Theraflex Advance, 250 mg+100 mg+200 mg capsules 60 pcs

Tereflex Advans – stimulates the regeneration of cartilage tissue, analgesic, anti-inflammatory.

Pharmacodynamics

Tereflex Advance is a combination drug that contains chondroitin sulfate, glucosamine sulfate and ibuprofen as the active ingredients.

Chondroitin sulfate is involved in the construction and repair of cartilage tissue, protects it from breakage and improves joint mobility.

Glucosamine sulfate activates the synthesis of proteoglycans, hyaluronic and chondroitin acids and other substances that make up the joint membranes, intra-articular fluid and cartilage tissue.

Ibuprofen is a derivative of propionic acid and has analgesic, antipyretic and anti-inflammatory effect due to non-selective blockade of COX-1 and COX-2.

The glucosamine sulfate and chondroitin sulfate contained in the drug potentiate the analgesic effect of ibuprofen.

Pharmacokinetics

The bioavailability of glucosamine when taken orally is 25% (first-pass effect through the liver), the highest concentrations are found in the liver, kidney and joint cartilage. About 30% of the dose taken persists in bone and muscle tissue for a long time. It is excreted mainly with urine unchanged, partially with feces. T1/2 is 68 hours.

More than 70% of chondroitin sulfate is absorbed in the digestive tract. Bioavailability is about 13%. When a single oral administration of an average therapeutic dose, Cmax in plasma is observed after 3-4 hours, in the synovial fluid – after 4-5 hours. Absorbed in the gastrointestinal tract, the drug accumulates in synovial fluid. It is excreted by the kidneys.

Ibuprofen is well absorbed from the stomach. Tmax is about 1 h. Ibuprofen is approximately 99% bound to plasma proteins. It is slowly distributed in synovial fluid and excreted more slowly than from plasma. Ibuprofen is metabolized in the liver mainly by hydroxylation and carboxylation of the isobutyl group.

The CYP2C9 isoenzyme is involved in metabolism of the drug. After absorption about 60% of pharmacologically inactive R-form of ibuprofen is slowly transformed into active S-form. Ibuprofen has biphasic elimination kinetics. T1/2 from plasma is 2-3 hours. Up to 90% of the dose can be detected in the urine as metabolites and their conjugates. Less than 1% is excreted unchanged in the urine and to a lesser extent in the bile. Ibuprofen is completely eliminated in 24 hours.

Indications

Arthritis, Sciatica, Lumbago, Rheumatoid arthritis, Neck pain, Osteoarthritis, Osteochondrosis, Joint pain (arthralgia), Radiculitis, Back pain

Osteoarthritis of large joints; spinal osteochondrosis accompanied by moderate pain syndrome.

Active ingredient

Glucosamine, Ibuprofen, Chondroitin sulfate

Composition

1 capsule contains:

Active substances:

glucosamine sulfate – 250 mg;

chondroitin sulfate sodium – 200 mg;

Ibuprofen – 100 mg;

Associates:

MCC, 30.78 mg;

Corn starch, 19.69 mg;
<

Pregelatinized starch – 17.47 mg;

Stearic acid – 11.59 mg;

sodium carboxymethyl starch – 10 mg;

crospovidone – 10 mg;

Magnesium stearate – 3 mg;

Silicon dioxide – 4.05 mg;

povidone – 2.382 mg.

How to take, the dosage

Ingestion with a small amount of water.

Adults: 2 capsules 3 times a day after meals.

The duration of treatment without medical advice should not exceed 3 weeks.

Continue use should be coordinated with the physician.

Interaction

Microsomal oxidation inducers (phenytoin, ethanol, barbiturates, rifampicin, phenylbutazone, tricyclic antidepressants) increase the production of hydroxylated active metabolites of ibuprofen, increasing the risk of severe hepatotoxic reactions.

Microsomal oxidation inhibitors reduce the risk of hepatotoxic effects.

Decreases hypotensive activity of vasodilators (including BCC and ACE inhibitors), natriuretic and diuretic activity of furosemide and hydrochlorothiazide.

Decreases the effectiveness of uricosuric drugs, increases the effect of indirect anticoagulants, antiaggregants, fibrinolytics (increased risk of hemorrhagic complications), ulcerogenic effect with bleeding of GCS, NSAIDs, colchicine, estrogen, ethanol, increases the effect of oral hypoglycemic drugs and insulin.

Antacids and colestiramine decrease absorption of ibuprofen.

Enhances blood concentrations of digoxin, lithium drugs and methotrexate.

Caffeine increases the analgesic effect.

When simultaneously prescribed, ibuprofen decreases anti-inflammatory and antiplatelet effects of acetylsalicylic acid (the incidence of acute coronary failure may increase in patients receiving low doses of acetylsalicylic acid as an antiplatelet agent after starting ibuprofen).

When administered simultaneously with anticoagulant and thrombolytic drugs (alteplase, streptokinase, urokinase) the risk of bleeding increases.

Cefamandole, cefoperazone, cefotetan, valproic acid, plikamycin increase the frequency of hypoprothrombinemia.

Myelotoxic drugs increase manifestations of hematotoxicity.

Cyclosporine and gold drugs increase the effect of ibuprofen on PG synthesis in the kidneys, which is manifested by increased nephrotoxicity.

Ibuprofen increases the plasma concentration of cyclosporine and the likelihood of its hepatotoxic effects.

Like drugs that block tubular secretion decrease excretion and increase the plasma concentration of ibuprofen.

The drug’s glucosamine may decrease the effectiveness of hypoglycemic agents, doxorubicin, teniposide, etoposide.

Glucosamine increases absorption of tetracyclines and reduces the effect of semi-synthetic penicillins and chloramphenicol.

.

Special Instructions

During long-term treatment it is necessary to monitor peripheral blood picture and functional state of the liver and kidneys.

In case of symptoms of gastropathy, close monitoring is indicated, including esophagogastroduodenoscopy, blood tests with determination of hemoglobin, hematocrit, stool analysis for occult blood.

If simultaneous use of additional NSAIDs and analgesic agents is necessary, the physician should consider the presence of ibuprofen in the drug. If prolonged use of additional NSAIDs is necessary, the drug Teraflex without ibuprofen should be used.

If it is necessary to determine 17-ketosteroids, the drug should be discontinued 48 hours before the study.

The intake of alcohol is not recommended during treatment.

Impact on ability to drive vehicles and other mechanisms requiring increased concentration

Patients should refrain from activities requiring increased attention, rapid mental and motor reactions.

Synopsis

Stronger composition – healthier joints(1). Terefleks Advans
Terefleks drug №1 for the treatment of osteoarthritis and osteochondrosis (2)
Terefleks Advans is a unique modern chondroprotector (3), which is produced in the USA in accordance with Bayer’s high quality standards.

Unlike other preparations (4) Tereflex Advance contains pain-relieving component Ibuprofen and Chondroitin with Glucosamine – substances affecting cartilage structure. The drug not only helps reduce moderate pain in the joints, but also reduces inflammation.