Nurofen forte instructions for use of the capsule. Nurofen Forte - an effective pain reliever in a special shell

Active ingredients
Compound

Ibuprofen 400 mg Excipients: macrogol 600 - 335.3 mg, potassium hydroxide - 44.82 mg, water - 29.88 mg. Shell composition: gelatin - 197 mg, sorbitol (partially dehydrogenated) - 95.68 mg, water - 25.02 mg, crimson dye [Ponceau 4R] (E124) - 0.79 mg, white ink [Opacode WB NS-78-18011] (water - 48 %, titanium dioxide (E171) - 29%, propylene glycol - 10%, isopropanol - 8%, hypromellose 3cP - 5%).

Pharmacological effect

The mechanism of action of ibuprofen, a derivative of propionic acid from the group of non-steroidal anti-inflammatory drugs (NSAIDs), is due to inhibition of the synthesis of prostaglandins - mediators of pain, inflammation and hyperthermic reaction. Indiscriminately blocks COX-1 and COX-2, as a result of which it inhibits the synthesis of prostaglandins. It has a rapid, targeted effect against pain (analgesic), antipyretic and anti-inflammatory effects. In addition, ibuprofen reversibly inhibits platelet aggregation.

Indications

Head and toothache, migraine, painful menstruation, neuralgia, back pain, muscle and rheumatic pain. febrile conditions with influenza and colds.

Contraindications

Hypersensitivity. erosive and ulcerative lesions of the gastrointestinal tract in the acute phase, incl. ulcerative colitis. severe course arterial hypertension. “aspirin” bronchial asthma, urticaria, rhinitis, provoked by taking acetylsalicylic acid(salicylates) and other NSAIDs. diseases optic nerve, violation color vision, amblyopia, scotoma. deficiency of glucose-6-phosphate dehydrogenase, hemophilia, hypocoagulation conditions, leukopenia. pregnancy, lactation period. impaired renal and/or liver function. hearing loss, pathology vestibular apparatus. childhood up to 12 years old.

Use during pregnancy and breastfeeding

The use of the drug is contraindicated in the third trimester of pregnancy. You should avoid using the drug in the first and second trimesters of pregnancy; if you need to take the drug, you should consult your doctor. There is evidence that ibuprofen can pass into breast milk in small quantities without any adverse effects. negative consequences for good health infant, therefore, usually with short-term use there is a need to stop breastfeeding does not arise. If necessary long-term use drug, you should consult a doctor to decide whether to stop breastfeeding for the period of use of the drug. Information for women planning pregnancy: data medicines suppress COX and prostaglandin synthesis, affect ovulation, disrupting female reproductive function(reversible after discontinuation of treatment).

Directions for use and doses

Adults and children over 12 years of age are prescribed 200 mg orally 3-4 times a day. To achieve fast therapeutic effect the dose can be increased to 400 mg 3 times / day. Maximum daily dose for adults is 1.2 g. The maximum daily dose for children and adolescents aged 12 to 17 years is 1 g. Capsules should be taken with water. The patient should be warned that if symptoms of the disease persist after taking the drug for 2-3 days, it is necessary to stop treatment and consult a doctor.

Side effects
special instructions

From the outside digestive system: NSAID gastropathy (abdominal pain, nausea, vomiting, heartburn, loss of appetite, diarrhea, flatulence, constipation. possible - increased activity of liver transaminases. rarely - erosive and ulcerative lesions of the gastrointestinal mucosa, which in some cases are complicated by perforation and bleeding) . irritation or dryness of the oral mucosa, pain in the mouth, ulceration of the gum mucosa, aphthous stomatitis, pancreatitis, hepatitis From the central nervous system: headache, dizziness, insomnia, anxiety, nervousness, irritability, psychomotor agitation, drowsiness, depression, confusion, hallucinations. rarely - aseptic meningitis (more often in patients with autoimmune diseases). From the outside of cardio-vascular system: heart failure, tachycardia, increased blood pressure. From the urinary system: acute renal failure, allergic nephritis, nephrotic syndrome(edema), polyuria, cystitis. possibly - a decrease in CC, an increase in serum creatinine concentration. From the senses: hearing loss, ringing or tinnitus, toxic damage optic nerve, blurred vision or diplopia, dryness and irritation of the eyes, swelling of the conjunctiva and eyelids (allergic origin), scotoma. From the outside respiratory system: shortness of breath, bronchospasm. From the hematopoietic system: anemia (including hemolytic and aplastic), thrombocytopenia, thrombocytopenic purpura, agranulocytosis, leukopenia. possible - increased bleeding time, decreased hematocrit or hemoglobin Allergic reactions: skin rash(usually erythematous or urticaria), itchy skin, Quincke's edema, anaphylactoid reactions, anaphylactic shock, bronchospasm or dyspnea, fever, multiform exudative erythema(including Stevens-Johnson syndrome), toxic epidermal necrolysis (Lyell's syndrome), eosinophilia, allergic rhinitis. Other: increased sweating. a decrease in blood glucose concentration is possible. When using the drug for 2-3 days Side effect observed very rarely.

