Indications for use
Brufen is prescribed for degenerative diseases, pathologies of the musculoskeletal system of inflammatory origin: osteochondrosis , psoriatic arthritis , ankylosing spondylitis, juvenile arthritis, neuralgic amyotrophy, rheumatoid arthritis , gouty arthritis.
Brufen relieves pain syndrome: ossalgia, arthralgia, myalgia, migraine , radiculitis , toothache, headache, bursitis, tendovaginitis , tendinitis, neuralgia, postoperative pain syndrome.
The drug is prescribed for pelvic inflammation, algodismenorrhea , adnexitis, febrile syndrome due to colds, and infectious diseases.
Indications
Rheumatoid arthritis, ankylosing spondylitis, osteoarthritis and other non-rheumatoid (seronegative) arthropathies.
Non-articular rheumatic and periarticular lesions such as glenohumeral periarthritis (capsulitis), bursitis, tendonitis, tenosynovitis and low back pain; soft tissue injuries such as sprains and ligament strains.
For the relief of moderate to moderate pain such as dysmenorrhea, dental pain and post-surgical pain, and for the symptomatic relief of headaches, including migraines.
Contraindications
"Aspirin" asthma, ulcerative lesions of the digestive system, Crohn's disease , hemophilia , hypersensitivity, breastfeeding, hemorrhagic diathesis, pregnancy.
For liver cirrhosis, anemia, nephrotic syndrome, enteritis, gastritis, arterial hypertension, prescribe with caution.
In pediatric practice, it is prescribed upon reaching 1 year of age.
Side effects
Digestive tract: flatulence, diarrhea, NSAID gastropathy, heartburn , epigastric pain, loss of appetite, dry mouth, hepatitis, pancreatitis, constipation .
Respiratory system: bronchospasm , transient shortness of breath.
Sense organs: scotoma , eyelid edema, conjunctival edema, dry eyes, diplopia, toxic optic neuritis, tinnitus, hearing impairment.
Nervous system: insomnia, headaches, psychomotor agitation, hallucinations , nervousness, depression, drowsiness, irritability.
Cardiovascular system: increased blood pressure, tachycardia, heart failure.
Urinary system: cystitis , polyuria , swelling, allergic nephritis, acute renal failure.
Possible development of skin itching, Lyell's syndrome, fever, bronchospasm, anaphylactic reactions , urticaria , allergic rhinitis , thrombocytopenia, agranulocytosis, increased sweating.
Brufen 600 mg No. 30 granules effervescent sachets
Instructions for medical use of the drug Brufen TRADE NAME BRUFEN INTERNATIONAL NON-PROPENTED NAME Ibuprofen Dosage form Effervescent granules 600 mg Composition 1 sachet contains: active substance - ibuprofen 600 mg, excipients: malic acid, sodium saccharinate, sucrose, povidone (K value from 29 to 32), orange flavor, sodium lauryl sulfate, sodium bicarbonate, sodium carbonate anhydrous. Description White granules, ranging in size from small to large with an orange smell. Pharmacotherapeutic group Anti-inflammatory and antirheumatic drugs. Non-steroidal anti-inflammatory drugs. Propionic acid derivatives. Ibuprofen. ATC code M01A E01 Pharmacological properties Pharmacokinetics Ibuprofen is a racemic mixture of [+]S- and [-]R-enantiomers. Ibuprofen is quickly absorbed from the gastrointestinal tract, with bioavailability of 80-90%. Peak serum concentrations are achieved within 1-2 hours after administration. Studies using standard food indicate that it does not significantly affect overall bioavailability. Ibuprofen is highly bound to plasma proteins (99%). The volume of distribution of ibuprofen is insignificant - 0.12-0.2 l/kg for adults. Ibuprofen is rapidly metabolized in the liver by cytochrome P450 enzymes, primarily CYP2C9, to two major inactive metabolites, 2-hydroxyibuprofen and 3-carboxyibuprofen. About 90% of the dose of ibuprofen taken can be found in the urine in the form of oxidative metabolites and their glucuronic conjugates. A small amount of ibuprofen is excreted unchanged in the urine. Excretion in urine is rapid and complete. The half-life is approximately 2 hours. Ibuprofen is almost completely eliminated from the body 24 hours after the last dose. Elderly Patients In the absence of renal impairment, only small, clinically insignificant differences in the pharmacokinetic profile and urinary excretion were observed between young and elderly patients. Children Systemic exposure of ibuprofen when used in therapeutic doses according to body weight (from 5 mg/kg to 10 mg/kg body weight) in children over 1 year of age is the same as in adults. In children aged 3 months to 2.5 years, the