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The mechanism anadrol cycle of action of ibuprofen, the propionic acid derivative from the group of nonsteroidal anti-inflammatory drugs (NSAIDs) is due to the inhibition of prostaglandin synthesis – mediators of pain, inflammation and hyperthermic response. Indiscriminately blocks cyclooxygenase 1 (COX-1) and cyclooxygenase 2 (COX-2), thus inhibits the synthesis of prostaglandins. It provides quick directional effect against pain (analgesic), antipyretic and anti-inflammatory effect. Furthermore, ibuprofen reversibly inhibits platelet aggregation. The analgesic effect of the drug is continued until 8 hours.
Absorption – high, rapidly and almost completely absorbed from the gastrointestinal tract (GIT). After ingestion fasting maximum concentration (C max ) of ibuprofen plasma levels achieved after 45 minutes.Taking the drug with food may increase the time to maximum concentration (TC max ) up to 1-2 hours. Contact with blood plasma proteins – 90%. Slowly into the joint cavity, it is retained in the synovial fluid, creating large concentrations therein than in blood plasma. In the cerebrospinal fluid found lower concentrations of ibuprofen compared with plasma sprinkles.
In limited studies ibuprofen detected in breast milk in very low concentrations.

Indications

Nurofen ® Forte is used for headache, migraine, toothache, painful menstruation, neuralgia, back pain, muscle pain, rheumatic pain and joint pain; as well as feverish with the flu and colds.

Contraindications

• Hypersensitivity to ibuprofen or any of the components that make up the drug.
• Complete or incomplete combination of bronchial asthma, recurrent nasal polyposis, and paranasal sinuses and intolerance of aspirin or other NSAIDs (including history).
• erosive and ulcerative diseases of gastrointestinal (including gastric and duodenal ulcer disease, Crohn’s disease, ulcerative colitis) or ulcer bleeding or active phase history (confirmed by two or more episodes of peptic ulcer disease or bleeding).
• bleeding gastrointestinal ulceration or perforation tract in history, triggered by the use of NSAIDs.
• severe liver failure or liver disease in the active phase.
• Renal failure-severe (creatinine clearance <30 mL / min), confirmed hyperkalemia.
• decompensated heart failure; since the aortokoroiarnogo bypass.
• Cerebrovascular or other bleeding.
• fructose intolerance, glucose-galactose malabsorption, lack of sucrase-isomaltase.
• Hemophilia and other bleeding disorders (including anticoagulation), hemorrhagic diathesis.
• pregnancy (III trimester).
• Children under the age of 12 years.

Carefully:

Simultaneous treatment with other NSAIDs, a history of a single episode of gastric ulcer and duodenal ulcer or gastrointestinal bleeding; gastritis, enteritis, colitis, presence of Helicobacter pylori infection, ulcerative colitis; bronchial asthma or allergic disease in the acute stage or history – may develop bronchospasm; systemic lupus erythematosus or mixed connective tissue disease (Sharp’s syndrome) – increased risk of aseptic meningitis; renal failure, including in dewatering (creatinine clearance less than 30-60 mL / min), nephrotic syndrome, liver failure, liver cirrhosis with portal hypertension, hyperbilirubinemia, hypertension and / or heart failure, cerebrovascular disease, blood disease of unknown etiology ( leucopenia and anemia), severe medical disorders, dyslipidemia / hyperlipidemia, diabetes anadrol cycle mellitus, peripheral arterial disease, smoking, frequent drinking, the simultaneous use of drugs that may increase the risk of ulcers or bleeding, in particular, oral corticosteroids (including prednisone ), anticoagulants (including warfarin), selective serotonin reuptake inhibitors (including citalopram, fluoxetine, paroxetine, sertraline) or antiplatelet agents (including aspirin, clopidogrel), pregnancy I-II trimester during breastfeeding, older age.

