Buy Airtal powder for the preparation of an oral suspension 100 mg pack. 3g No. 20 in pharmacies

What are Aertal tablets for?

The active ingredient of Aertal is aceclofenac. This is an anti-inflammatory drug with an analgesic effect. The tablets are taken for severe pain in the joints and tissues; the drug is especially often used for toothache, when it is not possible to quickly get to the dentist. In addition, sudden pain in the lumbar region can also be easily eliminated by taking the Aertal tablet.

Food intake does not affect the absorption and activity of the components. For severe and persistent pain, take the drug twice a day, one tablet. Exceeding the daily dose is not recommended to avoid negative reactions.

Drug combination

If you take the drug together with blood pressure medications and diuretics, the therapeutic effect of these medications may be weakened. If you have diabetes mellitus of the first degree, you should carefully monitor your blood sugar levels while taking the drug. Do not take simultaneously with aspirin, oral contraceptives, medications containing lithium and potassium, cyclosporins, blood thinners.

You should drive carefully while taking Aethral. Possible decrease in concentration.

What is Aertal powder from?

Powder is a type of dosage form. It is intended for preparing a suspension. A single dose of the drug is packaged in a sachet. The advantage of using the powder is its rapid absorption. The tablet requires time to be broken down and processed in the gastrointestinal tract, and the powder, once in the stomach, begins to be absorbed into the blood without waiting for delivery to the intestines. The active substance contained in the tablets is contained in the same volume in one sachet.

Another advantage of using powder is the ability to accurately adjust the dose. For example, people with kidney or liver failure need to reduce the single dose by half. By dividing the contents of the package into two parts, it is easy to prepare a suspension of the desired concentration.

What does it consist of?

Medicine for pain is available in several forms:

• powder from which it is easy to prepare a suspension;
• pills;
• cream.

The powder is available in a dosage of three grams. Typically sold in packs of twenty bags.

Tablets of one hundred milligrams, sold in packs of twenty and sixty tablets. Uniform white ointment in a sixty gram package.

The main active ingredient is aceclofenac.

What is Aertal ointment for?

Ointment is a form for topical use. It is applied to damaged joints or areas of the body. Indications for use are bruises, sprains, dislocations, torticollis, or shooting sharp pain in the lower back.

The ointment is applied in a small amount to the sore spot and thoroughly rubbed into the tissue with massaging movements. Once in the body, the drug is absorbed into the blood, from where it is distributed throughout the body. As additional components, the ointment contains liquid paraffin and wax, which make its consistency soft and elastic.

Aertal or Xefokam: which is better?

Ksefokam, like Airtal, is an anesthetic drug. Its activity is primarily observed in rheumatoid arthritis, osteoarthritis and other types of joint and bone pain. However, unlike Airtal, Xefocam is based on another active substance - lornoxicam, which does not in any way affect the level of inflammation and the patient’s body temperature. The drug is suitable for symptomatic use and relief of sudden pain.

Adverse reactions for both drugs are identical. Long-term use can cause anemia, thrombocytopenia, insomnia, and depression. When choosing between medications, you need to pay special attention to individual intolerance to the components, and the need to relieve inflammation and normalize the temperature.

Both drugs are contraindicated during pregnancy and breastfeeding, since their active ingredients are instantly and almost completely absorbed into the blood. These drugs are also not prescribed to patients under 18 years of age. Bronchial asthma is a direct contraindication to the use of both drugs, since both of them can cause bronchospasm.