Catad_pgroup NSAIDs

Nurofen® Express Forte - official instructions by application

Registration number:

LCP-005587/10

Trade name of the drug:

Nurofen® Express Forte

International nonproprietary name:

ibuprofen

Chemical name:

(RS)-2-(4-isobutylphenyl)propionic acid

Dosage form:

capsules

Compound:

One capsule contains:
active substance: ibuprofen 400 mg
Excipients: macrogol-600 335.3 mg, potassium hydroxide 44.82 mg, water 29.88 mg;
capsule shell: gelatin 197 mg, sorbitol (partially dehydrogenated) 95.68 mg, water 25.02 mg, crimson dye [Ponceau 4R] (E124) 0.79 mg, white ink [Opacode WB NS-78-18011] (water 48% , titanium dioxide (E171) 29%, propylene glycol 10%, isopropanol 8%, hypromellose ZsP 5%).

Description:

Oval capsules with a red translucent gelatin shell, with an identifying inscription white NUROFEN containing clear liquid from colorless to light pink.

Pharmacotherapeutic group:

non-steroidal anti-inflammatory drug (NSAID)

ATX code:

M01AE01

Pharmacological properties

Pharmacodynamics
The mechanism of action of ibuprofen, a derivative of propionic acid from the group of non-steroidal anti-inflammatory drugs (NSAIDs), is due to inhibition of the synthesis of prostaglandins - mediators of pain, inflammation and hyperthermic reaction. Indiscriminately blocks cyclooxygenase-1 (COX-1) and cyclooxygenase-2 (COX-2), as a result of which it inhibits the synthesis of prostaglandins. It has a rapid, targeted effect against pain (analgesic), antipyretic and anti-inflammatory effects.
In addition, ibuprofen reversibly inhibits platelet aggregation.
Pharmacokinetics
Absorption - high, quickly and almost completely absorbed from gastrointestinal tract(Gastrointestinal tract). After taking the drug on an empty stomach, ibuprofen is detected in the blood plasma after 15 minutes, the maximum concentration (Cmax) of ibuprofen in the blood plasma is achieved after 30-40 minutes, which is two times faster than after taking an equivalent dose of Nurofen®, in dosage form film-coated tablets 200 mg.
Taking the drug with food may increase the time to reach maximum concentration (TCmax). The connection with blood plasma proteins is more than 90%, the half-life (T½) is 2 hours. It slowly penetrates into the joint cavity, is retained in the synovial fluid, creating higher concentrations in it than in the blood plasma. After absorption, about 60% of the pharmacologically inactive R-form is slowly transformed into active S-form. Metabolized in the liver. It is excreted by the kidneys (no more than 1% unchanged) and, to a lesser extent, with bile.
There were no significant differences in the pharmacokinetic profile of the drug in older adults compared to younger adults.
In limited studies, ibuprofen has been found to breast milk in very low concentrations.

Indications for use

Nurofen® Express Forte is used for headaches, migraines, toothaches, painful menstruation, neuralgia, back pain, muscle and rheumatic pain; at feverish conditions for influenza and colds.

Contraindications

  • Hypersensitivity to ibuprofen or any of the components included in the drug.
  • Complete or incomplete combination bronchial asthma, recurrent polyposis of the nose and paranasal sinuses, and intolerance to acetylsalicylic acid or other non-steroidal anti-inflammatory drugs (including a history).
  • Erosive and ulcerative diseases of the gastrointestinal tract (including gastric ulcer and duodenum, Crohn's disease, ulcerative colitis) or ulcer bleeding V active phase or history (two or more confirmed episodes peptic ulcer or ulcer bleeding).
  • A history of bleeding or perforation of a gastrointestinal ulcer caused by the use of NSAIDs.
  • Heavy liver failure or active liver disease.
  • Kidney failure severe severity (creatinine clearance<30 мл/мин), подтвержденная гиперкалиемия.
  • Decompensated heart failure; period after coronary artery bypass surgery.
  • Cerebrovascular or other bleeding.
  • Hemophilia and other bleeding disorders (including hypocoagulation), hemorrhagic diathesis.
  • Fructose intolerance.
  • Pregnancy (III trimester).
  • Children's age up to 12 years.

Carefully
If you have the conditions listed in this section, you should consult a doctor before using the drug.
Concomitant use of other NSAIDs, a history of a single episode of gastric ulcer or gastrointestinal ulcer bleeding; gastritis, enteritis, colitis, infection Helicobacter pylori, ulcerative colitis; bronchial asthma or allergic diseases in the acute stage or in history - bronchospasm may develop; systemic lupus erythematosus or mixed connective tissue disease (Sharpe's syndrome) - increased risk of aseptic meningitis; renal failure, including with dehydration (creatinine clearance 30-60 ml/min), nephrotic syndrome; liver failure, liver cirrhosis with portal hypertension, hyperbilirubinemia, arterial hypertension and/or heart failure, cerebrovascular diseases; blood diseases of unknown etiology (leukopenia and anemia), severe somatic diseases, dyslipidemia/hyperlipidemia, diabetes mellitus, peripheral arterial diseases; smoking; frequent drinking of alcohol; simultaneous use of medications that may increase the risk of ulcers or bleeding, in particular oral glucocorticosteroids (including prednisolone), anticoagulants (including warfarin), antiplatelet agents (including acetylsalicylic acid, clopidogrel), selective serotonin reuptake inhibitors ( including citalopram, fluoxetine, paroxetine, sertraline); pregnancy I-II trimester, breastfeeding period, old age.

