Nurofast, 200 mg 20 pcs

Interaction

The concomitant use of ibuprofen with the following drugs should be avoided:

• Acetylsalicylic acid: except in low doses of acetylsalicylic acid (no more than 75 mg daily) prescribed by a physician, because co-administration may increase the risk of side effects. Co-administration of ibuprofen decreases anti-inflammatory and antiplatelet effects of acetylsalicylic acid (increased incidence of acute coronary failure is possible in patients receiving low doses of acetylsalicylic acid as antiplatelet agents after starting ibuprofen administration).

• Other NSAIDs, particularly COX-2 selective inhibitors: Avoid simultaneous use of two or more products from the NSAID group due to possible increased risk of side effects.

Precaution should be used concomitantly with the following drugs:

• Anticoagulants and thrombolytics: NSAIDs may increase the effect of anticoagulants, particularly warfarin and thrombolytics.

• Antihypertensives (ACE inhibitors and angiotensin II antagonists) and diuretics: NSAIDs may decrease the effectiveness of these groups. In some patients with impaired renal function (e.g., in patients with dehydration or elderly patients with impaired renal function), simultaneous administration of ACE inhibitors or angiotensin II antagonists and cyclooxygenase inhibitors may lead to worsening of renal function, including the development of acute renal failure (usually reversible). These interactions should be considered in patients taking coxibs concomitantly with ACE inhibitors or angiotensin II antagonists. In this regard, the combined use of the above drugs should be administered with caution, especially in the elderly. It is necessary to prevent dehydration in patients and to consider monitoring renal function after initiation of such combined treatment and periodically thereafter.

• Diuretics and ACE inhibitors may increase nephrotoxicity of NSAIDs.

• Glucocorticosteroids: increased risk of GI ulcers and gastrointestinal bleeding.

• Antiaggregants and selective serotonin reuptake inhibitors: increased risk of gastrointestinal bleeding.

• Cardiac glycosides: Simultaneous use of NSAIDs and cardiac glycosides may worsen heart failure, decrease glomerular filtration rate, and increase plasma concentrations of cardiac glycosides.

• Lithium preparations: There is evidence of the potential for increased plasma lithium concentrations with NSAIDs.

• Methotrexate: There is data on the potential for increased plasma concentrations of methotrexate with NSAIDs.

• Cyclosporine: Increased risk of nephrotoxicity with concomitant administration of NSAIDs and cyclosporine.

• Mifepristone: NSAIDs should not be administered earlier than 8-12 days after mifepristone, because NSAIDs may decrease the effectiveness of mifepristone.

• Tacrolimus: Simultaneous use of NSAIDs and tacrolimus may increase the risk of nephrotoxicity.

• Zidovudine: Concomitant use of NSAIDs and zidovudine may increase hematotoxicity. There is evidence of an increased risk of hemarthrosis and hematomas in HIV-positive patients with hemophilia who have received concomitant treatment with zidovudine and ibuprofen.

• Quinolone antibiotics: Patients co-treated with NSAIDs and quinolone antibiotics may have an increased risk of seizures.

• Myelotoxic drugs: increased hematotoxicity.

• Cefamandol, cefoperazone, cefotetan, valproic acid, plikamycin: increased incidence of hypoprothrombinemia.

• Drugs that block tubule secretion: decreased excretion and increased plasma concentration of ibuprofen.

• Microsomal oxidation inducers (phenytoin, ethanol, barbiturates, rifampicin, phenylbutazone, tricyclic antidepressants): increased production of hydroxylated active metabolites, increased risk of severe intoxication.

• Microsomal oxidation inhibitors: decreased risk of hepatotoxic effects.

• Peroral hypoglycemic drugs and insulin, sulfonylurea derivatives: increase the effect of the drugs.

• Antacids and colestyramine: decrease absorption.

• Uricosuric drugs: decrease the effectiveness of the drugs.

• Estrogens, ethanol: increased risk of side effects.

• Caffeine: increased analgesic effect.

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Special Instructions

It is recommended to take the drug in the shortest possible course and in the minimum effective dose necessary to eliminate the symptoms. If you need to take the drug for more than 10 days, it is necessary to consult a doctor.

Contraindications

• Hypersensitivity to ibuprofen or any of the ingredients in the drug.

• The complete or incomplete combination of bronchial asthma, recurrent polyposis of the nose and sinuses, and intolerance to acetylsalicylic acid or other NSAIDs (including a history).

• Erotic ulcerative diseases of the gastrointestinal tract (including gastric and duodenal ulcer, Crohn’s disease, ulcerative colitis) or ulcer bleeding in the active phase or in the history (two or more confirmed episodes of ulcer disease or ulcer bleeding).

• Hemorrhage or gastrointestinal ulcer perforation with a history of NSAID use.

• Severe heart failure (NYHA class IV).

• Severe hepatic impairment or active liver disease.

• Severe renal insufficiency (creatinine clearance <30 ml/min), confirmed hyperkalemia.

• Decompensated heart failure; period after coronary artery bypass surgery.

• Cerebrovascular or other bleeding.

• Hemophilia and other clotting disorders (including hypocoagulation), hemorrhagic diathesis.

• Pregnancy (III trimester).

• Children under 6 years of age.

Cautions

Consider your doctor before using this medicine if you have any of the conditions listed in this section.

