NUROFEN FORTE PILLS 400MG

Indications

- headache;

- toothache;

- migraine;

- Algomenorrhea;

- neuralgia;

- backache;

- myalgia;

- rheumatic pains;

- Fever with flu and ARVI.

Dosage and administration

Adults and children over 12 years old inside of 400 mg (1 tab.). If necessary, every 4 hours take 1 tab. (but you can not take more than 3 tab. / day). Maximum Daily Dose for adults is 1.2 g. The maximum daily dose for children and adolescents aged 12 to 17 years is 1 year

Tablets should be taken with water.

The patient should be warned that if the symptoms of the disease persist when taking the drug for 2-3 days, it is necessary to stop treatment and consult a doctor.

Adverse effects

Gastrointestinal: NPVS-gastropathy (abdominal pain, nausea, vomiting, heartburn, loss of appetite, diarrhea, flatulence, constipation; possibly increased activity of hepatic transaminases; rarely - erosive and ulcerative lesions of the gastrointestinal mucosa, which in some cases are complicated by perforation and bleeding); irritation or dryness of the oral mucosa, pain in the mouth, ulceration of the mucous membrane of the gums, aphthous stomatitis, pancreatitis, hepatitis.

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

Cardiovascular: heart failure, tachycardia, increased blood pressure.

Urogenital: acute renal failure, allergic nephritis, nephrotic syndrome (edema), polyuria, cystitis; perhaps - a decrease in QA, an increase in serum concentration of creatinine.

Special senses: hearing loss, ringing or tinnitus, toxic damage to the optic nerve, blurred vision or diplopia, dryness and irritation of the eyes, conjunctival edema and eyelids (allergic origin), scotoma.

Respiratory: shortness of breath, bronchospasm.

Hemic and lymphatic: anemia (incl.hemolytic and aplastic), thrombocytopenia, thrombocytopenic purpura, agranulocytosis, leukopenia; possibly an increase in bleeding time, a decrease in hematocrit or hemoglobin.

Allergic reactions: skin rash (usually erythematous or urticaria), pruritus, angioedema, anaphylactopiama reactions, anaphylactic shock, bronchospasm or dyspnea, fever, erythema multiforme exudative (including Stevens-Johnson syndrome), toxicity epidermus erythema, including toxic erythema, including toxic erythema, including toxic erythema, including toxic erythema, including toxic erythema and erythema;, eosinophilia, allergic rhinitis.

Other: may decrease the concentration of glucose in the blood.

When using the drug for 2-3 days, side effects are very rare.

Contraindications

- erosive and ulcerative lesions of the gastrointestinal tract in the acute phase (including gastric ulcer and duodenal ulcer, Crohn's disease, UC);

- hemophilia, hypocoagulation state, hemorrhagic diathesis;

- the period after coronary artery bypass surgery;

- Gastrointestinal bleeding and intracranial hemorrhage;

- severe liver failure or active liver disease;

- renal failure severe, confirmed hyperkalemia;

- pregnancy;

- lactation period;

- children's age up to 12 years;

- hypersensitivity to the drug;

- Hypersensitivity to Acetylsalicylic acid or other NSAIDs in history: including indications of attacks of bronchial obstruction, rhinitis, urticaria after taking acetylsalicylic acid or another NSAID; complete or incomplete intolerance syndrome acetylsalicylic acid (rhinosinusitis, urticaria, polyps of the nasal mucosa, bronchial asthma).

WITH caution prescribe the drug to elderly patients, patients with heart failure, arterial hypertension, coronary artery disease, cerebrovascular diseases, dyslipidemia, diabetes, peripheral artery disease, smokers, with frequent use of alcohol, with liver cirrhosis with portal hypertension, liver and / or kidney failure, patients with nephrotic syndrome, hyperbilirubinemia, with indications of a history of gastric ulcer and duodenal ulcer, patients with gastritis, enteritis, if ohm, blood diseases of unknown etiology (leucopenia and anemia), lactation, with prolonged use of NSAIDs with severe medical conditions, simultaneously with oral corticosteroids (prednisone v.t.ch) with anticoagulants (includingwith warfarin), antiplatelet agents (including acetylsalicylic acid, clopidogrel), selective serotonin reuptake inhibitors (including citalopram, Fluoxetine, paroxetine, sertraline).

Use during pregnancy and lactation

Nurofen® Forte is contraindicated for use during pregnancy and lactation.

Application for violations of the liver

The drug is contraindicated in violations of the liver.

WITH caution prescribe the drug for concomitant liver diseases.

Application for violations of kidney function

The drug is contraindicated in violation of renal function.

WITH caution prescribe the drug for concomitant kidney disease, nephrotic syndrome.

Use in children

Contraindicated in children under 12 years.

Maximum Daily Dose for children and adolescents aged 12 to 17 years is 1 year

Use in elderly patients

WITH caution prescribe the drug to elderly patients.

Special notes

Treatment with the drug should be carried out in the minimum effective dose, the shortest possible course.

The patient should be informed that if side effects occur, the drug should be stopped and the doctor should be consulted. During the period of treatment is not recommended to use ethanol.

Control of laboratory parameters

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, a careful monitoring is shown, including esophagogastroduodenoscopy, complete blood count (hemoglobin determination), fecal occult blood test.

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

Influence on ability to drive motor transport and control mechanisms

Patients should refrain from all activities that require increased attention and high-speed psychomotor reactions.

Overdosage

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 one hour after ingestion), Activated carbon, alkaline drink, forced diuresis; if necessary, conduct symptomatic therapy.

Drug interaction

It is not recommended to take Nurofen forte with acetylsalicylic acid and other NSAIDs at the same time.

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.

Simultaneous administration with serotonin reuptake inhibitors (including citalopram, fluoxetine, paroxetine, sertraline) increases the risk of serious bleeding from the gastrointestinal tract.

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 prostaglandin 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, inducers of microsomal oxidation (including phenytoin, ethanol, barbiturates, rifampicin, phenylbutazone, tricyclic antidepressants) increase the production of hydroxylated active metabolites, increasing the risk of severe intoxication.

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, fibrinolytics.

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

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

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 inaccessible to children at a temperature not exceeding 25 ° C.