Use during pregnancy and breastfeeding

The use of the drug is contraindicated in the third trimester of pregnancy. You should avoid using ibuprofen in the 1st trimester of pregnancy; if you need to take the drug, you should consult your doctor.
There is evidence that ibuprofen can pass into breast milk in small quantities without any adverse effects on the health of the nursing infant, so there is usually no need to stop breastfeeding when taken for a short period of time. If long-term use of the drug is necessary, you should consult a doctor to decide whether to stop breastfeeding for the period of use of the drug.

Directions for use and doses

Read the instructions carefully before taking the drug.
For oral administration. For short term use only.
Adults and children over 12 years of age: 1 capsule orally, without chewing. The capsule should be taken with water. The interval between doses of the drug should be at least 4 hours. The maximum daily dose is 1200 mg.
The maximum daily dose for children 12-17 years old is 800 mg.
If symptoms persist or worsen after taking the drug for 2-3 days, you should stop treatment and consult a doctor.

Side effect

The risk of side effects can be minimized if the drug is taken in a short course at the minimum effective dose required to eliminate symptoms.
Side effects are predominantly dose-dependent. The following adverse reactions were observed with short-term use of ibuprofen in doses not exceeding 1200 mg/day (3 capsules). When treating chronic conditions and with long-term use, other adverse reactions may occur.
The incidence of adverse reactions was assessed based on the following criteria: very often (> 1/10), often (from > 1/100 to<1/10), нечасто (от >1/1000 to<1/100), редко (от >1/10,000 to<1/1000), очень редко (<1/10 000), частота неизвестна (данные по оценке частоты отсутствуют).
Blood and lymphatic system disorders
Very rare: hematopoietic disorders (anemia, leukopenia, aplastic anemia, hemolytic anemia, thrombocytopenia, pancytopenia, agranulocytosis). The first symptoms of such disorders are fever, sore throat, superficial oral ulcers, flu-like symptoms, severe weakness, nosebleeds and subcutaneous hemorrhages, bleeding and bruising of unknown etiology.
Immune system disorders
Uncommon: hypersensitivity reactions - nonspecific allergic reactions and anaphylactic reactions, reactions from the respiratory tract (bronchial asthma, including its exacerbation, bronchospasm, shortness of breath), skin reactions (itching, urticaria, purpura, Quincke's edema, exfoliative and bullous dermatoses, in including toxic epidermal necrolysis (Lyell's syndrome), Stevens-Johnson syndrome, erythema multiforme), allergic rhinitis, eosinophilia.
Very rare: severe hypersensitivity reactions, including swelling of the face, tongue and larynx, shortness of breath, tachycardia, hypotension (anaphylaxis, Quincke's edema or severe anaphylactic shock).
Gastrointestinal disorders
Uncommon: abdominal pain, nausea, dyspepsia (including heartburn, bloating).
Rarely: 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 unknown: exacerbation of colitis and Crohn's disease.
Disorders of the liver and biliary tract
Very rare: liver dysfunction (especially with long-term use), hepatitis, jaundice.
Renal and urinary system disorders
Very rare: acute renal failure, hematuria and proteinuria, nephritic syndrome, nephrotic syndrome, papillary necrosis, interstitial nephritis, cystitis.
Nervous system disorders
Uncommon: headache.
Very rare: aseptic meningitis (isolated cases of symptoms of aseptic meningitis, such as a stiff neck, headache, nausea, vomiting, fever and disorientation, have been observed during treatment with ibuprofen in patients with autoimmune diseases (systemic lupus erythematosus and mixed connective tissue disease)) .
Cardiovascular disorders
Frequency unknown: heart failure, peripheral edema, with long-term use there is an increased risk of thrombotic complications (for example, myocardial infarction or stroke), increased blood pressure.
Respiratory, thoracic and mediastinal disorders
Frequency unknown: bronchial asthma, bronchospasm, shortness of breath.
Laboratory indicators

  • hematocrit or hemoglobin (may decrease)
  • bleeding time (may increase)
  • plasma glucose concentration (may decrease)
  • creatinine clearance (may decrease)
  • plasma creatinine concentration (may increase)
  • activity of “liver” transaminases (may increase)

If side effects occur, you should stop taking the drug and consult a doctor.

Overdose

In children, overdose symptoms may occur after taking a dose exceeding 400 mg/kg body weight. In adults, the dose-dependent effect of overdose is less pronounced. The half-life of the drug in case of overdose is 1.5-3 hours.
Symptoms: nausea, vomiting, epigastric pain or, less commonly, diarrhea, tinnitus, headache and gastrointestinal bleeding. In more severe cases, manifestations from the central nervous system are observed: drowsiness, rarely - agitation, convulsions, disorientation, coma. In cases of severe poisoning, metabolic acidosis and increased prothrombin time, acute renal failure, liver tissue damage, decreased blood pressure, respiratory depression and cyanosis may develop. In patients with bronchial asthma, exacerbation of this disease is possible.
Treatment: symptomatic, with mandatory provision of airway patency, ECG monitoring and vital signs until the patient’s condition is normalized.
Oral use of activated charcoal or gastric lavage is recommended within one hour after taking a potentially toxic dose of ibuprofen. If ibuprofen has already been absorbed, an alkaline drink may be prescribed in order to remove the acidic derivative of ibuprofen by the kidneys, forced diuresis. Frequent or prolonged seizures should be treated with intravenous diazepam or lorazepam. When bronchial asthma worsens, the use of bronchodilators is recommended.

