Ibuprofen tablets 200mg, No. 20

• Headache and toothache;

• migraine;

• painful periods;

• neuralgia;

• back pain, muscle and rheumatic pain;

• fevers with flu and colds.

Inside. Adults and children over 12 years old - 1 table. (200 mg) 3-4 times a day. To achieve a quick therapeutic effect, the dose is increased to 2 tablets. (400 mg) 3 times a day. Do not take more than 6 tablets. in 24 hours

Children 6-12 years old (weighing more than 20 kg) - 1 table. no more than 4 times a day.

The maximum daily dose is 1200 mg.

Active substance: ibuprofen

• hypersensitivity to ibuprofen or to drug components;

• erosive and ulcerative lesions of the gastrointestinal tract in the acute phase (including ulcerative colitis);

• heart failure, severe arterial hypertension;

• 'Aspirin' bronchial asthma, urticaria, rhinitis, provoked by the intake of salicylates or other NSAIDs;

• diseases of the optic nerve, color vision disorders, amblyopia, scotoma;

• deficiency of glucose-6-phosphate dehydrogenase, hemophilia, state of hypocoagulation, leukopenia;

• severe liver and / or kidney dysfunction;

• hearing loss, pathology of the vestibular apparatus;

• pregnancy (III trimester);

• breastfeeding period;

• children under 6 years of age.

pharmachologic effect

The drug belongs to non-steroidal anti-inflammatory drugs (NSAIDs). It has analgesic, antipyretic and anti-inflammatory effects. Blocks COG1 and COG2 indiscriminately.

The mechanism of action of ibuprofen is due to inhibition of the synthesis of prostaglandins - mediators of pain, inflammation and hyperthermic reaction.

Side effect

Gastrointestinal tract (GIT): NSAID gastropathy (abdominal pain, nausea, vomiting, heartburn, loss of appetite, diarrhea, flatulence, constipation; rarely - ulceration of the gastrointestinal mucosa, which in some cases is complicated by perforation and bleeding); irritation or dryness of the oral mucosa, pain in the mouth, ulceration of the gingival mucosa, aphthous stomatitis, pancreatitis.

Hepato-biliary system: hepatitis.

Respiratory system: shortness of breath, bronchospasm.

Sense organs: hearing impairment: hearing loss, ringing or tinnitus; visual impairments: toxic damage to the optic nerve, blurred vision or double vision, scotoma, dry and irritated eyes, edema of the conjunctiva and eyelids (allergic genesis).

Central and peripheral nervous system: headache, dizziness, insomnia, anxiety, nervousness and irritability, psychomotor agitation, drowsiness, depression, confusion, hallucinations, rarely - aseptic meningitis (more often in patients with autoimmune diseases).

Cardiovascular system: heart failure, tachycardia, increased blood pressure.

Urinary system: acute renal failure, allergic nephritis, nephrotic syndrome (edema), polyuria, cystitis.

Allergic reactions: skin rash (usually erythematous or urticaria), pruritus, Quincke's edema, anaphylactoid reactions, anaphylactic shock, bronchospasm or dyspnea, fever, erythema multiforme (including Stevens-Johnson syndrome), toxic epidermal syndrome , eosinophilia, allergic rhinitis.

Hematopoietic organs: anemia (including hemolytic, aplastic), thrombocytopenia and thrombocytopenic purpura, agranulocytosis, leukopenia.

Others: increased sweating.

The risk of ulceration of the mucous membrane of the gastrointestinal tract, bleeding (gastrointestinal, gingival, uterine, hemorrhoidal), visual impairment (color vision disorders, scotoma, amblyopia) increases with prolonged use in large doses.

Application during pregnancy and lactation

Contraindicated in pregnancy. Use with caution during lactation.

Application for violations of liver function

Contraindicated in severe liver failure or active liver disease.

Application for impaired renal function

Contraindicated in progressive kidney disease, severe renal failure with creatinine clearance less than 30 ml / min.

Application in children

Contraindicated in children under 6 years of age. Do not use in children under 12 years of age without consulting a doctor.