Use of Aertal (aceclofenac) in clinical practice

The NSAID group includes a large number of drugs that differ in analgesic and anti-inflammatory activity, routes of drug administration into the body, the range of adverse events, etc. In this regard, approaches to their prescription differ depending on the clinical manifestations of the disease, the age of the patients, the predicted duration of treatment and etc. It is necessary to take into account that when taking NSAIDs, especially long-term, the development of undesirable effects is possible - nausea, discomfort and pain in the epigastric region, flatulence, diarrhea, as well as erosive and ulcerative lesions, bleeding and perforation of the stomach wall, duodenum and intestines. The administration of NSAIDs in some patients can provoke the development of bronchospasm, dizziness, insomnia, and a disorder of bone marrow hematopoiesis, manifested by a decrease in the number of red blood cells, leukocytes and platelets in the peripheral blood, which, however, are rare. Some NSAIDs contribute to an increase in blood pressure, and their use reduces the effectiveness of ACE inhibitors, diuretics and beta-blockers [2].

One of the side effects of NSAIDs is their possible adverse effect on articular cartilage, which is especially important when treating patients with articular syndrome (rheumatoid arthritis, osteoarthritis, etc.). Thus, some non-selective NSAIDs (indomethacin, ibuprofen, etc.) with long-term use inhibit the proliferation of chondrocytes, thereby causing increased degradation of cartilage tissue [6]. The different effects of NSAIDs on the synthesis of proteoglycans by chondrocytes are also considered proven. In particular, Dingle JT and M. Parker (1997) divided all NSAIDs into 3 groups depending on their effect on the synthesis of cartilage matrix components in vitro

: inhibitory (indomethacin, naproxen, ibuprofen, nimesulide), neutral (piroxicam, nabumetone) and stimulating (tenidap, aceclofenac) [9]. There is also evidence of an increase in the frequency of destructive changes in articular cartilage when taking indomethacin and naproxen, detected radiographically [4].

The therapeutic effect of NSAIDs is realized through the suppression of the production of cyclooxygenase (COX) with a subsequent decrease in the synthesis of pro-inflammatory prostaglandins, in particular PGE2. All NSAIDs, according to the degree of COX inhibition, are divided into 2 groups - non-selective (“classical”, standard), equally inhibiting the production of COX-1 and COX-2 (diclofenac, indomethacin, ibuprofen, etc.) and selective (specific) COX-2 inhibitors – nimesulide, meloxicam, coxibs.

Varying degrees of effectiveness and inhibition of COX, as well as variability in the pharmacodynamic and pharmacokinetic properties of NSAIDs, apparently underlie the explanation (if not completely explain) of their very wide range of pharmacological activities. This functional heterogeneity also applies to the analgesic efficacy of these drugs, although the definition of NSAIDs as “weak analgesics” is not entirely correct, given the fact that for postoperative pain, some NSAIDs have a significantly better analgesic effect than opioid analgesics [7]. In recent years, evidence has accumulated indicating that the analgesic effect of NSAIDs cannot always be explained solely by their ability to inhibit prostaglandin synthesis in peripheral tissues. In particular, it has been found that some NSAID drugs that cross the blood-brain barrier interfere with the processing of nociceptive signals in the spinal cord. Proposed targets of NSAIDs in the central nervous system are excitatory neurotransmitters, in particular glutamate, G proteins, serotonergic and opiate pathways, and polyamines. In addition, it has been shown that some NSAIDs can inhibit prostaglandin synthesis directly in the CNS [1].

One of the drugs that is widely used in rheumatological practice is aceclofenac (Aertal), a derivative of phenylacetic acid, which has a short half-life (4 hours) and good efficacy, comparable to other “standard” NSAIDs [3,14]. It has been proven that aceclofenac inhibits both isoenzymes of cyclooxygenase with a predominant inhibition of COX-2, and also suppresses the synthesis of a number of pro-inflammatory cytokines, in particular IL-1 [13]. Aceclofenac is quickly absorbed in the body - the peak concentration of the drug in the blood is reached within 1-3 hours after administration, while in the synovial fluid it is about 50% of the plasma concentration. Elimination of the drug occurs predominantly (up to 66%) in the urine [8]. The therapeutic dose of Aertal is 200 mg per day, maintenance – 100 mg per day [5].