volume of distribution (l/kg) and clearance (l/kg/hour) of ibuprofen is higher than in children aged 2.5 years to 12 years. Renal failure Patients with moderate renal failure had increased plasma levels of (S)-ibuprofen, increased AUC values of (S)-ibuprofen and increased AUC enantiomeric ratio (S/R) values compared to healthy control subjects. In patients with end-stage renal disease on dialysis, the mean free fraction of ibuprofen was approximately 3% compared with approximately 1% in healthy volunteers. Severe renal impairment may lead to accumulation of ibuprofen metabolites. The significance of this effect is unknown. Metabolites can be removed by hemodialysis (see sections “Method of administration and dosage”, “Contraindications”, “Special instructions”). Liver failure The presence of alcoholic liver disease with mild or moderate liver failure did not have a significant effect on changes in pharmacokinetic parameters. In patients with cirrhosis and moderate hepatic impairment (Child-Pugh score 6-10) treated with racemic ibuprofen, an average of 2-fold increase in half-life was observed, and the AUC enantiomeric ratio (S/R) was significantly lower in comparison with healthy volunteers in the control group, which indicates a violation of the metabolic transformation of (R)-ibuprofen into the active (S)-enantiomer (see sections “Method of administration and dosage”, “Contraindications”, “Special instructions”). Pharmacodynamics Ibuprofen, the active substance of Brufen is a derivative of propionic acid, a non-steroidal anti-inflammatory drug (NSAID) has analgesic, anti-inflammatory and antipyretic activity. It is believed that the therapeutic effects of the drug are due to its inhibitory effect on the enzyme cyclooxygenase, which leads to a marked decrease in the synthesis of prostaglandins. These properties provide relief from symptoms of inflammation, pain, and fever. Experimental data suggest that ibuprofen may competitively inhibit the effects of low-dose acetylsalicylic acid/aspirin on platelet aggregation when both drugs are coadministered. In some pharmacodynamic studies, when a single dose of ibuprofen 400 mg was administered within 8 hours before or 30 minutes after taking acetylsalicylic acid/aspirin in the immediate release form (at a dose of 81 mg), the effect of acetylsalicylic acid/aspirin on thromboxane formation or platelet aggregation was reduced . Although there are uncertainties regarding the extrapolation of experimental data to the clinical situation, the possibility cannot be excluded that regular long-term use of ibuprofen may reduce the cardioprotective effect of low-dose acetylsalicylic acid/aspirin. Clinically significant effects are unlikely with irregular use of ibuprofen (see section "Drug Interactions"). Indications for use - rheumatoid arthritis, including juvenile arthritis or Still-Choffard disease, ankylosing spondylitis, osteoarthritis and other non-rheumatoid (seronegative) arthropathy and acute gouty arthritis - extra-articular rheumatic and periarticular lesions, such as glenohumeral periarthritis (capsulitis), bursitis, tendonitis, tenosynovitis and low back pain - soft tissue injuries, such as sprains and strains - relief of mild to moderate pain, such as primary dysmenorrhea, dental and post-operative pain, episiotomy pain, postpartum pain and symptomatic treatment of headaches, in including migraine - hyperthermia Method of administration and dosage Doses Side effects can be minimized by using the minimum effective dose for the shortest period of time necessary to control symptoms (see section "Special Instructions"). Before use, the granules must be thoroughly dissolved in enough water to avoid a burning sensation in the mouth or throat. To achieve faster action, it is recommended to take the drug on an empty stomach. Patients with a sensitive stomach are recommended to take the drug after meals. Adults and adolescents (over 18 years of age) The recommended dose is 1200-1800 mg/day, divided into several doses. For some patients, 600–1200 mg/day may be sufficient. In severe and acute cases, it is possible to increase the dose until the end of the acute phase of the disease. In this case, the maximum daily dose should not exceed 2400 mg, which is administered in several doses. Elderly patients There is no need to change the dose if liver or kidney function is not impaired. If liver or kidney function is impaired, the dose of the drug should be selected individually and with caution. Children