Interaction with other drugs

The simultaneous use of ibuprofen with the following medications should be avoided:

  • Acetylsalicylic acid: with the exception of low doses of acetylsalicylic acid (no more than 75 mg per day) prescribed by a doctor, since combined use may increase the risk of side effects. With simultaneous use, ibuprofen reduces the anti-inflammatory and antiplatelet effect of acetylsalicylic acid (an increase in the incidence of acute coronary insufficiency in patients receiving small doses of acetylsalicylic acid as an antiplatelet agent is possible after starting ibuprofen).
  • Other NSAIDs, including selective cyclooxygenase-2 inhibitors: The simultaneous use of two or more NSAIDs should be avoided due to a possible increased risk of side effects.

Use with caution simultaneously with the following medications:

  • Anticoagulants and thrombolytic drugs: NSAIDs may enhance the effect of anticoagulants, in particular warfarin and thrombolytic drugs.
  • Antihypertensives (ACE inhibitors and angiotensin II antagonists) and diuretics: NSAIDs may reduce the effectiveness of drugs in these groups. Diuretics may increase the nephrotoxicity of NSAIDs.
  • Glucocorticosteroids: increased risk of gastrointestinal ulceration and gastrointestinal bleeding.
  • Antiplatelet agents and selective serotonin reuptake inhibitors: increased risk of gastrointestinal bleeding.
  • Cardiac glycosides: simultaneous use of NSAIDs and cardiac glycosides can lead to worsening heart failure, a decrease in glomerular filtration rate and an increase in the concentration of cardiac glycosides in the blood plasma.
  • Lithium preparations: there is evidence of the likelihood of an increase in the concentration of lithium in the blood plasma during the use of NSAIDs.
  • Methotrexate: there is evidence of the likelihood of an increase in the concentration of methotrexate in the blood plasma during the use of NSAIDs.
  • Cyclosporine: Increased risk of nephrotoxicity with concomitant use of NSAIDs and cyclosporine.
  • Mifepristone: NSAIDs should be started no earlier than 8-12 days after stopping mifepristone, as NSAIDs may reduce the effectiveness of mifepristone.
  • Tacrolimus: Concomitant use of NSAIDs and tacrolimus may increase the risk of nephrotoxicity.
  • Zidovudine: Concomitant use of NSAIDs and zidovudine may result in increased hematotoxicity. There is evidence of an increased risk of hemarthrosis and hematomas in HIV-positive patients with hemophilia who received concomitant treatment with zidovudine and ibuprofen.
  • Quinolone antibiotics: In patients receiving concomitant treatment with NSAIDs and quinolone antibiotics, the risk of seizures may be increased.

special instructions

It is recommended to take the drug for the shortest possible course and in the minimum effective dose necessary to eliminate symptoms.
During long-term treatment, monitoring of the peripheral blood picture and the functional state of the liver and kidneys is necessary. When symptoms of gastropathy appear, careful monitoring is indicated, including esophagogastroduodenoscopy, a complete blood count (hemoglobin determination), and a stool test for occult blood. If it is necessary to determine 17-ketosteroids, the drug should be discontinued 48 hours before the study. During the treatment period, ethanol intake is not recommended.
Patients with renal failure should consult a doctor before using the drug, as there is a risk of deterioration in the functional state of the kidneys.
Patients with arterial hypertension, including a history of and/or chronic heart failure, should consult a doctor before using the drug, since the drug may cause fluid retention, increased blood pressure and edema.
Information for women planning pregnancy: the drug inhibits cyclooxygenase and prostaglandin synthesis and may affect ovulation, disrupting female reproductive function (reversible after discontinuation of treatment).

Impact on the ability to drive vehicles and operate machinery

Patients who experience dizziness, drowsiness, lethargy, or blurred vision while taking ibuprofen should avoid driving or operating machinery.

Release form

Capsules 400 mg.
4, 8 or 10 capsules in a blister made of PVC/PVDC/Aluminium.
1 blister (4, 8 or 10 capsules each) or 2 blisters (4, 8 or 10 capsules each) or 3 blisters (10 capsules each) are placed in a cardboard box along with instructions for use.

Storage conditions

Store at a temperature not exceeding 25°C.
Keep the drug out of the reach of children.

Best before date

3 years.
Do not use a drug that has expired.

Vacation conditions

Over the counter.

Manufacturer

The legal entity in whose name the registration certificate was issued and the manufacturer
Reckitt Benckiser Healthcare (UK) Limited,

Danceom Lane, Hull, East Yorkshire, HY8 7DS, UK.

Manufacturer:
Patheon Softgels B.V., Postornstraat 7, Tilburg, 5048AS, The Netherlands.

