duodenum, Crohn's disease, ulcerative colitis) or ulcerative bleeding in the active phase or history (two or more confirmed episodes peptic ulcer or ulcerative bleeding).

bleeding or perforation of a gastrointestinal ulcer in history, provoked by the use of NSAIDs;

severe liver failure or active liver disease;

severe renal failure (Cl creatinine<30 мл/мин), подтвержденная гиперкалиемия;

decompensated heart failure;

the period after coronary artery bypass grafting;

cerebrovascular or other bleeding;

fructose intolerance, glucose-galactose malabsorption, sucrase-isomaltase deficiency;

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

pregnancy (III trimester);

children's age up to 6 years.

Carefully: simultaneous use of other NSAIDs, a history of a single episode of gastric ulcer and duodenal ulcer or ulcerative bleeding of the gastrointestinal tract; gastritis, enteritis, colitis, infection Helicobacter pylori, ulcerative colitis; bronchial asthma or allergic diseases in the acute stage or history - bronchospasm may develop; systemic lupus erythematosus or mixed connective tissue disease (Sharpe's syndrome) - increased risk of aseptic meningitis; renal failure, incl. with dehydration (Cl creatinine<30-60 мл/мин), нефротический синдром, печеночная недостаточность, цирроз печени с портальной гипертензией, гипербилирубинемия, артериальная гипертензия и/или сердечная недостаточность, цереброваскулярные заболевания, заболевания крови неясной этиологии (лейкопения и анемия), тяжелые соматические заболевания, дислипидемия/гиперлипидемия, сахарный диабет, заболевания периферических артерий, курение, частое употребление алкоголя, одновременное применение ЛС , которые могут увеличить риск возникновения язв или кровотечения, в частности, пероральных ГКС (в т.ч. преднизолона), антикоагулянтов (в т.ч. варфарина), СИОЗС (в т.ч. циталопрама, флуоксетина, пароксетина, сертралина) или антиагрегантов (в т.ч. ацетилсалициловой кислоты, клопидогрела), беременность I-II триместры, период грудного вскармливания, пожилой возраст, возраст младше 12 лет.

Use during pregnancy and lactation

The use of the drug in the third trimester of pregnancy is contraindicated. The use of the drug in the I-II trimesters of pregnancy should be avoided; if necessary, the drug should be taken with a doctor.

There is evidence that small amounts of ibuprofen can pass into breast milk without any negative effects on the health of the infant, so usually with short-term use, there is no need to stop breastfeeding. If you need long-term use of the drug, you should consult a doctor to decide whether to stop breastfeeding for the period of drug use.

Side effects

The risk of side effects can be minimized if the drug is taken in a short course, in the minimum effective dose necessary to eliminate symptoms.

In the elderly, there is an increased frequency of adverse reactions against the background of the use of NSAIDs, especially gastrointestinal bleeding and perforation, in some cases with a fatal outcome. Side effects are predominantly dose-dependent. The following adverse reactions were noted with short-term use of ibuprofen in doses not exceeding 1200 mg / day (Table 6). In the treatment of chronic conditions and long-term use, other adverse reactions may occur.

The assessment of the incidence of adverse reactions was made on the basis of the following criteria: very often (≥1 / 10); often (from ≥1/100 to<1/10); нечасто (от ≥1/1000 до <1/100); редко (от ≥1/10000 до <1/1000); очень редко (<1/10000); частота неизвестна (данные по оценке частоты отсутствуют).

From the blood and lymphatic system: very rarely - 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.

From the immune system: infrequently - 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, angioedema, 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, shortness of breath, 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, hematemesis, in some cases fatal, especially in elderly patients, ulcerative stomatitis, gastritis; frequency unknown - exacerbation of colitis and Crohn's disease.

From the side of the liver and biliary tract: very rarely - abnormal liver function, increased activity of hepatic transaminases, hepatitis and jaundice.

From the side of the kidneys and urinary tract: very rarely - acute renal failure (compensated and decompensated), especially with prolonged 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.

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

From the CCC: the frequency is unknown - heart failure, peripheral edema, with prolonged use, the risk of thrombotic complications (for example, myocardial infarction), increased blood pressure is increased.

From the respiratory system and mediastinal organs: frequency is unknown - bronchial asthma, bronchospasm, shortness of breath.

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

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

Interaction

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

Acetylsalicylic acid: with the exception of low doses of acetylsalicylic acid (no more than 75 mg / day) prescribed by a doctor, since combined use may increase the risk of side effects. With the simultaneous use 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 low doses of acetylsalicylic acid as an antiplatelet agent 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 increase in the risk of side effects.

Use with caution simultaneously with the following drugs

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

Antihypertensive agents (ACE inhibitors and ARA II) and diuretics: NSAIDs may reduce the effectiveness of drugs in these groups. In some patients with impaired renal function (for example, patients with dehydration or elderly patients with impaired renal function), the simultaneous administration of ACE inhibitors or ARA II and drugs that inhibit COX may lead to 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 ARA II. In this regard, the combined use of the above funds should be administered with caution, especially to the elderly. Dehydration should be prevented in patients and consideration should be given to monitoring renal function after initiation of such combination therapy and periodically thereafter.

Diuretics and ACE inhibitors may increase the nephrotoxicity of NSAIDs.

