Ibuprofen

General characteristics. Structure:

Active ingredient: an ibuprofen - 0,2 g, potato starch enough magnesium stearate for receiving a tablet weighing 0,24 g (without cover) aerosil, vanillin, wax enough for bee, edible gelatin, receiving a tablet weight acid red 2 with, 0,45 g by a magnesium building method a carbonate the main, wheat flour, polyvinylpirrolidone, granulated sugar, titanium dioxide)

Pharmacological properties:

Pharmacokinetics. NPVP. Not selectively blocks a tsikloksigenaza 1 and 2. Analgetic action is most expressed at pains of inflammatory character. Has anesthetic, febrifugal and antiinflammatory effect. As well as all NPVP the ibuprofen proyoyavlyat antiagregantny activity.

Pharmacokinetics. Absorption - high, an elimination half-life (Ti/2) of-2 h, communication with proteins of plasma of-90%. Excretion - kidneys, with bile. Slowly gets into a cavity of joints, it zaderzhiyovatsya in synovial fluid, creating in it big concentration, than in plasma. Absorption slightly decreases at administration of drug after food. Time of a dosyotizheniye of a makimalnoa of concentration at reception on an empty stomach 45 min., at reception after food 1,5-2,5 hours. After absorption about 60% pharmacological of an inactive R-form are medyolenno transformed to an active S-form. It is metabolized. It is removed by kidneys (in an invariable look no more than 1%) and, to a lesser extent, with bile. Has a two-phase kiyonetika of elimination.

Indications to use:

1. Inflammatory diseases of joints and backbone (including the rhematoid arterit ankylosing a spondylarthritis, an osteoarthrosis, gouty arthritis).
2. Moderate pain syndrome of various etiology (including pharyngalgia, headache, migraine, dentagra, neuralgia, mialgiya, postoperative pains, poyosttravmatichesky pains, primary альгодисменорея).
3. Feverish syndrome of various genesis.

Route of administration and doses:

Inside, after food. The mode of dosing is set individually in a zavisiyomost from indications.

To adults and children 12 years drug are more senior appoint usually in an initial dose 200 mg 3-4 times a day. For achievement of bystry therapeutic effect the dose can be increased to 400 mg 3 times a day. On reaching medical effect the daily dose is reduced to 600-800 mg. According to the recommendation of the doctor, at an osteoarthrosis, psoriasis arthritis and an ankylosing spondylitis - on 400-600 mg 3-4 times a day. At a pseudorheumatism - on 800 mg 3 times a day; at injuries of soft tissues, injuries of ligaments to 2,4 g/days in несколь­ко receptions. At primary dysmenorrhea - on 400 mg 3-4 times a day; at a moderate boleyovy syndrome of-1,2 g/days.

At a juvenile pseudorheumatism - 30-40 mg/kg/days in stages.

Features of use:

The risk of development of ulcerations mucous a GIT, bleedings (gastrointestinal, gingival, uterine, hemorrhoidal), vision disorders (disturbance color a zreyoniya, scotomas, damages of an optic nerve) increases at prolonged use of drug in high doses.

At emergence of symptoms of bleeding from digestive tract ибу­профен it has to be cancelled (see the section of the Contraindication).

The ibuprofen can mask objective and subjective symptoms of an infection therefore therapy by an ibuprofen at patients with an infection has to be appointed with an ostorozhyonost.

Emergence of a bronchospasm is possible at the patients having bronchial asthma or allergic reactions in the anamnesis or in the present. Side effects can be reduced at use of the minimum effektivyony dose. At prolonged use of analgetics the risk of development of an analgetic nephropathy is possible.

Use of an ibuprofen can negatively influence female fertility and is not recommended to the women planning pregnancy.

Patients who note vision disorders at therapy by an ibuprofen, dolzhyona to stop treatment and to undergo ophthalmologic inspection.

During treatment control of a picture of peripheral blood and a funktsioyonalny condition of a liver and kidneys is necessary.

At emergence of symptoms of a gastropathy careful control, vklyuchayuyoshchy carrying out a zzofagogastroduodenoskopiya, blood test with definition of a gemoglobiyon, hematocrit, the analysis a calla on the occult blood is shown.

For the prevention of development of the NPVP-gastropathy it is recommended to combine with prostaglandin E drugs (мизопростол).

In need of definition of 17 ketosteroids drug should be cancelled in 48 hours prior to a research.

Patients have to abstain from all types of activity requiring povyyoshenny attention, bystry mental and motor reaction.

During treatment ethanol reception is not recommended.

Side effects:

• Digestive Tract (DT)
  
  NPVP-gastropathy (abdominal pains, nausea, vomiting, heartburn, decrease in an appeyotit, diarrhea, meteorism, lock; seldom - ulcerations mucous a GIT which in some cases are complicated by perforation and bleedings); irritation or dryness of a sliziyosty oral cavity, mouth pain, ulceration mucous gums, aphthous stomatitis, pancreatitis.