Representative in Russia / Organization receiving consumer complaints
Reckitt Benckiser Healthcare LLC Russia, 115114, Moscow, Kozhevnicheskaya st., 14

  • Excipients:
    • macrogol 600 - 335.3 mg;
    • potassium hydroxide - 44.82 mg;
    • water - 29.88 mg
  • shell:
    • gelatin - 197 mg;
    • sorbitol (partially dehydrogenated) - 95.68 mg;
    • water - 25.02 mg;
    • crimson dye (Ponceau 4R) (E124) - 0.79 mg;
    • white ink Opacode WB NS-78-I801 I (water - 48%, titanium dioxide (E171) - 29%, propylene glycol - 10%, isopropanol - 8%, hypromellose ZsP - 5%)

    Capsules, 400 mg. 4, 8 or 10 capsules. in a blister made of PVC/PVDC/aluminum. 1 bl. (4, 8 or 10 caps.) or 2 bl. (4, 8 or 10 caps.) or 3 bl. (10 capsules each) are placed in a cardboard box.

    Description of the dosage form

    Oval capsules with a red translucent gelatin shell, with a white identifying inscription “NUROFEN”, containing a transparent liquid from colorless to light pink.

    Pharmacokinetics

    Absorption is high, quickly and almost completely absorbed from the gastrointestinal tract. After taking 2 caps. of the drug on an empty stomach, ibuprofen is detected in the blood plasma after 15 minutes. Cmax of ibuprofen in the blood plasma is achieved after 30-40 minutes, which is two times faster than after taking an equivalent dose of the drug Nurofen ® in the dosage form of film-coated tablets, 200 mg. Taking the drug with food may increase Tmax.

    Connection with blood plasma proteins - 90%, T 1/2 - 2 hours. Slowly penetrates into the joint cavity, lingers in the synovial fluid, creating higher concentrations in it than in the blood plasma. After absorption, about 60% of the pharmacologically inactive R-form is slowly transformed into the active S-form. Metabolized in the liver. Excreted by the kidneys (no more than 1% unchanged) and to a lesser extent with bile.

    There were no significant differences in the pharmacokinetic profile of the drug in older adults compared to younger adults. In limited studies, ibuprofen has been found in breast milk at very low concentrations.

    Pharmacodynamics

    The mechanism of action of ibuprofen, a derivative of propionic acid from the NSAID group, is due to inhibition of the synthesis of PG - mediators of pain, inflammation and hyperthermic reaction. Indiscriminately blocks COX-1 and COX-2, as a result of which it inhibits the synthesis of PG. It has a rapid, targeted effect against pain (analgesic), antipyretic and anti-inflammatory effects. In addition, ibuprofen reversibly inhibits platelet aggregation.

    Indications for use

    • headache;
    • migraine;
    • toothache;
    • painful menstruation;
    • neuralgia;
    • back pain, muscle pain, rheumatic pain;
    • febrile conditions with influenza and colds.

    Contraindications for use

    • hypersensitivity to ibuprofen or any of the components included in the drug;
    • complete or incomplete combination of bronchial asthma, recurrent polyposis of the nose and paranasal sinuses and intolerance to acetylsalicylic acid or other NSAIDs (including a history);
    • erosive and ulcerative diseases of the gastrointestinal tract in the acute stage (including peptic ulcer of the stomach and duodenum, Crohn's disease, ulcerative colitis) or ulcerative bleeding in the active phase or history (two or more confirmed episodes of peptic ulcer or ulcerative bleeding);
    • a history of bleeding or perforation of a gastrointestinal ulcer caused by the use of NSAIDs;
    • severe liver failure or active liver disease;
    • severe renal failure (Cl creatinine<30 мл/мин), подтвержденная гиперкалиемия;
    • decompensated heart failure; period after coronary artery bypass surgery;
    • cerebrovascular or other bleeding;
    • fructose intolerance;
    • hemophilia and other bleeding disorders (including hypocoagulation), hemorrhagic diathesis;
    • pregnancy (III trimester);
    • children up to 12 years of age.

    With caution: if you have the conditions listed in this section, you should consult your doctor before using the drug - simultaneous use of other NSAIDs; a history of a single episode of gastric ulcer or ulcerative bleeding of the gastrointestinal tract, gastritis, enteritis, colitis, Helicobacter pylori infection, ulcerative colitis; bronchial asthma or allergic diseases in the acute stage or in history - bronchospasm may develop; systemic lupus erythematosus or mixed connective tissue disease (Sharp's syndrome) increased risk of aseptic meningitis; renal failure, incl. with dehydration (creatinine Cl less than 30-60 ml/min); nephrotic syndrome; liver failure; liver cirrhosis with portal hypertension; hyperbilirubinemia; arterial hypertension and/or heart failure; cerebrovascular diseases; blood diseases of unknown etiology (leukopenia and anemia); severe somatic diseases; dyslipidemia/hyperlipidemia; diabetes; peripheral arterial disease; smoking; frequent drinking of alcohol; phenylketonuria or phenylalanine intolerance; simultaneous use of drugs that may increase the risk of ulcers or bleeding, in particular, oral corticosteroids (including prednisolone), anticoagulants (including warfarin), SSRIs (including citalopram, fluoxetine, paroxetine, sertraline) or antiplatelet agents (including acetylsalicylic acid, clopidogrel); pregnancy, I-II trimester; breastfeeding period; elderly age.

