Nurofast Forte tablets 400mg, No. 20

• Inflammatory and degenerative diseases of the joints and spine (including rheumatic and rheumatoid arthritis, ankylosing spondylitis, osteoarthritis), articular syndrome during exacerbation of gout, psoriatic arthritis, ankylosing spondylitis, tendinitis, bursitis, radiculitis, traumatic inflammation of the soft tissues apparatus.

• Neuralgia, myalgia, pain syndrome in infectious and inflammatory diseases of the upper respiratory tract, adnexitis, algomenorrhea, headache and toothache.

• Fever in infectious and inflammatory diseases.

Set individually, depending on the nosological form of the disease, the severity of clinical manifestations. When taken orally or rectally for adults, a single dose is 200-800 mg, the frequency of administration is 3-4 times / day; for children - 20-40 mg / kg / day in several doses.

Film-coated tablets of white or almost white color, biconvex, oblong, with rounded edges, with a risk; in cross section, the core is white or almost white.

1 tab.

ibuprofen 400 mg

Excipients: sodium croscarmellose, sodium citrate dihydrate, sodium lauryl sulfate, colloidal silicon dioxide (aerosil), magnesium stearate, stearic acid.

• Erosive and ulcerative lesions of the gastrointestinal tract in the acute phase,

• diseases of the optic nerve,

• 'aspirin triad',

• disorders of hematopoiesis,

• severe renal and / or liver dysfunction;

• III trimester of pregnancy;

• hypersensitivity to ibuprofen.

pharmachologic effect

NSAIDs, a derivative of phenylpropionic acid. It has anti-inflammatory, analgesic and antipyretic effects. The mechanism of action is associated with inhibition of the activity of COX, the main enzyme of the metabolism of arachidonic acid, which is a precursor of prostaglandins, which play a major role in the pathogenesis of inflammation, pain and fever. The analgesic effect is due to both a peripheral (indirectly, through suppression of prostaglandin synthesis) and a central mechanism (inhibition of prostaglandin synthesis in the central and peripheral nervous system). Suppresses platelet aggregation. When applied externally, it has anti-inflammatory and analgesic effects. Reduces morning stiffness, increases the range of motion in the joints.

Pharmacokinetics

When taken orally, ibuprofen is almost completely absorbed from the gastrointestinal tract. Simultaneous food intake slows down the rate of absorption. Metabolized in the liver (90%). T1 / 2 is 2-3 hours. 80% of the dose is excreted in the urine mainly in the form of metabolites (70%), 10% - unchanged; 20% is excreted through the intestines as metabolites.

Side effect

From the digestive system: often - nausea, anorexia, vomiting, epigastric discomfort, diarrhea; development of erosive and ulcerative lesions of the gastrointestinal tract is possible; rarely - bleeding from the gastrointestinal tract; with prolonged use, liver dysfunctions are possible. From the side of the central nervous system and peripheral nervous system: often - headache, dizziness, sleep disturbances, agitation, visual disturbances. From the hematopoietic system: with prolonged use, anemia, thrombocytopenia, agranulocytosis are possible. From the urinary system: with prolonged use, renal dysfunction is possible. Allergic reactions: often - skin rash, Quincke's edema; rarely - aseptic meningitis (more often in patients with autoimmune diseases), bronchospastic syndrome. Local reactions: when applied externally, skin flushing, burning sensation or tingling sensation is possible.

Application during pregnancy and lactation

Use in the third trimester of pregnancy is contraindicated. Use in the I and II trimesters of pregnancy is justified only in cases where the expected benefit to the mother outweighs the possible risk to the fetus. Ibuprofen is excreted in small amounts in breast milk. Application during lactation for pain and fever is possible. If you need long-term use or use in high doses (more than 800 mg / day), you should decide on the termination of breastfeeding.

Application for violations of liver function

Contraindicated in severe liver dysfunction. Use with caution in case of concomitant liver diseases.

Application for impaired renal function

Contraindicated in severe renal impairment.

Use with caution in case of concomitant kidney disease.

special instructions

It is used with caution in case of concomitant liver and kidney diseases, chronic heart failure, with dyspeptic symptoms before starting treatment, immediately after surgical interventions, with indications of a history of bleeding from the gastrointestinal tract and gastrointestinal diseases, allergic reactions associated with taking NSAIDs. In the course of treatment, systematic monitoring of the functions of the liver and kidneys, and the picture of peripheral blood is necessary. Do not apply topically to damaged skin areas.

Drug interactions

With the simultaneous use of ibuprofen reduces the effect of antihypertensive drugs (ACE inhibitors, beta-blockers), diuretics (furosemide, hydrochlorothiazide). With simultaneous use with anticoagulants, their effect may be enhanced. With simultaneous use with GCS, the risk of side effects from the gastrointestinal tract increases. With the simultaneous use of ibuprofen, indirect anticoagulants (acenocoumarol), hydantoin derivatives (phenytoin), oral hypoglycemic drugs, sulfonylurea derivatives can be displaced from compounds with blood plasma proteins. With simultaneous use with amlodipine, a slight decrease in the antihypertensive effect of amlodipine is possible; with acetylsalicylic acid - the concentration of ibuprofen in the blood plasma decreases; with baclofen - a case of intensification of the toxic effect of baclofen is described.With simultaneous use with warfarin, an increase in bleeding time is possible, microhematuria, hematomas were also observed; with captopril - it is possible to reduce the antihypertensive effect of captopril; with cholestyramine - a moderately pronounced decrease in the absorption of ibuprofen. With simultaneous use with lithium carbonate, the concentration of lithium in the blood plasma increases. With simultaneous use with magnesium hydroxide, the initial absorption of ibuprofen increases; with methotrexate - the toxicity of methotrexate increases.With simultaneous use with lithium carbonate, the concentration of lithium in the blood plasma increases. With simultaneous use with magnesium hydroxide, the initial absorption of ibuprofen increases; with methotrexate - the toxicity of methotrexate increases.With simultaneous use with lithium carbonate, the concentration of lithium in the blood plasma increases. With simultaneous use with magnesium hydroxide, the initial absorption of ibuprofen increases; with methotrexate - the toxicity of methotrexate increases.