Application of pregnancy and during breastfeeding

Do not use this product in the III trimester of pregnancy. Avoid the use of the drug in the I-II trimesters of pregnancy, should consult a physician if necessary dose. There is evidence that ibuprofen in small quantities can penetrate into breast milk without any adverse effects on the baby’s health, so it is usually necessary at short reception in breastfeeding cessation does not arise. If necessary, long-term use of the drug should consult a doctor to decide on the termination of breastfeeding during treatment.

Dosing and Administration

For oral administration. Patients with increased sensitivity of the stomach is recommended to take the drug during meals.
Only for short-term use. Carefully read the instructions before taking the drug.
Adults and children over 12 years inside of 1 tablet (400 mg) 3 times a day.
The tablets should be taken with water.
The interval between the tablet intake should be at least 6 hours.
The maximum daily dose is 1200 mg ( 3 tablets). The maximum daily dose for children 12 to 18 years of age is 800 mg (2 tablets).
If you are taking the drug in the symptoms persist for 2-3 days, or worse, you must stop treatment and seek medical advice.

Side effect

 

The risk of side effects can be minimized, if you take the drug a short course in the minimum effective dose necessary to relieve symptoms.
In older people there is an increased frequency of adverse reactions during treatment with NSAIDs, especially gastrointestinal bleeding and perforation, in some cases, deaths.
Adverse effects are predominantly dose dependent.
The following adverse reactions have been reported with short-term ibuprofen in doses not exceeding 1200 mg / day (3 tablets). . In the treatment of chronic conditions and long-term use may cause other adverse reactions
Assessment of the incidence of adverse reactions produced on the basis of the following criteria: very common (≥1 / 10), frequent (of ≥1 / 100 to <1/10), infrequent ( by ≥1 / 1,000 to <1/100), rare (from ≥1 / 10,000 to <1/1000), very rare (<1/10 000), frequency not known (data on the frequency of assessment available).

 

Violations of the blood and lymphatic system
• Very rare: disturbances of hematopoiesis (anemia, leukopenia, aplastic anemia, hemolytic anemia, thrombocytopenia, pancytopenia, agranulocytosis). The first symptoms of such disorders include fever, sore throat, superficial oral ulcers, flu-like symptoms, severe weakness, nosebleeds and bruising, bleeding and bruising of unknown etiology.
Violations by the immune system
• Infrequent: Hypersensitivity reactions – non-specific allergic reactions and anaphylactic reactions, from the respiratory tract reactions (asthma, including its aggravation, bronchospasm, dyspnea, dyspnea), skin reactions (pruritus, urticaria, purpura, angioedema, exfoliative and bullous dermatoses, including toxic epidermal necrolysis (Lyell’s syndrome), Stevens-Johnson syndrome, erythema multiforme), allergic rhinitis, eosinophilia.
• Very rare: hypersensitivity severe reactions, including swelling of the face, tongue and throat, shortness of breath, tachycardia, arterial hypotension (anaphylaxis, angioedema or severe anaphylactic shock).
Disorders of the gastrointestinal tract
• Infrequent: abdominal pain, anadrol cycle nausea, dyspepsia (including heartburn, bloating).
• Rare: diarrhea, flatulence, constipation, vomiting.
• Very rare: peptic ulcer, perforation or gastrointestinal bleeding, melena, hematemesis, . in some cases fatal, especially in elderly patients, ulcerative stomatitis, gastritis
• frequency not known: exacerbation of colitis and Crohn’s disease.
Disorders of the liver and biliary tract
• Very rare: abnormal liver function, increased activity of “liver” transaminases, hepatitis and jaundice.
Violations of the kidney and urinary tract
• Very rare: acute renal failure (compensated and decompensated), especially with prolonged use, coupled with an increase in the concentration of urea in the blood plasma and the appearance of edema, hematuria and proteinuria, nephritic syndrome, nephrotic syndrome, papillary necrosis, interstitial nephritis, cystitis.

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