The pharmacokinetics of Aertal (aceclofenac) does not change with age, which is very important when prescribing it to elderly patients, and bioavailability does not decrease when taken with food [24]. In addition, no interaction of the drug with other pharmacological agents was detected, in particular, with diuretics, ACE inhibitors, anticoagulants, etc. In particular, with the combined administration of aceclofenac and diuretics, no changes in blood pressure and urine osmolarity were observed. There were also no negative clinical effects identified when taking aceclofenac together with antidiabetic drugs, however, with long-term use of NSAIDs, dose adjustment of glucose-lowering drugs is sometimes necessary. The combined use of aceclofenac and warfarin led to a slight increase in the plasma concentration of the latter, but this did not have a significant effect on coagulogram parameters. No changes were detected when taking aceclofenac and methotrexate together, which is widely used in the complex therapy of rheumatic diseases [3].

Taking into account the fact that Airtal has been widely used in clinical practice since 1992 (the drug was registered in Russia in 2002), a lot of practical experience has now been accumulated in its use for various rheumatic diseases. Many clinical studies have demonstrated similar effectiveness of aceclofenac and other non-selective NSAIDs (diclofenac, piroxicam, naproxen) for rheumatoid arthritis, osteoarthritis, ankylosing spondylitis, etc. In animal experiments, it was shown that aceclofenac, with equal effectiveness with standard NSAIDs, has much less damaging effects effect on the gastrointestinal mucosa. Thus, its ulcerogenic dose in the experiment turned out to be approximately 4 times higher than that of diclofenac, indomethacin and naproxen. A comparative study of aceclofenac and selective NSAIDs (celecoxib and rofecoxib) in relation to the suppression of the activity of COX-1 and COX-2 in human whole blood showed that aceclofenac inhibits both isoenzymes, but predominantly the expression of COX-2 and, thus, the mechanism of action is close to to selective [17].

The ability of Aertal (aceclofenac) to inhibit the synthesis of a number of pro-inflammatory cytokines (TNF-α and IL-1β) has been proven, which is important when used both for inflammatory diseases of the joints (rheumatoid arthritis, gouty arthritis, ankylosing spondylitis, etc.) and for osteoarthritis. The results of the study by Y. Henrotin et al. (2001) indicate the potential ability of aceclofenac to influence the processes of degradation of the cartilage matrix by inhibiting the activity of IL-1β and stimulating the synthesis of glycosaminoglycans (GAGs) in cartilage during osteoarthritis [13]. As is known, IL-1β suppresses the synthesis of chondrocytes and initiates cartilage degradation processes as a result of increased release of proteolytic enzymes. The stimulating effect of aceclofenac on the synthesis of IL-1β receptor antagonist in human chondrocytes and suppression of the production of metalloproteinases has also been established [4]. Thus, the prescription of aceclofenac in these cases has both a symptom-modifying and, to some extent, a pathogenetic effect. In particular, clinical studies demonstrated the inhibitory effect of aceclofenac on PGE2 production in the synovial fluid of patients with gonarthrosis.

Taking these data into account, the use of aceclofenac for osteoarthritis (OA) is pathogenetically justified. Thus, in a study by HEL Hajjal et al. (2003), performed in vitro

on cartilage obtained during surgical treatment of patients with OA, it was shown that the use of celecoxib, in contrast to diclofenac, increased the number of [3H]-PG molecules involved in the synthesis of cartilage prostaglandins, and also increased the concentration of newly synthesized hyaluronic acid molecules [11].
Similar effects were also detected with the use of aceclofenac, which in in vitro
led to stimulation of GAG synthesis in cartilage tissue in patients with osteoarthritis.