    Use during pregnancy and children

    The use of the drug is contraindicated in the third trimester of pregnancy. You should avoid using the drug in the first and second trimesters of pregnancy; if you need to take the drug, you should consult your doctor.

    There is evidence that ibuprofen can pass into breast milk in small quantities without any adverse effects on the health of the nursing infant, so there is usually no need to stop breastfeeding when taken for a short period of time. If long-term use of the drug is necessary, you should consult a doctor to decide whether to stop breastfeeding for the period of use of the drug.

    Side effects

    The risk of side effects can be minimized if the drug is taken in a short course at the minimum effective dose required to eliminate symptoms.

    Side effects are predominantly dose-dependent.

    The following adverse reactions were observed with short-term use of ibuprofen in doses not exceeding 1200 mg/day (3 caps.). When treating chronic conditions and with long-term use, other adverse reactions may occur.

    The incidence of adverse reactions was assessed based on the following criteria: very often (≥1/10); often (from ≥1/100 to<1/10); нечасто (от ≥1/1000 до <1/100); редко (от ≥1/10 000 до <1/1000); очень редко (<1/10000); частота неизвестна (данные по оценке частоты отсутствуют).

    From the blood and lymphatic system: very rarely - hematopoietic disorders (anemia, leukopenia, aplastic anemia, hemolytic anemia, thrombocytopenia, pancytopenia, agranulocytosis). The first symptoms of such disorders are fever, sore throat, superficial oral ulcers, flu-like symptoms, severe weakness, nosebleeds and subcutaneous hemorrhages, bleeding and bruising of unknown etiology.

    From the immune system: infrequently - hypersensitivity reactions - nonspecific allergic reactions and anaphylactic reactions, reactions from the respiratory tract (bronchial asthma, including its exacerbation, bronchospasm, shortness of breath), skin reactions (itching, urticaria, purpura, Quincke's edema , exfoliative and bullous dermatoses, including toxic epidermal necrolysis (Lyell's syndrome), Stevens-Johnson syndrome, erythema multiforme), allergic rhinitis, eosinophilia; very rarely - severe hypersensitivity reactions, incl. swelling of the face, tongue and larynx, shortness of breath, tachycardia, arterial hypotension (anaphylaxis, Quincke's edema or severe anaphylactic shock).

    From the gastrointestinal tract: infrequently - abdominal pain, nausea, dyspepsia (including heartburn, bloating); rarely - diarrhea, flatulence, constipation, vomiting; very rarely - peptic ulcer, perforation or gastrointestinal bleeding, melena, hematemesis, in some cases fatal, especially in elderly patients, ulcerative stomatitis, gastritis; frequency unknown - exacerbation of colitis and Crohn's disease.

    From the liver and biliary tract: very rarely - liver dysfunction (especially with long-term use), hepatitis, jaundice.

    From the kidneys and urinary system: very rarely - acute renal failure, hematuria and proteinuria, nephritic syndrome, nephrotic syndrome, papillary necrosis, interstitial nephritis, cystitis.

    From the nervous system: infrequently - headache; very rarely - aseptic meningitis (isolated cases of symptoms of aseptic meningitis, such as stiff neck, headache, nausea, vomiting, fever and disorientation, were observed during treatment with ibuprofen in patients with autoimmune diseases (systemic lupus erythematosus and mixed connective tissue disease).

    From the cardiovascular system: frequency unknown - heart failure, peripheral edema, with long-term use there is an increased risk of thrombotic complications (for example, myocardial infarction or stroke), increased blood pressure.

    From the respiratory system, chest and mediastinal organs: frequency unknown - bronchial asthma, bronchospasm, shortness of breath.

    Laboratory values: hematocrit or hemoglobin (may decrease); bleeding time (may increase); plasma glucose concentration (may decrease); creatinine clearance (may decrease); plasma creatinine concentration (may increase); liver transaminase activity (may increase).

    If side effects occur, stop taking the drug and consult a doctor.⁠

    Drug interactions

    The simultaneous use of ibuprofen with the following drugs should be avoided

    Acetylsalicylic acid: with the exception of low doses of acetylsalicylic acid (no more than 75 mg/day) prescribed by a doctor, since combined use may increase the risk of side effects. With simultaneous use, ibuprofen reduces the anti-inflammatory and antiplatelet effect of acetylsalicylic acid (an increase in the incidence of acute coronary insufficiency in patients receiving small doses of acetylsalicylic acid as an antiplatelet agent is possible after starting ibuprofen).

    Other NSAIDs, in particular selective COX-2 inhibitors: the simultaneous use of two or more drugs from the NSAID group should be avoided due to a possible increased risk of side effects.

    Use with caution simultaneously with the following drugs

    Anticoagulants and thrombolytic drugs: NSAIDs may enhance the effect of anticoagulants, in particular warfarin and thrombolytic drugs.