Simultaneous use of other NSAIDs; history of a single episode of gastric or duodenal ulcer or GI bleeding; gastritis, enteritis, colitis, Helicobacter pylori infection, ulcerative colitis; bronchial asthma or allergic diseases in the acute stage or in the history – possible development of bronchospasm; systemic lupus erythematosus or mixed connective tissue disease (Sharp syndrome) – increased risk of aseptic meningitis; varicella renal failure, including dehydration (creatinine clearance less than 30-60 ml/min), nephrotic syndrome, liver failure, cirrhosis with portal hypertension, hyperbilirubinemia, arterial hypertension and/or heart failure, cerebrovascular diseases, blood diseases of unclear etiology (leukopenia and anemia), severe somatic diseases, dyslipidemia/hyperlipidemia, diabetes, peripheral arterial disease, smoking, frequent alcohol consumption, concomitant use of medications that may increase the risk of ulceration or bleeding, particularly oral glucocorticosteroids (including prednisolone), anticoagulants (including warfarin), selective serotonin reuptake inhibitors (including citalopram, fluoxetine, paroxetine, sertraline) or antiaggregants (including acetylsalicylic acid, clopidogrel), pregnancy I-II trimester, breastfeeding, old age, age less than 12 years.

Side effects

The risk of side effects can be minimized by taking the drug in a short course, at the lowest effective dose necessary to relieve symptoms.

The elderly have an increased incidence of adverse reactions with NSAIDs, especially gastrointestinal bleeding and perforations, in some cases fatal.

The side effects are predominantly dose-dependent.

The following adverse reactions have been reported with short-term administration of ibuprofen in doses not exceeding 1200 mg/day (6 tablets).

Treatment of chronic conditions and long-term use may cause other adverse reactions.

The frequency of adverse reactions was evaluated based on the following criteria: very frequent (≥1/10), frequent (≥1/100 to < 1/10), infrequent (≥1/1000 to < 1/100), rare (≥1/10000 to < 1/1000), very rare (1/10000), frequency unknown (data to estimate frequency are not sufficient).

Disorders of the blood and lymphatic system

– Very rare: disorders of hematopoiesis (anemia, leukopenia, aplastic anemia, hemolytic anemia, thrombocytopenia, pancytopenia, agranulocytosis). The first symptoms of these disorders are fever, sore throat, superficial mouth ulcers, flu-like symptoms, marked weakness, nosebleeds and subcutaneous hemorrhages, bleeding and bruising of unknown etiology.

Immune system disorders

– Infrequent: hypersensitivity reactions – non-specific allergic reactions and anaphylactic reactions, respiratory reactions (bronchial asthma, including its exacerbation, bronchospasm, dyspnea), skin reactions (itching, urticaria, purpura, Quincke’s edema, exfoliative and bullous dermatoses, including toxic epidermal necrolysis (Lyell syndrome), Stevens-Johnson syndrome, erythema multiforme), allergic rhinitis, eosinophilia.

– Very rare: severe hypersensitivity reactions, including swelling of the face, tongue and throat, shortness of breath, tachycardia, arterial hypotension (anaphylaxis, Quincke’s edema or severe anaphylactic shock).

Gastrointestinal disorders

– Infrequent: abdominal pain, nausea, dyspepsia (including heartburn, bloating).

– Rare: diarrhea, flatulence, constipation, vomiting.

– Very rare: peptic ulcer, perforation or gastrointestinal bleeding, melena, bloody vomiting, in some cases fatal, especially in elderly patients, ulcerative stomatitis, gastritis.

– Frequency unknown: exacerbation of colitis and Crohn’s disease.

Liver and biliary tract disorders

– Very rare: liver dysfunction, increased activity of “hepatic” transaminases, hepatitis and jaundice.

Relary and urinary tract disorders

– Very rare: Acute renal failure (compensated and decompensated) especially with long-term use, combined with increased plasma urea concentration and the appearance of edema, hematuria and proteinuria, nephritic syndrome, nephrotic syndrome, papillary necrosis, interstitial nephritis, cystitis.

Nervous system disorders

– Infrequent: headache.

– Very rare: aseptic meningitis.

Cardiovascular system disorders

– Frequent unknown: heart failure, peripheral edema, with prolonged use, increased risk of thrombotic complications (e.g., myocardial infarction), increased blood pressure.

Respiratory and mediastinal disorders

– Frequency unknown: bronchial asthma, bronchospasm, dyspnea.

Laboratory measures

– Hematocrit or hemoglobin (may decrease)

– Bleeding time (may increase)

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– plasma glucose concentration (may decrease)

– creatinine clearance (may decrease)

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– plasma creatinine concentration (may increase)

– “hepatic” transaminase activity (may increase)

If side effects occur, discontinue the drug and consult a physician.

Overdose

In children, symptoms of overdose may occur after taking a dose exceeding 400 mg/kg body weight. In adults the dose-dependent effect of overdose is less pronounced. Half-life of the drug in case of overdose is 1.5-3 hours.

Pregnancy use

The drug is contraindicated in the third trimester of pregnancy. Avoid using the drug in the I-II trimesters of pregnancy if it is necessary to take the drug should be consulted with a physician.

There is evidence that ibuprofen may pass into the breast milk in small amounts without any adverse effect on the health of the infant, therefore usually with short-term use there is no need to stop breast-feeding. If long-term use of the drug is necessary, it is necessary to consult a physician to decide on stopping breast-feeding for the period of using the drug.

Similarities

Nurofen, Nurofen Express, Brufen, Ibuprofen, Dolgit, Ibuprofen-Chemopharm, Nurofen Forte, MIG 400, Faspik, Nurofen Express Lady, Nurofen Express Forte, Nurofen Children, Next Uno Express, Nurofast