1. Gepato-biliarnaya Hepatitis system.
2. Respiratory Asthma system, bronchospasm.
3. Sense bodys

Hearing disorder: decrease in hearing, ring or sonitus, toxic damage of an optic nerve, not clear sight or doubling, scotoma, dryness and irritation of eyes, chemosis and century (allergic genesis).

Central and peripheral nervous system. A headache, dizziness, sleeplessness, uneasiness, nervousness and a razdrayozhitelnost, psychomotor arousing, drowsiness, a depression, confusion of consciousness, a hallucination, it is rare - aseptic meningitis (more often at patients with autoimmune zayobolevaniye).

Cardiovascular system. Heart failure, tachycardia, increase in arterial pressure.

Mochevydelitepny system. Acute renal failure, allergic nephrite, nephrotic sinyodry (hypostases), polyuria, cystitis.

Allergic reactions. Skin rash (usually erythematic or small tortoiseshell), skin itch, Quincke's edema, anaphylactoid reactions, acute anaphylaxis, bronchospasm or диспноэ, fever, mnogoformny exudative erythema (including Stephens-Johnson's syndrome), toksiyochesky epidermal necrolysis (Lyell's disease), eosinophilia, allergic rhinitis.

Bodies of a hemopoiesis. Anemia (including hemolitic, aplastic), thrombocytopenia and Werlhof's disease, agranulocytosis, leukopenia.

1. Laboratory indicators:
2. bleeding time (can increase)
3. concentration of glucose in serum (can decrease)

clearance of creatinine (can decrease)

1. hematocrit or hemoglobin (can decrease)

serumal concentration of creatinine (can increase)

activity of "hepatic" transaminases (can raise)

Interaction with other medicines:

1. Efficiency of furosemide and thiazide diuretics can be reduced because of the delay of sodium connected with inhibition of synthesis of prostaglandins in kidneys.
2. The ibuprofen can strengthen effect of peroral anticoagulants therefore odyonovremenny use of an ibuprofen and peroral anticoagulants does not rekoyomendutsya.
3. At co-administration with acetylsalicylic acid the ibuprofen sniyozhat its antiagregantny action (possibly increase in frequency of development of acute coronary insufficiency in the patients receiving small doses of acetylsalicylic acid as antiagregantny means).
4. The ibuprofen can reduce efficiency of anti-hypertensive means.
5. In literature isolated cases of increase in plasma kontsenyotration of digoxin, Phenytoinum and lithium at a concomitant use of an ibuprofen were described.
6. The ibuprofen (it is similar to other NPVP) has to be applied with care in a komyobination with acetylsalicylic acid or other NPVP and glucocorticosteroids (it increases risk of development of adverse influences of drug on a zheyoludochno-intestinal path).
7. The ibuprofen can increase concentration of a methotrexate in plasma.
8. The combined treatment by a zidovudine and an ibuprofen can increase risk of a hemarthrosis and a hematoma at the HIV-positive patients suffering from a gemofiyoliya.
9. The combined use of an ibuprofen and takrolimus can increase risk of development of nephrotoxic action because of decrease in synthesis of prostaglandins in kidneys.
10. The ibuprofen strengthens hypoglycemic action of oral hypoglycemic means and insulin; there can be a need of dose adjustment.

Contraindications:

1. Hypersensitivity to any of the ingredients which are a part of drug. Hypersensitivity to acetylsalicylic acid or other NPVP in an anamneyoza.
2. Erosive and ulcer diseases of bodies of digestive tract (in that chisyol a peptic ulcer of a stomach and duodenum in aggravation stages, a disease Krone, nonspecific ulcer colitis).
3. "Aspirinovy" asthma.
4. Hemophilia and other disturbances of coagulability of blood (including hypocoagulation), hemorrhagic diathesis.
5. Bleedings of any etiology.
6. Deficit glyukozo-6-fosfatdegidrogenazy.
7. Pregnancy (III trimester), lactation period.

Children's age up to 12 years.

Diseases of an optic nerve.

Overdose:

Symptoms: abdominal pains, nausea, vomiting, block, drowsiness, depression, headache, sonitus, metabolic acidosis, coma, acute renal failure, lowering of arterial pressure, bradycardia, tachycardia, fibrilyolyation of auricles, apnoea. Treatment: a gastric lavage (only within 1 hour after reception), aktiviroyovanny coal, alkaline drink, an artificial diuresis, symptomatic therapy (a koryorektion of an acid-base state, arterial pressure).

Storage conditions:

In dry, protected from light and the place, unavailable to children. A period of validity - 3 years. Not to use drug after a period of validity.

Issue conditions:

Without recipe

Packaging:

On 10 tablets in a blister strip packaging; on 50 tablets in banks of dark glass. 2 either 5 blister strip packagings or place each can together with the application instruction in a pack cardboard. It is allowed to place banks or blister strip packagings together with the equal number of application instructions in group packaging.