Also important is the established fact that the analgesic effect of aceclofenac in patients with OA is comparable to other NSAIDs, including diclofenac, piroxicam and naproxen. Thus, in a study by DE Ward et al. (1995) demonstrated that in two groups of patients with OA of the knee joints (n=397) after 12 weeks of therapy with aceclofenac (200 mg/day) and diclofenac (150 mg/day) there was a significant reduction in pain assessed by 100 –mm visual analogue scale (VAS), while in the aceclofenac group the pain intensity decreased by 75%, in the diclofenac group – by 70% [23]. Other parameters of the disease - general health, pain on movement and functional activity - also significantly improved in both groups, however, according to the survey, patients gave greater preference to aceclofenac (71% versus 59%, p = 0.005).

In another 8-week, double-blind study, aceclofenac and piroxicam were used in patients with knee OA (n=240). During therapy, both groups showed a significant decrease in pain intensity and improvement in joint function according to the LOSI (Lequense Osteoarthritis Severity Index) osteoarthritis severity index, but the best result was observed in patients receiving aceclofenac [21]. Similar results were obtained in another comparative study of aceclofenac and piroxicam in patients with gonarthrosis [22].

In a 12-week study, which involved 374 patients with knee OA, comparable therapeutic efficacy of aceclofenac (200 mg/day, group 1) and naproxen (1000 mg/day, group 2) was established. By the end of the course of therapy, the majority of the examined patients noted a decrease in pain at rest and during movement, while the range of motion in the affected joints increased in 81% of patients in group 1 and 84% in group 2, and an improvement in general condition was noted by 73 and 69% of patients respectively [15].

In patients with rheumatoid arthritis, when prescribed aceclofenac, a good anti-inflammatory and analgesic effect was observed, comparable to taking “standard” NSAIDs - diclofenac, indomethacin and tenoxicam. Thus, in a multicenter, double-blind, 6-month study, a comparison was made of aceclofenac (200 mg/day, 170 patients) and diclofenac (150 mg/day, 173 patients) in parallel groups [19]. Both drugs significantly reduced the severity of pain, Ritchie index and morning stiffness after 15 days from the start of therapy, while the achieved positive effect was maintained throughout the entire treatment period. According to the patients' assessment, good or very good treatment results were observed in 70.3% of patients treated with aceclofenac and in 65.6% with diclofenac, and according to the researcher's assessment - in 76.3 and 69.6% of patients, respectively.

Taking into account the fact that for seronegative spondyloarthropathies, NSAIDs are the basis of drug therapy, special requirements are placed on their effectiveness and tolerability. Studies of the effectiveness of aceclofenac and standard NSAIDs in patients with ankylosing spondylitis (AS) have shown their equivalence, however, aceclofenac demonstrated a better tolerability and safety profile. Thus, in a randomized controlled trial, aceclofenac was prescribed at a dose of 200 mg/day. and naproxen at a dose of 1000 mg/day. equally effectively reduced the intensity of pain and contributed to the improvement of functional activity in 126 patients with AS [20]. Another study demonstrated equal therapeutic efficacy of aceclofenac and other NSAIDs (indomethacin, tenoxicam and naproxen) in relieving pain, reducing the duration of morning stiffness and improving motor activity in ankylosing spondylitis [10].

As is known, the feasibility of using a particular drug in clinical practice is impossible without a comprehensive study of its tolerability. One of the serious side effects of NSAIDs that limits their use is the development of NSAID-induced gastropathy, manifested by erosions (often multiple) and ulcers of the antrum of the stomach. The main risk factors for their development are the elderly age of patients, a history of peptic ulcer disease, gastrointestinal bleeding or melena, long-term use of high doses of NSAIDs, and concurrent use of NSAIDs and drugs of other pharmacological groups (glucocorticoids, anticoagulants, etc.) [2].

Data from numerous clinical studies indicate that the incidence of adverse events from the gastrointestinal tract when taking the vast majority of non-selective NSAIDs reaches 30%, and hospitalization of elderly patients due to the development of peptic ulcers is 4 times higher compared with people of the same age group who are not taking NSAIDs.