Use in elderly patients

With care: old age.

special instructions

Treatment with the drug should be carried out in the minimum effective dose, the minimum possible short course. 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 shown, including esophagogastroduodenoscopy, general blood count (hemoglobin determination), and fecal occult blood test.

If it is necessary to determine 17-ketosteroids, the drug should be discontinued 48 hours before the study.

Patients should refrain from all types of activities that require increased attention, quick mental and motor reactions. During the period of treatment, it is not recommended to take ethanol.

Overdose

Symptoms: abdominal pain, nausea, vomiting, lethargy, drowsiness, depression, headache, tinnitus, metabolic acidosis, coma, acute renal failure, decreased blood pressure, bradycardia, tachycardia, atrial fibrillation, respiratory arrest.

Treatment: gastric lavage (only within 1 hour after ingestion), activated charcoal, alkaline drink, forced diuresis, symptomatic therapy.

Drug interactions

Simultaneous administration of ibuprofen with acetylsalicylic acid and other NSAIDs is not recommended. 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 in patients receiving small doses of acetylsalicylic acid as an antiplatelet agent after starting ibuprofen). When administered with anticoagulant and thrombolytic drugs (alteplase, streptokinase, urokinase), the risk of bleeding increases at the same time. Concomitant use with serotonin reuptake inhibitors (citalopram, fluoxetine, paroxetine, sertraline) increases the risk of serious gastrointestinal bleeding.

Cefamandol, cephaperazone, cefotetan, valproic acid, plikamycin, increase the incidence of hypoprothrombinemia. Cyclosporine and gold preparations increase the effect of ibuprofen on the synthesis of prostaglandins in the kidneys, which is manifested by an increase in nephrotoxicity. Ibuprofen increases the plasma concentration of cyclosporine and the likelihood of developing its hepatotoxic effects. Drugs that block tubular secretion reduce excretion and increase the plasma concentration of ibuprofen. Microsomal oxidation inducers (phenytoin, ethanol, barbiturates, rifampicin, phenylbutazone, tricyclic antidepressants) increase the production of hydroxylated active metabolites, increasing the risk of severe intoxication. Microsomal oxidation inhibitors - reduce the risk of hepatotoxic effects. Reduces the hypotensive activity of vasodilators,natriuretic and diuretic activity in furosemide and hydrochlorothiazide. Reduces the effectiveness of uricosuric drugs, enhances the effect of indirect anticoagulants, antiplatelet agents, fibrinolytics (increasing the risk of hemorrhagic disorders), enhances the ulcerogenic effect with bleeding of mineralocorticosteroids, glucocorticosteroids, colchicine, estrogens, ethanol. Enhances the effect of oral hypoglycemic drugs and insulin, sulfonylurea derivatives. Antacids and cholestyramine reduce absorption. Increases the concentration in the blood of digoxin, lithium preparations, methotrexate. Caffeine enhances the analgesic effect.fibrinolytics (increased risk of hemorrhagic disorders), enhances the ulcerogenic effect with bleeding of mineralocorticosteroids, glucocorticosteroids, colchicine, estrogens, ethanol. Enhances the effect of oral hypoglycemic drugs and insulin, sulfonylurea derivatives. Antacids and cholestyramine reduce absorption. Increases the concentration in the blood of digoxin, lithium preparations, methotrexate. Caffeine enhances the analgesic effect.fibrinolytics (increased risk of hemorrhagic disorders), enhances the ulcerogenic effect with bleeding of mineralocorticosteroids, glucocorticosteroids, colchicine, estrogens, ethanol. Enhances the effect of oral hypoglycemic drugs and insulin, sulfonylurea derivatives. Antacids and cholestyramine reduce absorption. Increases the concentration in the blood of digoxin, lithium preparations, methotrexate. Caffeine enhances the analgesic effect.Increases the concentration in the blood of digoxin, lithium preparations, methotrexate. Caffeine enhances the analgesic effect.Increases the concentration in the blood of digoxin, lithium preparations, methotrexate. Caffeine enhances the analgesic effect.