Brufen in this pharmaceutical form is contraindicated for use in children. Side effects Adverse reactions reported with ibuprofen are similar to those reported with other NSAIDs. The most common side effects are related to the gastrointestinal tract. Nausea, vomiting, diarrhea, flatulence, constipation, dyspepsia, abdominal pain, melena, hematemesis, ulcerative stomatitis, gastrointestinal bleeding and exacerbation of colitis and Crohn's disease (see section "Contraindications") have been recorded after taking ibuprofen. Gastritis, duodenal ulcer, gastric ulcer and gastrointestinal perforation were observed less frequently. When taking the drug, you may experience a temporary burning sensation in your mouth or throat. Immune system disorders Cases of hypersensitivity reactions have been reported with the use of ibuprofen. They may include: (a) nonspecific allergic reactions and anaphylactic shock, (b) respiratory tract reactions, incl. asthma, exacerbation of asthma, bronchospasm or shortness of breath, and (c) various skin reactions, including various types of rashes, pruritus, urticaria, purpura, angioedema and, in rare cases, erythema multiforme and bullous dermatitis (including Steven-Johnson syndrome and toxic epidermal necrolysis). Infections and infestations Cases of exacerbation of skin inflammation caused by infections (for example, the development of necrotizing fasciitis) have been described when using NSAIDs. If a patient develops or worsens signs of infection while using ibuprofen, they should contact their doctor immediately. Disorders of the skin and subcutaneous tissue In exceptional cases, serious skin infections and disorders of soft tissues may occur due to chickenpox (see also “Infections and infestations”) Disorders of the cardiovascular system The results of clinical studies indicate that Use of ibuprofen, especially at high doses (2400 mg/day), may be associated with a slight increase in the risk of arterial thrombotic complications (eg, myocardial infarction and stroke) (see section "Special Instructions"). Adverse reactions are distributed according to frequency of occurrence: very common ≥ 1/10, common ≥1/100 to ≤1/10, uncommon ≥1/1000 to ≤ 1/100, rare ≥1/10000 to ≤ 1/1000, very rare ˂ 1/10000, frequency unknown (cannot estimate frequency from available data) Common - headache, dizziness - dyspepsia, diarrhea, nausea, vomiting, abdominal pain, flatulence, constipation, melena, hematemesis, gastrointestinal bleeding - rash - fatigue Uncommon - rhinitis - insomnia, anxiety - parasthesia, drowsiness - blurred vision - impaired hearing, noise or ringing in the ears, vertigo - asthma, bronchospasm, shortness of breath - gastritis, duodenal ulcer and stomach ulcer, ulcerative stomatitis, gastrointestinal perforation - hepatitis, jaundice, impaired liver function - urticaria, itching, purpura, angioedema, photosensitivity - toxic nephropathy in various forms, including tubulointerstitial nephritis, nephrotic syndrome, renal failure Rarely - anaphylactic shock - depression and confusion - retrobulbar neuritis - toxic optic neuropathy nerve - swelling Very rarely - aseptic meningitis - leukopenia, thrombocytopenia, aplastic anemia, neutropenia, agranulocytosis and hemolytic anemia - severe general hypersensitivity reactions, which are manifested by swelling of the face, tongue and larynx, dyspnea, increased heart rate, drop in blood pressure (anaphylaxis, angioneurotic swelling or severe shock). - pancreatitis - liver failure - severe skin reactions, for example, erythema multiforme, bullous reactions, including Stevens-Johnson syndrome and toxic epidermal necrolysis - cardiac failure, myocardial infarction (see section "Special instructions") - arterial hypertension Frequency unknown - colitis and Crohn's disease Contraindications - hypersensitivity to the active substance or other components of the drug - asthma, urticaria or other allergic reactions after taking acetylsalicylic acid/aspirin or other non-steroidal anti-inflammatory drugs (NSAIDs) in history - severe heart failure (IV functional class according to New criteria - York Heart Association (NYHA) - severe liver failure - severe renal failure (glomerular filtration rate < 30 ml/min) - conditions accompanied by an increased risk of bleeding or active bleeding - gastrointestinal bleeding or perforation associated with taking NSAIDs, history of acute or previous ulcerative colitis, Crohn's disease, recurrent peptic ulcer or gastrointestinal bleeding (a history of two independently confirmed episodes of ulcerative lesions or bleeding) - third trimester of pregnancy - childhood and adolescence under 18 years of age - lactation period Drug interactions Caution should be used when coadministering with the following drugs due to possible drug interactions in some patients. Other NSAIDs, including selective COX-2 inhibitors. Concomitant use with other NSAIDs, including selective COX-2 inhibitors, should be avoided due to the risk of additive effects (see section "Special Instructions"). Cardiac glycosides. NSAIDs may cause exacerbation of heart failure, a decrease in glomerular filtration rate and an increase in the level of cardiac glycosides in the blood plasma. Corticosteroids. Increased risk of gastrointestinal ulcers or bleeding when prescribed with NSAIDs. Anticoagulants. NSAIDs may enhance the effects of anticoagulants such as warfarin. Antiplatelet drugs and selective serotonin reuptake inhibitors. NSAIDs increase the risk of gastrointestinal bleeding. Acetylsalicylic acid/aspirin. As with other drugs containing NSAIDs, concomitant use of ibuprofen and acetylsalicylic acid/aspirin is usually not recommended due to the risk of increased adverse reactions. Experimental evidence suggests that ibuprofen may competitively inhibit the effect of low-dose acetylsalicylic acid/aspirin on platelet aggregation when administered concomitantly. However, despite uncertainties about the possibility of extrapolating these data to the clinical situation, the possibility cannot be excluded that regular long-term use of ibuprofen may reduce the cardioprotective effect of low doses of acetylsalicylic acid. If ibuprofen is not taken regularly, there are no clinically significant effects (see section “Pharmacodynamics”). Lithium. NSAIDs may reduce lithium excretion. Antihypertensive drugs, β-blockers and diuretics. NSAIDs may reduce the effect of antihypertensive drugs such as ACE inhibitors, angiotensin II receptor antagonists, beta blockers and diuretics. Diuretics may also increase the risk of NSAID nephrotoxicity. Methotrexate. NSAIDs may suppress tubular secretion of methotrexate and reduce the clearance of methotrexate. Cyclosporine. NSAIDs increase the risk of nephrotoxicity. Tacrolimus. There may be an increased risk of nephrotoxicity when NSAIDs are prescribed to patients taking tacrolimus. Zidovudine. NSAIDs increase the risk of hematological toxicity. There is evidence of an increased risk of developing hemarthrosis and hematomas in HIV-positive patients with hemophilia when prescribed ibuprofen while taking zidovudine. Quinolone antibiotics. Animal data indicate that NSAIDs may increase the risk of seizures associated with quinolones. Patients taking NSAIDs and quinolones concomitantly are at increased risk of developing seizures. CYP2C9 inhibitors. Coadministration of ibuprofen with CYP2C9 inhibitors may increase exposure to ibuprofen (a CYP2C9 substrate). One study showed that voriconazole and fluconazole (CYP2C9 inhibitors) increased exposure to S(+)-ibuprofen by approximately 80-100%. A dose reduction of ibuprofen should be considered when co-administered with CYP2C9 inhibitors, especially when prescribing high doses of Brufen to patients taking voriconazole or fluconazole. Sulfonylurea. NSAIDs may potentiate the effects of sulfonylureas. Hypoglycemia has rarely been reported in patients taking sulfonylureas when prescribed Brufen. Cholestyramine. The simultaneous administration of ibuprofen and cholestyramine may reduce the absorption of ibuprofen in the gastrointestinal tract. However, the clinical significance of this is unknown. Aminoglycosides. NSAIDs may reduce the excretion of aminoglycosides. Herbal extracts. Ginkgo biloba may potentiate the risk of bleeding associated with NSAIDs. Mifepristone. A decrease in the effectiveness of the drug could theoretically occur due to the antiprostaglandin properties of NSAIDs. Limited data suggest that concomitant use of NSAIDs on the same day as prostaglandin administration does not interfere with the effects of mifepristone or prostaglandin on cervical or uterine contractility and does not reduce the clinical effectiveness of medical abortion. Special instructions General precautions Adverse effects can be minimized by using the lowest effective dose for the minimum period of time necessary to control symptoms (see section "Special instructions"). As with other NSAIDs, taking ibuprofen may mask the symptoms of an infection. Brufen