GKS: increased risk of gastrointestinal ulceration and gastrointestinal bleeding.

Antiplatelet agents and SSRIs: increased risk of gastrointestinal bleeding.

cardiac glycosides: the simultaneous appointment of NSAIDs and cardiac glycosides can lead to aggravation of heart failure, a decrease in GFR and an increase in the concentration of cardiac glycosides in blood plasma.

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

Methotrexate: there are data on the likelihood of an increase in the concentration of methotrexate in the blood plasma against the background of the use of NSAIDs.

Cyclosporine: increased risk of nephrotoxicity with the simultaneous appointment of NSAIDs and cyclosporine.

Mifepristone: NSAIDs should be started no earlier than 8-12 days after taking mifepristone, since NSAIDs may reduce the effectiveness of mifepristone.

Tacrolimus: with the simultaneous appointment of NSAIDs and tacrolimus, an increase in the risk of nephrotoxicity is possible.

Zidovudine: the simultaneous use of NSAIDs and zidovudine can lead to increased hematotoxicity. There is evidence of an increased risk of hemarthrosis and hematomas in HIV-positive patients with hemophilia receiving concomitant treatment with zidovudine and ibuprofen.

Quinolone antibiotics: Patients receiving concomitant treatment with NSAIDs and quinolone antibiotics may have an increased risk of seizures.

Myelotoxic drugs: increased hematotoxicity.

Cefamandol, cefoperazone, cefotetan, valproic acid, plicamycin: an increase in the incidence of hypoprothrombinemia.

Drugs that block tubular secretion: decrease in excretion and increase in plasma concentration of ibuprofen.

Microsomal oxidation inducers (phenytoin, ethanol, barbiturates, rifampicin, phenylbutazone, tricyclic antidepressants): an increase in the production of hydroxylated active metabolites, an increase in the risk of developing severe intoxications.

Microsomal oxidation inhibitors: reduced risk of hepatotoxicity.

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

Antacids and colestyremias: decrease in absorption.

Uricosuric drugs: decrease in the effectiveness of drugs.

Caffeine: enhancement of the analgesic effect.

Dosage and administration

inside drinking water. Patients with hypersensitivity of the stomach are recommended to take the drug during meals. For short term use only. Before taking the drug, you should carefully read the instructions.

Adults and children over 12 years old: inside 1 tab. (200 mg) up to 3-4 times a day. To achieve a faster therapeutic effect in adults, the dose may be increased to 2 tablets. (400 mg) up to 3 times a day.

Children from 6 to 12 years old: 1 tab. (200 mg) up to 3-4 times a day; the drug can be taken only if the child's body weight is more than 20 kg.

The interval between taking the tablets should be at least 6 hours.

The maximum daily dose for adults is 1200 mg (table 6).

The maximum daily dose for children from 6 to 18 years old is 800 mg (table 4).

If, when taking the drug for 2-3 days, the symptoms persist or intensify, it is necessary to stop treatment and consult a doctor.

Overdose

In children, overdose symptoms may occur after taking doses exceeding 400 mg/kg. In adults, the dose-dependent effect of overdose is less pronounced. T 1/2 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, there are manifestations from the side of the central nervous system: drowsiness, rarely - agitation, convulsions, disorientation, coma. In cases of severe poisoning, metabolic acidosis and an increase in PT, renal failure, liver tissue damage, decreased blood pressure, respiratory depression and cyanosis may develop. In patients with bronchial asthma, an exacerbation of this disease is possible.

Treatment: symptomatic, with the obligatory provision of airway patency, ECG monitoring and basic vital signs up to the normalization of the patient's condition. Oral activated charcoal or gastric lavage is recommended for 1 hour after taking a potentially toxic dose of ibuprofen. If ibuprofen has already been absorbed, an alkaline drink may be given to eliminate the acidic ibuprofen derivative by the kidneys, forced diuresis. Frequent or prolonged convulsions should be stopped by intravenous administration of diazepam or lorazepam. With the worsening of bronchial asthma, the use of bronchodilators is recommended.

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

Patients with renal insufficiency 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, incl. in history, 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 edema.

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

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

Release form

Coated tablets, 200 mg. 6, 8, 10 or 12 tab. in blister (PVC/PVDC/aluminium). One blister (6, 8, 10 or 12 tablets each) or two blisters (6, 8, 10 or 12 tablets each) or three blisters (10 or 12 tablets each) or four blisters (12 tablets each) or eight blisters (12 tablets each) are placed in a cardboard box.

Manufacturer

Reckitt Benckiser Healthcare International Ltd., Thane Road, Nottingham, NG90 2DB, UK.

Entity in whose name the registration certificate is issued: Reckitt Benckiser Healthcare International Ltd., Thane Road, Nottingham, NG90 2DB, UK.

Representative in Russia/Organization accepting consumer claims: OOO Reckitt Benckiser Healthcare. 115114, Russia, Moscow, st. Kozhevnicheskaya, 14.

Tel.: 8-800-505-1-500 (toll-free within Russia).

[email protected]

Terms of dispensing from pharmacies

Over the counter.

Storage conditions for Nurofen ®

Keep out of the reach of children.

Shelf life of Nurofen ®

Do not use after the expiry date stated on the packaging.

Synonyms of nosological groups