    Antihypertensives (ACE inhibitors and ARA II) and diuretics: NSAIDs may reduce the effectiveness of drugs in these groups. Diuretics may increase the nephrotoxicity of NSAIDs.

    GCS: increased risk of gastrointestinal ulcers and gastrointestinal bleeding.

    Antiplatelet agents and SSRIs: increased risk of gastrointestinal bleeding.

    Cardiac glycosides: simultaneous administration of NSAIDs and cardiac glycosides can lead to worsening heart failure, a decrease in GFR and an increase in the concentration of cardiac glycosides in the blood plasma.

    Lithium preparations: there is evidence of the likelihood of an increase in the concentration of lithium in the blood plasma during the use of NSAIDs.

    Methotrexate: there is evidence of the likelihood of an increase in the concentration of methotrexate in the blood plasma during the use of NSAIDs.

    Cyclosporine: increased risk of nephrotoxicity when NSAIDs are administered concomitantly with cyclosporine.

    Mifepristone: NSAIDs should be started no earlier than 8 to 12 days after taking mifepristone, as NSAIDs may reduce the effectiveness of mifepristone.

    Tacrolimus: Concomitant administration of NSAIDs and tacrolimus may increase the risk of nephrotoxicity.

    Zidovudine: Concomitant use of NSAIDs and zidovudine may result in increased hematotoxicity. There is evidence of an increased risk of hemarthrosis and hematomas in HIV-positive patients with hemophilia who received concomitant treatment with zidovudine and ibuprofen.

    Quinolone antibiotics: Patients receiving concomitant treatment with NSAIDs and quinolone antibiotics may have an increased risk of seizures.⁠

    Dosage

    Adults and children over 12 years old - 1 capsule, without chewing. The capsule should be taken with water. The interval between doses of the drug should be at least 4 hours. The maximum daily dose is 1200 mg. The maximum daily dose for children 12-17 years old is 800 mg.

    If symptoms persist or worsen after taking the drug for 2-3 days, you should stop treatment and consult a doctor.

    Overdose

    In children, overdose symptoms may occur after taking a dose exceeding 400 mg/kg. In adults, the dose-dependent effect of overdose is less pronounced. T1/2 of the drug in case of overdose is 1.5-3 hours.

    Symptoms: nausea, vomiting, epigastric pain or, less commonly, diarrhea, tinnitus, headache and gastrointestinal bleeding. In more severe cases, manifestations from the central nervous system are observed: drowsiness, rarely - agitation, convulsions, disorientation, coma. In cases of severe poisoning, metabolic acidosis and increased PT, acute renal failure, liver tissue damage, decreased blood pressure, respiratory depression and cyanosis may develop. In patients with bronchial asthma, exacerbation of this disease is possible.

    Treatment: symptomatic, with mandatory maintenance of airway patency, monitoring of ECG and vital signs until the patient’s condition is normalized. Oral use of activated charcoal or gastric lavage is recommended within one hour after taking a potentially toxic dose of ibuprofen. If ibuprofen has already been absorbed, an alkaline drink may be prescribed in order to remove the acidic derivative of ibuprofen by the kidneys, forced diuresis. Frequent or prolonged seizures should be treated with IV diazepam or lorazepam. When bronchial asthma worsens, the use of bronchodilators is recommended.

    Precautionary measures

    During long-term treatment, monitoring of the peripheral blood picture and the functional state of the liver and kidneys is necessary. When symptoms of gastropathy appear, careful monitoring is indicated, including esophagogastroduodenoscopy, a complete blood count (Hb determination), and a stool test for occult blood.

    If it is necessary to determine 17-ketosteroids, the drug should be discontinued 48 hours before the study. During the treatment period, ethanol intake is not recommended.

    Patients with renal failure should consult a doctor before using the drug, as there is a risk of deterioration in the functional state of the kidneys.

    Patients with arterial hypertension, incl. history and/or CHF, you should consult a doctor before using the drug, since the drug can cause fluid retention, increased blood pressure and edema.

    Information for women planning pregnancy: the drug suppresses COX and the synthesis of PGi can affect ovulation, disrupting female reproductive function (reversible after discontinuation of treatment).

    Impact on the ability to drive vehicles or operate machinery. Patients who experience dizziness, drowsiness, lethargy, or blurred vision while taking ibuprofen should avoid driving or operating machinery.⁠

    1 capsule contains: ibuprofen 400 mg.

    Excipients: macrogol 600 - 335.3 mg, potassium hydroxide - 44.82 mg, water - 29.88 mg.
    Soft gelatin capsules, oval, translucent, red, with the identifying inscription "NUROFEN" in white. The contents of the capsules are a transparent liquid from colorless to light pink.

    pharmachologic effect

    The mechanism of action of ibuprofen, a derivative of propionic acid from the group of non-steroidal anti-inflammatory drugs (NSAIDs), is due to inhibition of the synthesis of prostaglandins - mediators of pain, inflammation and hyperthermic reaction. Indiscriminately blocks COX-1 and COX-2, as a result of which it inhibits the synthesis of prostaglandins. It has a rapid, targeted effect against pain (analgesic), antipyretic and anti-inflammatory effects. In addition, ibuprofen reversibly inhibits platelet aggregation.

