The drug belongs to the combined drugs. It has analgesic, antipyretic, anti-inflammatory and antitussive effect. The mechanism of action of ibuprofen is due to inhibition of prostaglandin synthesis – mediators of pain, inflammation and hyperthermic response.
Codeine analgesic effect on CNS opioid receptors and has antitussive effect.
Absorption – high, anadrol steroid the connection with plasma proteins – 90%. Slowly into the joint cavity, it is retained in the synovial tissue, creating in it a large concentration than in plasma. After absorption of about 60% pharmacologically inactive R-form slowly transformed into the active S-form. The half-life (T ½) – 2h, kodeina- (T1 / 2) – 3h. Metabolized. Excreted by the kidneys (unchanged no more than 1%) and, to a lesser extent in the bile.
Pain mild to moderate severity (toothache and headache, migraine, tuberculosis, neuralgia, myalgia, rheumatic pain); feverish syndrome of different genesis (including influenza, SARS).
- erosive and ulcerative lesions of the gastrointestinal tract in the acute phase, including ulcerative colitis;
- heart failure;
- respiratory failure;
- severe course of hypertension;
- increased intracranial pressure
- traumatic brain injury
- hypersensitivity to ibuprofen or to the drug;
- “Aspirin” asthma, urticaria, rhinitis, triggered by taking aspirin (salicylates) or other NSAIDs;
- diseases of the optic nerve; violation of color vision, amblyopia, scotoma;
- Hemophilia, anticoagulation status, leukopenia;
- expressed human liver and / or kidney problems;
- chronic constipation;
- hearing loss, vestibular pathology;
- children’s age (12 years).
Be wary – peptic ulcer and 12 duodenal ulcer history, gastritis, enteritis, colitis, history of bleeding from the gastrointestinal tract; related liver disease and / or kidney problems; chronic heart failure; blood disease of unknown etiology; bronchial asthma, urticaria, rhinitis, polyps of the nasal mucosa; hyperbilirubinemia; lactation; hypothyroidism; elderly age.
Dosing and Administration
Adults and children over 12 years 1-2 tablets 3-4 times a day with water.
the dose may be increased to 400 mg (2 tablets) three times a day to achieve a rapid therapeutic effect.
Do not take more anadrol steroid than 6 tablets in 24 hours. The maximum daily dose is 1,200 mg.
If you are taking the drug for 2-3 days, the symptoms persist, you must stop treatment and seek medical advice.
When applying Nurofen Plus in side effects hardly observed within 2-3 days. In the case of long-term use may cause the following side effects:
- From the gastrointestinal tract: nausea, vomiting, heartburn, anorexia, epigastric discomfort, diarrhea, flatulence, abnormal liver function, abdominal pain.
- From the nervous system: headache, dizziness, hearing loss, tinnitus, insomnia, agitation, drowsiness, depression.
- Cardio – vascular system: congestive heart failure, increased blood pressure, tachycardia.
- From the urinary system: edema syndrome, renal failure.
- From the side of blood: anemia, thrombocytopenia, agranulocytosis, leukopenia.
- Allergic reactions: skin rash, pruritus, urticaria, angioedema.
- Bronchospasm, respiratory depression, antitussive effect.
- Increased sweating.
With prolonged use at high doses – ulceration of the mucosa of the gastrointestinal tract bleeding (gastrointestinal, gingival, uterine, hemorrhoids), blurred vision (disturbance of color vision, scotoma, amblyopia).
When side effects, stop taking the drug and consult a doctor.
Symptoms: abdominal pain, nausea, vomiting, lethargy, sleepiness, depression, headache, tinnitus, contraction of the pupil, metabolic acidosis, coma, acute renal failure, decreased blood pressure, bradycardia, tachycardia, atrial fibrillation, respiratory arrest.
Treatment: gastric lavage (only for an hour after ingestion), activated carbon, alkaline water, forced diuresis, symptomatic therapy.
If respiratory depression using a specific opioid antagonist- naloxone (Narcan).
Interaction with other drugs
Not recommended simultaneous reception of Nurofen Plus tablets with acetylsalicylic acid and other NSAIDs. When concomitant administration of ibuprofen reduces inflammatory and antiplatelet effect of acetylsalicylic acid (may increase the incidence of acute coronary insufficiency in patients receiving antiplatelet agents as low-dose acetylsalicylic acid, after you start taking ibuprofen). In the appointment of anticoagulant and thrombolytic drugs (alteplase, streptokinase, urokinase) also increase the risk of bleeding. Tsefamandol, tsefaperazon, tsefotetan, valproic acid, plikamitsin, increase the incidence of gipoprotrombinemii. Cyclosporine and gold preparations boost the effect of ibuprofen on prostaglandin synthesis in the anadrol steroid kidneys, which is manifested by increased nephrotoxicity. Ibuprofen increases the plasma concentration of cyclosporin and the likelihood of its hepatotoxic effects. Drugs that block tubular secretion, reduce excretion and increase plasma concentration of ibuprofen. Inductors microsomal oxidation (phenytoin, ethanol, barbiturates, rifampicin, phenylbutazone, tricyclic antidepressants) increase the production of hydroxylated active metabolites, increasing the risk of severe intoxication.Inhibitors of microsomal oxidation – reduce the risk of hepatotoxicity. Reduces hypotensive activity vasodilators natriuretic have furosemide and hydrochlorothiazide. Reduces the effectiveness of uricosuric drugs, increases the effects of anticoagulants, antiplatelet agents, fibrinolytics. It increases the side effects of mineralocorticoids, corticosteroids, estrogens, ethanol. Enhances hypoglycemic effect of sulfonylureas. Antacids and cholestyramine reduce the absorption. Increases concentration of digoxin in the blood, drugs lithium methotrexate. Caffeine increases the analgesic effect.
During long-term treatment is necessary to monitor patterns of peripheral blood and functional state of the liver and kidneys. When symptoms of gastropathy shows careful control, including holding esophagogastroduodenoscopy, complete blood count (hemoglobin), fecal occult blood. If necessary, the definition of 17 – ketosteroidov drug should be discontinued 48 hours prior to the study. Patients should refrain from all activities that require attention, rapid mental and motor responses. During the period of treatment is not recommended intake of ethanol.