Instructions for Ibuprofen
Composition Ibuprofen:
Composition per tablet: Active substance: Ibuprofen - 400 mg; Excipients: collidone 90 F - 6.8 mg, microcrystalline cellulose - 136 mg, talc - 13.6 mg, crospovidone (collidone CL) - 20.4 mg, calcium stearate - 6.8 mg, colloidal silicon dioxide (aerosil) - 20.4 mg, corn starch - 76.0 mg;
Shell: hypromellose (hydroxypropyl methylcellulose) - 7.54 mg, talc - 0.82 mg, titanium dioxide - 2.32 mg, propylene glycol - 1.1 mg, macrogol-4000 (polyethylene glycol-4000, polyethylene oxide-4000) - 2.22 mg Ibuprofen
Pharmacodynamics Ibuprofen:
The mechanism of action of Ibuprofen, a derivative of propionic acid from the group of non-steroidal anti-inflammatory drugs (NSAIDs), is due to the inhibition of the synthesis of prostaglandins - mediators of pain, inflammation and hyperthermia.
Indirectly blocks cyclooxygenase 1 (COX-1) and cyclooxygenase 2 (COX-2), as a result of which it inhibits prostaglandin synthesis.
It has a quick directed action against pain (analgesic), antipyretic and anti-inflammatory effect. In addition, Ibuprofen reversibly inhibits platelet aggregation. The analgesic effect of the drug lasts up to 8 hours. Ibuprofen
Pharmacokinetics Ibuprofen:
Ibuprofen is rapidly and almost completely absorbed from the gastrointestinal tract, its maximum plasma concentration is reached 1-2 hours after ingestion, in the synovial fluid - after 3 hours, it binds to plasma proteins by 99%. Slowly penetrates into the joint cavity, lingers in the synovial tissue, creating higher concentrations in it than in plasma.
Ibuprofen metabolism occurs predominantly in the liver. The half-life (T1 / 2) from plasma is 2-3 hours. It is excreted by the kidneys in the form of metabolites (no more than 1% is excreted unchanged), to a lesser extent - with bile. Ibuprofen is completely excreted in 24 hours. Ibuprofen
Side effects Ibuprofen:
The risk of side effects can be minimized if you take the drug in a short course, at the minimum effective dose necessary to eliminate the symptoms.
Elderly people have an increased frequency of adverse reactions with NSAIDs, 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 dose range and on the duration of treatment. The following adverse reactions were noted with short-term intake of ibu-profen in doses not exceeding 1200 mg / day (6 tablets - 200 mg; 3 tablets -400 mg).
In the treatment of chronic conditions and with prolonged use, other adverse reactions may occur. The frequency of adverse reactions was estimated based on the following criteria: very frequent (> 1/10), frequent (from> 1/100 to <1/10), infrequent (from> 1/1000 to <1/100), rare ( from> 1/10000 to <1/1000), very rare (<1/10000), the frequency is unknown (no data on frequency estimation). Disorders from the blood and lymphatic system Very rare: hematopoietic disorders (anemia, leukopenia, aplastic anemia, hemolytic anemia, thrombocytopenia, pancytopenia, agranulocytosis). Ibuprofen
Unknown frequency:
bronchial asthma, bronchospasm, shortness of breath. Laboratory indicators
hematocrit or hemoglobin (may decrease);
bleeding time (may increase);
plasma glucose concentration (may decrease);
creatinine clearance (may decrease);
plasma concentration of creatinine (may increase);
activity of “liver” transaminases (may increase).
If side effects occur, you should stop taking the drug and consult a doctor.
Special conditions Ibuprofen:
It is recommended to take the drug as short as possible and in the minimum effective dose necessary to eliminate the symptoms. If you need to take the drug for more than 10 days, you must 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 can 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 prolonged 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, a general blood test (determination of hemoglobin), fecal occult blood analysis.
If it is necessary to determine 17-ketosteroids, the drug should be discontinued 48 hours before the study. During treatment, ethanol is not recommended. Patients with renal failure should consult a doctor before using the drug, since there is a risk of impaired renal function.
Indications Ibuprofen:
Ibuprofen is used for headaches, migraines, toothaches, painful menstruation, neuralgia, back pain, muscle pain, rheumatic pain and joint pain; as well as with a fever with flu and colds.
