Ibuprofen (When ATH M02AA13)

When ATH:
M02AA13

Characteristic.

The racemic mixture of R- и S-энантиомеров. 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, stretching ligamentous apparatus, 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 substanceDescription of interaction
Acetylsalicylic acidFKV. FMR. When combined administration decreases (It is shown in animal studies) antiinflammatory effect.
WarfarinFMR: synergism. Against the background of enhanced effect of ibuprofen, It increases the risk of bleeding complications.
GidroxlorotiazidFMR: antagonizm. Against the background of ibuprofen reduced natriuretic, diuretic and antihypertensive effects.
GlipizideFMR: synergism. Against the background of enhanced effect of ibuprofen.
Dalteparin sodiumFMR: synergism. Against the background of ibuprofen increases the risk of bleeding complications; joint application requires caution.
DigoxinFKV. On the background of the ibuprofen concentration in plasma increased.
CaffeineFMR: synergism. It enhances the analgesic effect.
Lithium carbonateFKV. Against the background of ibuprofen reduced clearance and increased plasma concentration.
MethotrexateFKV. FMR. Against the background of ibuprofen (blocks tubular secretion) slows down and increases the risk of toxicity.
OfloxacinFMR: synergism. Against the background of ibuprofen increases the risk of excitation of the central nervous system and the development of seizures.
PerindoprilFMR: antagonizm. Against the background of the effect of ibuprofen is weakened.
RamiprilFMR: antagonizm. Against the background of the effect of ibuprofen is weakened.
SpiraprilFMR: antagonizm. Against the background of the effect of ibuprofen is weakened.
TiclopidineFMR: synergism. Strengthens (mutually) antiplatelet effect. Against the background of ibuprofen increases the risk of bleeding complications.
TimololFMR: antagonizm. Against the background of the hypotensive effect of ibuprofen is weakened.
TrandolaprilFMR: antagonizm. Against the background of the effect of ibuprofen is weakened.
FurosemidFMR: antagonizm. Against the background of ibuprofen reduces the diuretic, natriuretic and hypotensive effects.
CyclosporineFMR. Against the background of ibuprofen increases the risk of nephrotoxicity manifestations; the combined assignment requires monitoring serum creatinine.
EnalaprilatFMR: antagonizm. Against the background of the effect of ibuprofen is weakened.
Ethacrynic acidFMR: antagonizm. Against the background of ibuprofen reduces the diuretic, natriuretic and hypotensive effects.
EthanolFMR. Increases irritation of the gastrointestinal tract and the risk of hemorrhagic complications.

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