contains sucrose. Patients with rare hereditary diseases such as fructose intolerance, glucose-galactose malabsorption or sucrose-isomaltase deficiency should not take this drug. Each Brufen sachet contains sodium. Patients on a sodium-controlled diet should take this into account. Elderly patients in elderly patients in the frequency of adverse reactions when using the NSAIDs are higher, especially gastrointestinal bleeding and perforation, which can be mortal. Gastrointestinal bleeding, ulcer formation and Ibuprofen perforation should be prescribed with caution in patients with a peptic ulcer and other diseases of the gastrointestinal tract (gastrointestinal tract) in the history, as these conditions can worsen (see the “contraindications” section). The development of gastrointestinal bleeding, ulcers or perforations was reported when using all NSAIDs at any time during treatment. These adverse reactions can be lethal and develop with or without the symptoms of subjectors, regardless of the presence of a serious pathology of the gastrointestinal tract in a history. The risk of gastrointestinal bleeding, ulcers or perforations with an increase in Ibuprofen doses in patients with ulcer, especially complicated bleeding or perforation in an history of elderly. Such patients should begin treatment with the lowest affordable dose. The possibility of the simultaneous prescribing to such patients of protective drugs (for example, a mizrostol or proton pump inhibitors), as well as patients who simultaneously take acetylsalicylic acid/aspirin in a low dose or other drugs that increase the risk of gastrointestinal tract (see the section “Medicinal interactions”). The simultaneous purpose of ibuprofen and other NSAIDs should be avoided, including selective cyclooxygenase inhibitors of the Cycosigenase-2 (COO-2), due to increased risk of ulcers and bleeding (see the section “Medicinal interactions”). Patients, especially the elderly, with a history of gastrointestinal tract should report any unusual abdominal symptoms (especially gastrointestinal bleeding) at the initial stages of treatment. With caution, ibuprofen should be prescribed to patients receiving concomitant treatment with drugs who can increase the risk of ulcers or bleeding, such as oral corticosteroids, anticoagulants, such as warfarin, selective capture of serotonin or antitrombocytic drugs, such as acetylsalicylic acid/ acid/ acid. Aspirin (see section "Medicinal interactions"). In the case of the development of gastrointestinal bleeding or ulcers in a patient receiving ibuprofen, the drug should be canceled. Respiratory disorders with caution should be prescribed ibuprofen to patients suffering from bronchial asthma, chronic rhinitis or allergic diseases, as well as patients with a history of these diseases, since it was reported that ibuprofen could cause bronchospasm, urticiper, and angioneral edema in such patients. Violation of the function of the heart, kidneys and liver with caution should be prescribed ibuprofen to patients who have a violation of the function of the heart, kidneys and liver, since the use of NSAIDs can lead to a deterioration in the function of the kidneys. Regular intake of similar analgesics simultaneously additionally increases the risk of deterioration of renal function. Patients who have a violation of the function of the heart, kidneys and liver should use the minimum effective dose of the drug over the shortest period of time and control the function of the kidneys, especially in patients receiving prolonged treatment (MS. Section “Contraindications”). Ibuprofen cardiovascular and cerebral-vascular effects should be prescribed with caution to patients with heart failure or arterial hypertension in an anamnesis, since it was reported about the development of edema due to ibuprofen. Clinical studies indicate that the purpose of ibuprofen, especially in a high dose (2400 mg per day) may be associated with a slight increase in the risk of arterial thrombotic complications (for example, myocardial infarction or stroke). In general, epidemiological studies do not suggest the presence of a connection between Ibuprofen in a low dose (≤ 1200 mg per day) and an increased risk of arterial thrombotic complications. Patients with uncontrolled arterial hypertension, congestive heart failure (II-III functional class according to NYHA criteria), diagnosed with coronary heart disease, the disease of the peripheral arteries and cerebrovascular diseases