Ibuprofen (When ATH M01AE01)

When ATH:
M01AE01

Characteristic.

The racemic mixture of R- and s-enantiomers. White or off-white crystalline powder, almost insoluble, soluble in organic solvents (ethanol, acetone).

Pharmacological action.
Anti-inflammatory, analgesic, pyretic.

Application.

Rheumatoid arthritis, reactive synovitis in deforming osteoarthritis, psoriaticheskiy arthritis, acute articular gout attack, ankylosing spondylitis (ankylosing spondylitis), cervical spondylosis, Barre syndrome - Leu (cervical migraine, vertebral artery syndrome), lyumbalgiya, işialgija, thoracic radicular syndrome, ʙursit, tendinitis, myalgia, neuralgic amyotrophy, zatыlochnaya and mezhrebernaya neuralgia, sprains ankle, hematoma, injury, pain in the surgical wound, toothache, surgery in the oral cavity, pannykulyt, tonsillitis, pharyngitis, laringit, sinusitis, rhinitis, bronchitis, pneumonia, inflammatory processes in the pelvis, disalgomenoreya, cold, SARS, fevers, postural hypotension while taking antihypertensives, nephrotic syndrome (to reduce the severity of proteinuria).

Contraindications.

Hypersensitivity, gastric ulcer and duodenal ulcer in the acute phase, nespetsificheskiy yazvennыy colitis, «Aspirinovaya» asthma, leukopenia, thrombocytopenia, hemorrhagic diathesis, severe liver and kidney, portal hypertension, arterial hypertension, heart failure, diseases of the optic nerve, scotoma, amblyopia, impaired color vision, the last trimester of pregnancy.

Side effects.

Diarrhoeal disorders (nausea, heartburn, anorexia, vomiting, epigastric discomfort, flatulence, diarrhea, constipation), erosive and ulcerative lesions of the gastrointestinal tract with symptoms of gastrointestinal bleeding, headache, dizziness, noise in ears, insomnia, excitation, visual impairment (blurring of vision, changes in color vision), fluid retention, swelling, increased blood pressure, thrombocytopenia, granulocytopenia, gemoliticheskaya anemia, angioedema, bronchial obstruction, allergic skin reactions.

Cooperation.

Decreases antihypertensive activity of ACE inhibitors, natriuretic - furosemide and hydrochlorothiazide. May enhance the toxicity of methotrexate and lithium preparations. If concomitant use of coumarin-type anticoagulants and alcohol increases the risk of bleeding complications, with with oral corticosteroids - a risk of gastrointestinal bleeding. Increases in plasma concentration of digoxin. Caffeine increases the analgesic effect of ibuprofen.

Overdose.

Symptoms: abdominal pain, nausea, vomiting, lethargy, drowsiness, depression, headache, noise in ears, metabolic acidosis, coma, acute renal failure, gipotenziya, bradycardia, tachycardia, Atrial fibrillation and respiratory arrest.

Treatment: gastric lavage (Only during the first hour after ingestion), Activated carbon (to reduce absorption), alkaline water, forsirovannыy diuresis and simptomaticheskaya therapy (Correction KHS, FROM, gastrointestinal bleeding).

Dosing and Administration.

Inside, after meal, adult 400-600 mg 3-4 times a day. In rheumatoid arthritis - by 800 mg 3 times / day. Children over 12 s - 20-40 mg / kg in divided doses (3-4 Times daily); reducing body temperature 39,2 ° C or higher - rate of 10 mg / kg, If the temperature is below 39,2 °C — 5 mg / kg. Dysmenorrhea - 400-600 mg every 4-6 hours. External used for 2-3 weeks. Gel or cream is applied to the affected area 3-4 times a day. Sublingual, keep the mouth until resorption. Adults and children over 12 years - 200-400 mg 2-3 times a day (no more 1,2 g / day).

Precautions.

Considering the possibility of developing NSAID-gastropathy, administered with caution to the elderly with a history of stomach ulcers and other gastrointestinal diseases, gastrointestinal bleeding, with simultaneous treatment with glucocorticoids, other NSAIDs for long-term therapy. When symptoms of gastropathy shows careful monitoring (incl. conduct esophagogastroduodenoscopy, blood tests, hemoglobin, gematokrita, fecal occult blood test). For the prevention of NSAID-gastropathy should be combined with drugs PGE (Misoprostol). With care prescribe in childhood (to 12 years), Patients with severely impaired liver and kidney function (required regular monitoring of bilirubin, transaminases, creatinine, concentration ability of the kidneys), hypertension and chronic heart failure (daily monitoring of diuresis, body weight, FROM). When impairment should reduce the dose or stop the drug. We do not recommend the use of alcoholic beverages during the treatment period.

Cooperation

Active substance	Description of interaction
Acetylsalicylic acid	FKV. FMR. When combined administration decreases (It is shown in animal studies) antiinflammatory effect.
Warfarin	FMR: synergism. Against the background of enhanced effect of ibuprofen, It increases the risk of bleeding complications.
Gidroxlorotiazid	FMR: antagonizm. Against the background of ibuprofen reduced natriuretic, diuretic and antihypertensive effects.
Glipizide	FMR: synergism. Against the background of enhanced effect of ibuprofen.
Dalteparin sodium	FMR: synergism. Against the background of ibuprofen increases the risk of bleeding complications; joint application requires caution.
Digoxin	FKV. On the background of the ibuprofen concentration in plasma increased.
Caffeine	FMR: synergism. It enhances the analgesic effect.
Lithium carbonate	FKV. Against the background of ibuprofen reduced clearance and increased plasma concentration.
Methotrexate	FKV. FMR. Against the background of ibuprofen (blocks tubular secretion) slows down and increases the risk of toxicity.
Ofloxacin	FMR: synergism. Against the background of ibuprofen increases the risk of excitation of the central nervous system and the development of seizures.
Perindopril	FMR: antagonizm. Against the background of the effect of ibuprofen is weakened.
Ramipril	FMR: antagonizm. Against the background of the effect of ibuprofen is weakened.
Spirapril	FMR: antagonizm. Against the background of the effect of ibuprofen is weakened.
Ticlopidine	FMR: synergism. Strengthens (mutually) antiplatelet effect. Against the background of ibuprofen increases the risk of bleeding complications.
Timolol	FMR: antagonizm. Against the background of the hypotensive effect of ibuprofen is weakened.
Trandolapril	FMR: antagonizm. Against the background of the effect of ibuprofen is weakened.
Furosemid	FMR: antagonizm. Against the background of ibuprofen reduces the diuretic, natriuretic and hypotensive effects.
Cyclosporine	FMR. Against the background of ibuprofen increases the risk of nephrotoxicity manifestations; the combined assignment requires monitoring serum creatinine.
Enalaprilat	FMR: antagonizm. Against the background of the effect of ibuprofen is weakened.
Ethacrynic acid	FMR: antagonizm. Against the background of ibuprofen reduces the diuretic, natriuretic and hypotensive effects.
Ethanol	FMR. Increases irritation of the gastrointestinal tract and the risk of hemorrhagic complications.