Nurofen pills 200mg №8

Indications

- headache;

- migraine;

- toothache;

- neuralgia;

- myalgia;

- back pain;

- rheumatic pains;

- Algomenorrhea;

- Fever with flu and ARVI.

Dosage and administration

Adults and children over 12 years old administered orally after meals 200 mg 3-4 times / day. To achieve a rapid therapeutic effect, the dose can be increased to 400 mg (2 tab.) 3 times / day.

Children aged 6 to 12 years - 200 mg not more than 4 times / day. It should be borne in mind that the drug can be prescribed only to children with a body weight of more than 20 kg. The interval between taking pills should be at least 6 hours.

You should not take more than 6 tab./day. The maximum daily dose - 1.2 g.

pills should be taken with water.

If while taking the drug for 2-3 days the symptoms persist, you must stop treatment and consult a doctor.

Adverse effects

When using the drug Nurofen ^® within 2-3 days, side effects are practically not observed. In case of prolonged use, the following side effects may occur.

Gastrointestinal: nausea, vomiting, heartburn, anorexia, pain and epigastric discomfort, diarrhea, flatulence, erosive and ulcerative lesions of the gastrointestinal tract (in some cases complicated by perforation and bleeding), abdominal pain, irritation, dry oral mucosa or pain in the mouth, ulceration mucous membrane of the gums, aphthous stomatitis, pancreatitis, constipation, hepatitis.

From the nervous system: headache, dizziness, insomnia, agitation, drowsiness, depression, confusion, hallucinations; rarely, aseptic meningitis (more often in patients with autoimmune diseases).

Cardiovascular: heart failure, increased blood pressure, tachycardia.

Urogenital: nephrotic syndrome (including edema), acute renal failure, allergic nephritis, polyuria, cystitis.

Hemic and lymphatic: anemia (including hemolytic, aplastic), thrombocytopenia, thrombocytopenic purpura, agranulocytosis, leukopenia.

Special senses: hearing loss, ringing or tinnitus, reversible toxic neuritis of the optic nerve, blurred vision, diplopia, dryness and irritation of the eyes, conjunctival edema and eyelid (allergic genesis), scotoma.

Allergic reactions: skin rash, pruritus, urticaria, Quincke edema, anaphylactoid reactions, anaphylactic shock, fever, erythema multiforme exudative (including Stevens-Johnson syndrome), toxic epidermal necrolysis (Lyell's syndrome), eosinophilia, allergic rhinitis, eosinophilia, allergic rhinitis, epidermal necrolysis (Lyell's syndrome), eosinophilia, allergic rhinitis, eosinophilia, allergic necrolysis

Respiratory: bronchospasm, shortness of breath.

Other: increased sweating.

With prolonged use in high doses: ulceration of the mucous membrane of the gastrointestinal tract, bleeding (including from the gastrointestinal tract, gums, uterine, hemorrhoidal), visual impairment (violation of color vision, scotoma, amblyopia).

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

Contraindications

- erosive and ulcerative lesions of the gastrointestinal tract in the acute phase, including peptic ulcer and duodenal ulcer in the acute phase, ulcerative colitis, peptic ulcer, Crohn's disease;

- heart failure;

- Severe arterial hypertension;

- complete or incomplete intolerance to Acetylsalicylic acid (rhinosinusitis, urticaria, nasal polyps, bronchial asthma);

- diseases of the optic nerve, impaired color vision, amblyopia, scotoma;

- deficiency of glucose-6-phosphate dehydrogenase;

- hemophilia and other bleeding disorders, hemorrhagic diathesis, hypocoagulation state;

- severe liver dysfunction;

- severe renal failure (CC <30 ml / min);

- hearing loss, pathology of the vestibular apparatus;

- the period after coronary artery bypass surgery;

- Gastrointestinal bleeding;

- intracranial hemorrhage;

- III trimester of pregnancy;

- lactation period (breastfeeding);

- children's age up to 6 years;

- Hypersensitivity to Ibuprofen and other components of the drug.

Carefully: IHD, cerebrovascular diseases, dyslipidemia, diabetes mellitus, diseases of the peripheral arteries, severe somatic diseases, simultaneous administration of oral GCS (including prednisone), anticoagulants (includingwarfarin, clonidogrel, acetylsalicylic acid), receiving selective inhibitors of serotonin reuptake, gastric ulcer and duodenal ulcer in history, gastritis, enteritis, colitis, instructions in history of bleeding from the gastrointestinal tract; concomitant diseases of the liver and / or kidneys; cirrhosis of the liver with portal hypertension, nephrotic syndrome, chronic heart failure; arterial hypertension; blood diseases of unknown etiology (leukopenia and anemia); bronchial asthma, hyperbilirubinemia; long-term use of NSAIDs; I and II trimesters of pregnancy; age under 12 years old; smoking, frequent use of alcohol.