should be prescribed by ibuprofen, and the use of high doses of ibuprofen should also be avoided (should also be avoided ( 2400 mg per day). A thorough analysis of the situation is also necessary before the onset of long-term therapy of ibuprofen patients with risk factors for the development of cardiovascular diseases (such as arterial hypertension, hyperlipidemia, diabetes, smoking), especially if it is necessary to take high doses of ibuprofen (2400 mg per day). Dermatological effects very rarely, when using the NSAIDs, reported the development of serious skin reactions, some of which could be lethal, including exfoliative dermatitis, Stevens-Johnson syndrome and toxic epidermal necrolysis. Presumably, the greatest risk of developing these reactions exists at the beginning of treatment. In most cases, the beginning of the reaction occurs during the first month of therapy. Ibuprofen intake should be stopped at the first appearance of a rash on the skin, damage to the mucous membrane or any other signs of hypersensitivity. The effects of the kidneys with caution should begin treatment of ibuprofen patients with significant dehydration. There is a risk of renal failure, especially in children and adolescents with dehydration. As with the appointment of other NSAIDs, a long -term intake of ibuprofen can lead to papillary necrosis of the kidneys and other pathological changes in the kidneys. Toxic effect on the kidneys was also observed in patients in whom renal prostaglandins played a compensatory role in maintaining kidney perfusion. The appointment of NSAIDs to such patients can cause a dose -dependent decrease in the formation of prostaglandins and, secondly, a decrease in renal blood flow, which can lead to renal failure. The high -risk of the development of such a reaction includes patients with impaired renal function, heart failure, liver dysfunction, taking diuretics and angiotenzinzinoproding enzyme (APF), as well as elderly patients. The termination of the reception of NSAIDs is usually accompanied by the restoration of the condition that preceded the treatment. The hematological effects of ibuprofen, like other NSAIDs, can inhibit platelet aggregation and lengthen bleeding time in healthy people. Aseptic meningitis in rare cases in patients who received ibuprofen developed aseptic meningitis. Although this is more likely in patients with systemic lupus erythematosus and other diseases of the connective tissue, the development of this complication was also reported in patients without related chronic diseases. Pregnancy and lactation period Pregnancy inhibition of prostaglandins synthesis can adversely affect the course of pregnancy and/or the development of the embryo/fetus. Data of epidemiological studies suggest an increase in the risk of non -infinition and development of heart defects and gastroshisis after the use of prostaglandin synthesis inhibitors in the early stages of pregnancy. It is assumed that the risk increases with an increase in the dose and duration of therapy. Ibuprofen should not be prescribed in the first and second trimesters of pregnancy without extreme necessity. In the case of Ibuprofen, women planning pregnancy, or in the first or second trimester of pregnancy, should be used as low as possible dose for as low as possible. The use of any prostaglandin inhibitors in the third trimester of pregnancy can affect the fetus, causing the development of cardiopulmonary toxicity (with premature closure of the arterial duct and pulmonary hypertension); Dysfunction of the kidneys, which can progress to renal failure with oligohydramnion. At the end of pregnancy, prostaglandin synthesis inhibitors can affect the condition of the mother and a newborn child with a possible lengthening of bleeding time, inhibition of the contractility of the uterus, which may be accompanied by delay and prolongation of childbirth. Thus, the use of ibuprofen in the third trimester of pregnancy is contraindicated. It is not recommended to prescribe ibuprofen to women during labor. This can lead to a delay in the beginning of childbirth, lengthening the period of childbirth and an increase in the tendency to bleeding in the mother and the child. The use during lactation during a limited number of Ibuprofen studies was determined in breast milk in a very low concentration. Ibuprofen is not recommended to be prescribed to women who are breastfeeding. Ibuprofen can affect female fertility, so its use is not recommended for women