Today, it is generally accepted that there are no absolutely safe NSAIDs, and therefore they can be divided into 2 groups: with a high and low risk of developing side effects from the gastrointestinal tract. The spectrum of adverse events during treatment with aceclofenac was similar to that during treatment with other NSAIDs, but differed significantly in the frequency of their development. This was demonstrated in the SAMM (Safety Assessment of Marketed Medicines) study, which involved 10,142 patients (7,890 patients were prescribed aceclofenac, 2,252 patients were prescribed diclofenac) suffering from rheumatoid arthritis, osteoarthritis and ankylosing spondylitis [12]. The results of the study indicated a better tolerability profile of aceclofenac compared to diclofenac (Fig. 1). The authors concluded that the use of aceclofenac was accompanied by a lower risk of developing NSAID gastropathy and better tolerability, even taking into account the fact that among the patients receiving aceclofenac, there were significantly more patients with a history of gastrointestinal pathology.

In a study by A. Yanagawa et al. (1998) studied the possible side effects of aceclofenac and diclofenac on the mucous membrane of the duodenum (according to the results of fibrogastroduodenoscopy) in a double-blind, placebo-controlled study [25]. Endoscopic changes after 2 weeks of taking aceclofenac, diclofenac and placebo were significantly more often observed in the diclofenac group. It was found that in patients receiving diclofenac, the content of hexosamine (a factor that has a cytoprotective effect) and local blood flow in the mucous membrane of the stomach and duodenum were significantly reduced, while when treated with aceclofenac, these indicators did not differ significantly from placebo groups.

The results of these studies correspond with the work of MJ Llorente Melero et al. (2002), which presented a comparative population analysis of the incidence of gastrointestinal bleeding when taking various NSAIDs according to data from medical institutions in Spain (data were studied on 180,995 patients over a 4-year period) [18]. As can be seen from Figure 2, taking aceclofenac and meloxicam was accompanied by the lowest risk of bleeding from the upper gastrointestinal tract, while when prescribing ketorolac and indomethacin, the risk of gastrointestinal bleeding was more than 10 times higher.

Based on the presented data, it can be stated that the key point in choosing an NSAID by a rheumatologist is its high clinical effectiveness, safety, and good tolerability. In this regard, the results of the European observational cohort study, which analyzed the effectiveness of aceclofenac in 23,407 patients with inflammatory and degenerative rheumatic diseases, are interesting [16]. This study assessed the severity of pain during therapy, overall satisfaction with treatment, and the level of compliance. The results obtained demonstrated the rapid and long-lasting analgesic effect of aceclofenac, with an improvement in general condition observed in 84% of the patients examined, and 93.5% of patients noted satisfaction with treatment at the end of the study.

Thus, summing up the data on the effectiveness and tolerability of aceclofenac obtained in numerous controlled clinical studies, we can conclude that aceclofenac (Aertal) is a highly effective NSAID and has a number of advantages over other “standard” NSAIDs: fast half-life (4 hours), which reduces the possibility of drug accumulation and, accordingly, the risk of side effects; high bioavailability, which does not depend on food intake; comparable pharmacokinetics in individuals of different age groups; comparable effectiveness with diclofenac, indomethacin, naproxen and ketoprofen in the treatment of degenerative and inflammatory joint diseases; better gastrointestinal tolerability in comparison with other “standard” NSAIDs according to clinical and endoscopic studies; the possibility of combined use with drugs from other pharmacological groups (indirect anticoagulants, hypoglycemic drugs, diuretics); no evidence of negative effects on cartilage.