Contraindications Ibuprofen:
- hypersensitivity to Ibuprofen or any of the components that make up the drug;
- a complete or incomplete combination of bronchial asthma, recurrent polyposis of the nose and paranasal sinuses, and intolerance to acetylsalicylic acid or other NSAIDs (including a history);
- erosive and ulcerative diseases of the organs 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 in the anamnesis (two or more confirmed episodes of peptic ulcer or bleeding);
- a history of bleeding or perforation of an ulcer of the gastrointestinal tract, provoked by the use of NSAIDs; - severe liver failure or liver disease in the active phase; - severe renal failure (creatinine clearance <30 ml / min), confirmed hyperkalemia;
- decompensated heart failure; the period after coronary artery bypass grafting;
- cerebrovascular or other bleeding;
- hemophilia and other bleeding disorders (including hypocoagulation), hemorrhagic diathesis; pregnancy (III trimester);
- children's age: up to 6 years - for tablets 200 mg; up to 12 years - for tablets of 400 mg.
Drug Interactions Ibuprofen:
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 per day) prescribed by a doctor, since combined use may increase the risk of side effects.
With the simultaneous use of Ibuprofen reduces the anti-inflammatory and antiplatelet effect of acetylsalicylic acid (it is possible to increase the incidence of acute coronary insufficiency in patients receiving small 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 medicines: - anticoagulants and thrombolytic drugs: NSAIDs may enhance the effect of anticoagulants, in particular warfarin and thrombolytic drugs; - antihypertensive agents (ACE inhibitors and angiotensin II antagonists) and diuretics: NSAIDs may reduce the effectiveness of drugs in these groups.
In some patients with impaired renal function (for example, in patients with dehydration or in elderly patients with impaired renal function), the simultaneous administration of ACE inhibitors or angiotensin II antagonists and agents that inhibit cyclooxygenase can lead to impaired renal function, including the development of acute renal failure (usually reversible).
These interactions should be considered in patients taking coxibs concurrently with ACE inhibitors or angiotensin II antagonists. In this regard, the combined use of the above funds should be prescribed with caution, especially in the elderly. It is necessary to prevent dehydration in patients, as well as to consider the monitoring of renal function after the start of such combined treatment and periodically in the future.
Diuretics and ACE inhibitors may increase the nephrotoxicity of NSAIDs; - glucocorticosteroids: increased risk of gastrointestinal ulcers and gastrointestinal bleeding; - antiplatelet agents and selective serotonin reuptake inhibitors: increased risk of gastrointestinal bleeding.
- cardiac glycosides Ibuprofen: the simultaneous administration of NSAIDs and cardiac glycosides can lead to aggravation of heart failure, a decrease in glomerular filtration rate and an increase in the concentration of cardiac glycosides in blood plasma;
- lithium preparations: there is evidence of the likelihood of an increase in the concentration of lithium in blood plasma during the use of NSAIDs;
- methotrexate:
Dosage Ibuprofen:
Adults, elderly and children over 12 years of age: in tablets of 200 mg 3-4 times a day; in tablets of 400 mg 2-3 times a day. The daily dose is 1200 mg (do not take more than 6 tablets of 200 mg or 3 tablets of 400 mg) for 24 hours. The tablets should be swallowed with water, preferably during or after meals.
Do not take more often than after 4 hours. Do not exceed the indicated dose! The course of treatment without consulting a doctor should not exceed 5 days. If symptoms persist, consult a physician. Do not use in children under 12 years of age without consulting a doctor.
Children from 6 to 12 years old (weighing more than 20 kg): 1 tablet 200 mg no more than 4 times a day. The interval between taking pills is at least 6 hours. Ibuprofen
Overdose Ibuprofen:
Do not exceed the indicated dose. If you exceed the dose, consult a doctor or the nearest medical facility immediately. Take along the packaging of the drug Ibuprofen. Symptoms, abdominal pain, nausea, vomiting, lethargy, drowsiness, depression, headache, tinnitus, metabolic acidosis, coma, acute renal failure, lowering blood pressure, bradycardia, tachycardia, atrial fibrillation, respiratory arrest. Treatment, gastric lavage (only within an hour after ingestion), activated charcoal, alkaline drink, forced diuresis, symptomatic therapy (correction of the acid-base state, blood pressure).