planning pregnancy. Women who cannot get pregnant or who are examined about infertility should consider the possibility of abolishing ibuprofen. Features of the effect of the drug on the ability to drive a vehicle or potentially dangerous mechanisms, Ibuprofen treatment can affect the time of the reaction of patients, which should be taken into account if necessary increased attention, for example, when driving a car or operational equipment. An overdose of the signs and symptoms of an overdose in adults were usually not observed at doses below 100 mg/kg. However, in some cases, supporting measures may be required. Symptoms In most patients, the symptoms of an overdose develop within 4-6 hours after taking a significant amount of ibuprofen. The most frequent symptoms of overdose include: nausea, vomiting, abdominal pain, apathetic and drowsiness. Manifestations from the central nervous system (central nervous system): headache, ringing in the ears, dizziness, cramps and loss of consciousness. It was rarely reported about nystagmus, metabolic acidosis, hypothermia, symptoms from the kidneys, gastrointestinal bleeding, coma, apnea and inhibition of the central nervous system and the respiratory system. The cardiovascular toxicity was reported, including the development of arterial hypotension, bradycardia and tachycardia. In cases of significant overdose, the development of renal failure and liver damage is possible. Significant overdose is usually well tolerated if other drugs have not been taken. Treatment. There is no specific antidote with an overdose of ibuprofen. In the case of taking a dose exceeding 400 mg/kg, it is necessary to rinse the stomach and take maintenance measures within an hour from the date of administration. To obtain the most relevant information, you must contact the local toxicological center. The form of release and packaging sparkling granules in Sasha. 30 Sasha, along with instructions for medical use in the state and Russian languages, are invested in a pack of cardboard. Storage conditions Store at a temperature not exceeding 25 °C. Keep out of the reach of children! The shelf life of 2 years is not used after the expiration of the shelf life indicated on the packaging. Conditions for the vacation from pharmacies according to the recipe manufacturer Abbvi S.R.L., Italy SR 148 Pontina KM 52 SNC, 04011 Campoverde di Aprilia, (LT) Owner of the registration certificate of Abbott Laboratory GMBH, Hanover, Germany Pacific ABBVI S.R.L., Germany, Germany, Germany, Germany, Germany Italy SR 148 Pontina KM 52 SNC, 04011 Campoverde di Aprilia, (LT) address of the organization that accepts in the territory of the Republic of Kazakhstan claims from consumers on the quality of products (goods) and responsible for post -art monitoring of the safety of the drug. Abbott Kazakhstan LLP 050059 Almaty, Dostyk Ave., 117/6, Khan Tengri 2
Instructions for use of Brufen (Method and dosage)
Brufen tablets, instructions for use
Brufen is taken orally.
Ankylosing spondylitis, osteoarthritis, psoriatic arthritis: 400 mg of ibuprofen three times a day.
Treatment of rheumatoid arthritis: three times a day at a dose of 800 mg.
Algomenorrhea: 400 mg three times a day.
Suspension
Three times a day, 5-10 mg/kg.
Feverish syndrome after immunization: 50 mg once, then repeat after six hours.
Gel
For adults, apply about 3 g of gel to the desired area.
Sachet powder Brufen, instructions for use
Dissolve with sufficient amount of water. Used during or after meals. 600 mg 3 times a day. No more than 2400 mg in 24 hours.
Pharmacological properties
Pharmacodynamics.
Ibuprofen is a derivative of propionic acid, an NSAID, which has analgesic, anti-inflammatory and antipyretic activity. It is believed that the therapeutic effects of the drug are due to its inhibitory effect on the TsOG enzyme, which leads to a marked decrease in the synthesis of prostaglandins. these properties provide a reduction in the severity of symptoms of inflammation, pain and fever. Experimental evidence suggests that ibuprofen may competitively inhibit the effects of low-dose acetylsalicylic acid/aspirin on platelet aggregation when both drugs are coadministered. Some pharmacodynamic studies show that when a single dose of ibuprofen 400 mg was administered 8 hours before or 30 minutes after taking acetylsalicylic acid in the immediate release form (at a dose of 81 mg), the effect of acetylsalicylic acid/aspirin on thromboxane formation or platelet aggregation was reduced .