Literature 1. Dexketoprofen trometamol / Description of the medicinal product. – B.I., 2003. – 58 p. 2. Nasonov E.L. Non-steroidal anti-inflammatory drugs: new aspects of use in rheumatology and cardiology // Russian Medical Journal. – 2003. – T.11, No. 23. – P.1280–1284. 3. Nasonova V.A. Aceclofenac – safety and effectiveness // Russian Medical Journal. – 2003. – T.11, No. 5. – P. 3–6. 4. Chichasova N.V. Treatment of osteoarthritis: the effect of various anti-inflammatory drugs on cartilage tissue // Russian Medical Journal. – 2005. – T.13, No. 8. – P.539–543. 5. Aceclofenac. Almirall Prodespharma SA – Barcelona, ​​2003. – 120 p. 6. Brandt KD The mechanism of action of nonsteroidal anti-inflammatory drugs //J.Rheum. – 1991. – Vol.18. – P. 120–121. 8. Brandt KD The role of analgesics in the management of osteoarthritis pain // Am.J.Therap. – 2000. – Vol. 7. – P. 75–90. 9. Creamer J. A comparison of the pharmacokinetics of single and repeated doses of aceclofenac in young and elderly volunteers // Brit.J.Clin.Res. – 1992. – Vol. 3. – P. 99–107. 10. Dingle JT, Parker M. NSAID stimulation of human cartilage matrix synthesis: a study of the mechanism of action of aceclofenac // Clin.Drug Invest. – 1997. – Vol. 14. – P. 353–362. 11. Dooley M, Spencer CM, Dunn CJ et al. Aceclofenac. A reappraisal of its use in the management of pain and rheumatic disease // Drugs. – 2001. – Vol. 61, N 9. – P. 1351–1378. 12. Hajjal HEL, Marcelis A., Devogelaer J–P., Manicourt D–H. Celecoxib has a positive effect on the overall metabolism of hyaluronan and proteoglycans in human osteoarthritic cartilage // J. Rheum. – 2003. – Vol. 30. – P. 2444–2451. 13. Haskinsson EC, Irani M., Murray F. A large prospective open-label, multi-centre SAMM study, comparing the safety of aceclofenac with diclofenac in patients with rheumatic disease // Eur.J.Rheumatol.Inflam. – 2000. – Vol. 17. – P. 1–7. 14. Henrotin Y., De Leval H, Mathy-Hartet M et al. In vitro effects of aceclofenac and its metabolites on the production by chondrocytes of inflammatory mediators // Inflamm.Res. – 2001. – Vol. 50. – P. 391–399. 15. Huskisson EC Editorial. Aceclofenac: Ace or just another Jack? // Europ.J.Rheum.Inform. – 1996. – Vol. 16, N1. – P. 1–2. 16. Kornasoff D., Frerick H., Bowdler J., Montull E. Aceclofenac is a well-tolerated alternative to naproxen in the treatment of osteosrthrosis. Clin.Rheumatol. – 1997. – Vol. 16. – P. 32–38. 17. Lemmel E.M., Leeb B., De Bast J., Aslanidis S. Patient and physician satisfaction with aceclofenac results of the European Observational Cohort Dtudy // Curr. Med. Res. Opt. – 2002. – Vol. 18, N3. – P. 146–153. 18. Lidburg Ps, Vojnovic J., Warner TD “COX2/COX1 selectivity of aceclofenac in comparison with celecoxib and rofecoxob in the human whole blood assay / Fith world Congress og the OARS, Barselona, ​​Spain, 4–6 October, 2000. – Suppl B, Th053. 19. Llorente Melero MJ, Tenias Burillo JM, Zaragoza M. Comparative incidence of upper gastrointestinal bleeding associated with individual non-steroidal anti-inflammatory drugs. Rev. Esp. Enferm. Dig. – 2002. – Vol. 94. – P. 7–18. 20. Pasero G, Marcolongo R, Serni U et al. A multi-centre, double-blind comparative study of the efficacy and safety of aceclofenac and diclofenac in the treatment of rheumatoid arthritis // Rev.Esp.Reumatol. – 1992. – Vol. 19. – P. 263–268. 21. Pasero G, Ruju G, Macolongo R et al. Aceclofenac versus naproхen in the treatment of ankylosing spondylitis: a double–blend, controlled study // Curr.Nher.Res. – 1994. – Vol. 55. – P. 833–842. 22. Perez Busquiner M., Calero E., Rodriguez M. et al. Comparison of aceclofenac with piroxicam in the treatment of osteosrthrosis // Clin.Rheumatol. – 1997. – Vol. 16. – P. 154–159. 23. Torri G., Vignati C., Agrifoglio E. et al. Aceclofenac versus piroxicam in the management of osteosrthrosis of the knee: a double–blind controlled study // Curr.Ther.Res. – 1994. – Vol. 55. – P. 576–583. 24. Ward DE, Veys EM, Bowdker JM, Roma J. Comparison of aceclofenac with diclofenac in the treatment of osteoarthrosis // Clin.Rheumatol. – 1995. – Vol. 14. – P. 656–662. 25. Wood SG, Fitzpatrik K. et al. Pharmacokinetics and metabolism of a new NSAID/analgesic aceclofenac in man // Pharm.Res. – 1990. – Vol. 7, N9. – S–212. 26. Yanagawa A., Endo T., Kusakari K. et al. Endoscopie evaluation of aceclofenac–induced gastroduodenal mucosal damage: a double–blind comparison with sodium diclofenac and placebo // JJRheumaco L. – 1998 – Vol. 18. – P. 249–259.