Use during pregnancy and lactation

The use of the drug in the I and II trimesters of pregnancy is undesirable, but possible with caution and only under the supervision of a physician.

The use of the drug in the third trimester of pregnancy is contraindicated.

Use of the drug during lactation (breastfeeding) is possible with caution.

Application for violations of the liver

The drug is contraindicated for use in marked violations of the liver.

Use with caution in case of concomitant liver diseases (including liver cirrhosis with portal hypertension).

Application for violations of kidney function

Contraindicated in severe renal impairment.

To be used with caution in concomitant kidney diseases (including nephrotic syndrome).

Use in children

Contraindicated in children under 6 years.

For adults and children over 12 years old The initial dose of the drug is 200 mg 3-4 times / day. To achieve a rapid clinical effect, it is possible to increase the initial dose to 400 mg 3 times / day. The maximum daily dose is 1200 mg.

Children aged 6 to 12 years - 200 mg not more than 4 times / day. It should be borne in mind that the drug can be prescribed only to children with a body weight of more than 20 kg. The interval between taking pills should be at least 6 hours.

Special notes

During the long-term administration of the drug, it is necessary to control the pattern of peripheral blood and the functional state of the liver and kidneys. When symptoms of gastropathy appear, close monitoring is shown, including esophagogastroduodenoscopy, general blood test (hemoglobin determination), fecal occult blood test.

If necessary, determine the 17-ketosteroids drug should be canceled 48 hours before the study.

During the period of treatment is not recommended to use ethanol.

Influence on ability to drive motor transport and control mechanisms

Patients should refrain from all activities related to driving and working with moving machinery, as well as from other potentially dangerous activities that require increased concentration of attention and speed of psychomotor reactions.

Overdosage

Symptoms: abdominal pain, nausea, vomiting, lethargy, drowsiness, depression, headache, tinnitus, metabolic acidosis, coma, acute renal and hepatic failure, gastrointestinal bleeding, decrease in blood pressure, bradycardia, tachycardia, atrial fibrillation, respiratory arrest, an increase in prothrombin time; rarely convulsions.

Treatment: gastric lavage (only within 1 h after ingestion), ingestion of Activated carbon, alkaline drinking, forced diuresis, symptomatic therapy. In the case of frequent or prolonged seizures, it is necessary to use anticonvulsant drugs (diazepam or lorazepam in / in).

Drug interaction

The simultaneous use of the drug Nurofen is not recommended.^® with acetylsalicylic acid and other NSAIDs.

With the simultaneous appointment of ibuprofen reduces the anti-inflammatory and antiplatelet effect of acetylsalicylic acid (it is possible to increase the incidence of acute coronary insufficiency after starting ibuprofen in patients receiving small doses of acetylsalicylic acid as an antiplatelet agent).

With simultaneous use with anticoagulants and thrombolytic drugs (including alteplazy, streptokinase, urokinase) increases the risk of bleeding.

When combined with ibuprofen, cefamundol, cefoperazone, cefotetan, valproic acid, plicamycin increase the incidence of hypoprothrombinemia.

With the combined use of cyclosporine and gold preparations enhance the effect of ibuprofen on the synthesis of prostaglandins in the kidneys, which leads to increased nephrotoxicity.

Ibuprofen increases the plasma concentration of cyclosporine and the likelihood of its hepatotoxic effects.

Drugs that block tubular secretion, with simultaneous use, reduce excretion and increase the plasma concentration of ibuprofen.

When used together, microsomal oxidation inducers (including phenytoin, ethanol, barbiturates, rifampicin, phenylbutazone, tricyclic antidepressants) increase the production of hydroxylated active metabolites, increasing the risk of developing severe hepatotoxic reactions.

Inhibitors of microsomal oxidation reduce the risk of the development of the hepatotoxic effect of ibuprofen.

With the combined use of ibuprofen reduces the hypotensive activity of vasodilators, the natriuretic effect of Furosemide and hydrochlorothiazide.

Ibuprofen reduces the effectiveness of uricosuric drugs, enhances the effect of indirect anticoagulants, antiplatelet agents and fibrinolytics.

Enhances the side effects of mineralocorticoids, GCS, estrogen, ethanol.

When used together, it enhances the effect of oral hypoglycemic drugs - sulfonylurea and insulin derivatives.

While taking antacids and Kolestiramin reduce the absorption of ibuprofen.

With the combined use of ibuprofen increases the concentration in the blood of Digoxin, lithium preparations, Methotrexate .

Caffeine enhances the analgesic effect of ibuprofen.

Terms and conditions of storage

The drug should be stored in a dry place out of reach of children at a temperature not exceeding 25 ° C.