Although there are uncertainties regarding the extrapolation of these findings to the clinical situation, the possibility cannot be excluded that regular long-term use of ibuprofen may reduce the cardioprotective effect of low-dose acetylsalicylic acid/aspirin. Clinically significant effects are unlikely with intermittent use of ibuprofen (see INTERACTIONS).
Pharmacokinetics. Ibuprofen is rapidly absorbed from the gastrointestinal tract, with peak plasma concentrations achieved within 1–2 hours after administration. T½ - approximately 2 hours.
Ibuprofen is metabolized in the liver to 2 inactive metabolites, which are excreted by the kidneys along with unchanged ibuprofen in pure form or in the form of conjugates. Renal excretion is rapid and complete. Ibuprofen is highly bound to plasma proteins.
Interaction
Tricyclic antidepressants, phenytoin, barbiturates, inducers of microsomal oxidation increase the production of active, hydroxylated metabolites, which increases the risk of hepatotoxic reactions.
When taking microsomal oxidation inhibitors, the risk of hepatotoxicity .
Brufen reduces the hypotensive effect of vasodilators, reduces the effectiveness of uricosuric medications, and enhances the effect and effectiveness of indirect anticoagulants .
Brufen increases the level of digoxin and methotrexate in the blood.
When taken simultaneously with caffeine, it enhances the analgesic effect.
special instructions
Mandatory monitoring of the condition of the hepatic, renal systems, and peripheral blood.
With the development of NSAID gastropathy fibrogastroduodenoscopy , the level of hemoglobin and hematocrit , and feces are examined for occult blood.
It is recommended to take misoprostol or PgE drugs at the same time.
Drinking alcohol is not allowed.
Brufen affects the speed of motor, emotional, and mental reactions.
Brufen's analogs
Level 4 ATC code matches:
Artrum
Brustan
Ketonal Duo
Nurofen Plus
Nurofen Express
Nurofen Forte
Nurofen Express Lady
Nurofen for children
Nurofen
Ibuprom
Ibuprofen
Advil
MIG 400
Has
Ketoprofen
Vimovo
Naproxen
Flexen
Nalgesin
Flamax
Analogues of the drug are products containing ibuprofen: Arofen , Bolinet , Eurofast , Ibunorm, Ibuprex , Ibuprom , Ibutex , Ivalgin , Imet , Nurofen , Faspik .
Brufen price, where to buy
The price of syrup is about 135 hryvnia.
30 sachets cost about 200 hryvnia.
- Online pharmacies in RussiaRussia
- Online pharmacies in UkraineUkraine
- Online pharmacies in KazakhstanKazakhstan
LuxPharma* special offer
- Brufen SR 800 mg tab.
No. 28 1980 rub. order
ZdravCity
- Brufen SR tablets p.p.o. with prolonged release 800 mg 28 pcs. Famar A.V.E
RUR 542 order
- Brufen SR tablets p.p.o. with prolonged release 800 mg 14 pcs. Famar A.V.E
RUB 281 order
Pharmacy Dialogue
- Brufen SR tablets 800 mg No. 28Abbot/Famar
RUB 289 order
show more
Pharmacy24
- Brufen 600 mg N30 granules Abbvi S.r.l., Italy
238 UAH.order
PaniPharmacy
- Brufen Brufen sachet 600 mg No. 30 Italy, Abbvie
246 UAH order
show more
Note!
Description of the drug Brufen gran. thorn. 600 mg sachet No. 30 on this page is a simplified author’s version of the apteka911 website, created on the basis of the instructions for use.
Before purchasing or using the drug, you should consult your doctor and read the manufacturer's original instructions (attached to each package of the drug). Information about the drug is provided for informational purposes only and should not be used as a guide to self-medication. Only a doctor can decide to prescribe the drug, as well as determine the dose and methods of its use.