Is it possible to take Aertal with alcohol?

Removing Airtal from the body puts a serious burden on the liver and kidneys. Alcohol, entering the blood at the same time as Aertal, can aggravate the condition of the filtering organs, because its presence puts additional stress on the liver. Alcoholism is a direct contraindication to the use of Aertal, as this can lead to organ dysfunction.

In addition, many alcoholic drinks are diuretics, which increases the load on the kidneys. If there is stagnation of fluid in the body and the simultaneous use of Aertal, intoxication is possible, since the initially taken dose of the drug will not be removed from the body before the patient takes the second tablet.

Who should not be prescribed

"Aertal" is contraindicated in the following conditions:

• peptic ulcer of the stomach and duodenum;
• gastritis in the acute phase;
• allergic manifestations;
• poor blood clotting;
• liver diseases;
• kidney inflammation;
• heart failure;
• minor patients;
• pregnancy.

The ointment is not used for external skin lesions, as well as allergic rashes.

How to replace the drug Airtal

The group of non-steroidal anti-inflammatory analgesics includes a whole list of drugs, including cheaper ones and those that have fewer contraindications in their description.

Paracetamol and ibuprofen are considered the safest. These substances, being part of many multicomponent drugs, relieve pain, normalize body temperature and reduce the intensity of the inflammatory process. Both paracetamol and ibuprofen are approved for use in children. The dosage form in the form of syrup allows use by children over 3 months. Ibuprofen is better for toothache and joint pain.

Paracetamol is aimed at combating headaches and muscle aches. For severe joint pain, Aertan can be replaced with Diclofenac. This active substance is sold in pharmacies. Under the same name it is found not only in the form of tablets, but also in the form of ointments, patches and ampoules for intramuscular administration. The extended-release formula of the tablets allows you to take one dose, which will relieve severe pain for 24 hours.

Side effects

Sometimes during treatment with Aertal, undesirable effects appear.

They are expressed as:

• nausea and vomiting;
• ulcerative lesions of the stomach and intestines;
• decreased appetite;
• diarrhea or constipation;
• liver failure;
• headache;
• tremors of the limbs;
• emotional lability;
• overexcitement;
• hearing and vision disturbances;
• kidney dysfunction;
• swelling;
• heart rhythm disturbances;
• hypertension;
• allergic reactions;
• hives;
• Quincke's edema;
• anaphylactic shock.

It is necessary to take the drug very carefully if you have existing stomach problems, as life-threatening gastric bleeding is likely to develop.

Sometimes when taking Aethral, ​​photosensitivity reactions on the skin may occur.