    Mode of application

    Read the instructions carefully before taking the drug.
    For oral administration. For short term use only.
    Adults and children over 12 years of age: 200 mg orally (1 capsule) 3-4 times a day. The capsule is taken without chewing with water. The interval between doses of the drug should be 6-8 hours.
    To achieve a faster therapeutic effect in adults, the dose can be increased to 2 capsules (400 mg) up to 3 times a day.
    The maximum daily dose is 1200 mg.
    The maximum daily dose for children 12-17 years old is 1000 mg.
    If symptoms persist or worsen after taking the drug for 2-3 days, you should stop treatment and consult a doctor.

    Interaction

    The concomitant use of ibuprofen with the following drugs should be avoided
    Acetylsalicylic acid: with the exception of low doses of acetylsalicylic acid (no more than 75 mg/day) prescribed by a doctor, since combined use may increase the risk of side effects. With simultaneous use, ibuprofen reduces the anti-inflammatory and antiplatelet effect of acetylsalicylic acid (an increase in the incidence of acute coronary insufficiency in patients receiving small doses of acetylsalicylic acid as an antiplatelet agent is possible after starting ibuprofen).
    Other NSAIDs, in particular selective COX-2 inhibitors: the simultaneous use of two or more drugs from the NSAID group should be avoided due to a possible increased risk of side effects.
    Use with caution concomitantly with the following medications
    Anticoagulants and thrombolytic drugs: NSAIDs may enhance the effect of anticoagulants, in particular warfarin and thrombolytic drugs.
    Antihypertensives (ACE inhibitors and angiotensin II antagonists) and diuretics: NSAIDs may reduce the effectiveness of drugs in these groups. Diuretics and ACE inhibitors may increase the nephrotoxicity of NSAIDs.
    GCS: increased risk of gastrointestinal ulcers and gastrointestinal bleeding.
    Antiplatelet agents and selective serotonin reuptake inhibitors: increased risk of gastrointestinal bleeding.
    Cardiac glycosides: simultaneous administration of NSAIDs and cardiac glycosides can lead to worsening heart failure, a decrease in glomerular filtration rate and an increase in the concentration of cardiac glycosides in the blood plasma.
    Lithium preparations: there is evidence of the likelihood of an increase in the concentration of lithium in the blood plasma during the use of NSAIDs.
    Methotrexate: there is evidence of the likelihood of an increase in the concentration of methotrexate in the blood plasma during the use of NSAIDs.
    Cyclosporine: increased risk of nephrotoxicity when NSAIDs are administered concomitantly with cyclosporine.
    Mifepristone: NSAIDs should be started no earlier than 8 to 12 days after taking mifepristone, as NSAIDs may reduce the effectiveness of mifepristone.
    Tacrolimus: When NSAIDs are administered concomitantly with tacrolimus, the risk of nephrotoxicity may increase.
    Zidovudine: Concomitant use of NSAIDs and zidovudine may result in increased hematotoxicity. There is evidence of an increased risk of hemarthrosis and hematomas in HIV-positive patients with hemophilia who received concomitant treatment with zidovudine and ibuprofen.
    Quinolone antibiotics: In patients receiving concomitant treatment with NSAIDs and quinolone antibiotics, the risk of seizures may increase.
    Cefamandole, cefoperazone, cefotetan, valproic acid, plicamycin: increased incidence of hypoprothrombinemia.
    Drugs that block tubular secretion: decreased excretion and increased plasma concentrations of ibuprofen.
    Inducers of microsomal oxidation (phenytoin, ethanol, barbiturates, rifampicin, phenylbutazone, tricyclic antidepressants): increased production of hydroxylated active metabolites, increased risk of developing severe intoxications.
    Microsomal oxidation inhibitors: reducing the risk of hepatotoxicity.
    Oral hypoglycemic drugs, sulfonylurea derivatives and insulin: enhanced effect.
    Antacids and cholestyramine: decreased absorption.
    Caffeine: increased analgesic effect.

    Side effect

    The risk of side effects can be minimized if the drug is taken in a short course, at the minimum effective dose required to eliminate symptoms.
    Side effects are predominantly dose-dependent.
    The following adverse reactions were observed with short-term use of ibuprofen in doses not exceeding 1200 mg/day (6 capsules). When treating chronic conditions and with long-term use, other adverse reactions may occur.
    The frequency of adverse reactions was assessed based on the following criteria: very often (?1/10), often (from?1/100 to From the blood and lymphatic system: very rarely - hematopoietic disorders (anemia, leukopenia, aplastic anemia, hemolytic anemia , thrombocytopenia, pancytopenia, agranulocytosis). The first symptoms of such disorders are fever, sore throat, superficial ulcers in the mouth, flu-like symptoms, severe weakness, nosebleeds and subcutaneous hemorrhages, bleeding and bruising of unknown etiology.
    From the immune system:
    - uncommon - hypersensitivity reactions - nonspecific allergic reactions and anaphylactic reactions, reactions from the respiratory tract (bronchial asthma, including its exacerbation, bronchospasm, shortness of breath, dyspnea), allergic rhinitis, eosinophilia;
    - very rarely - severe hypersensitivity reactions, incl. swelling of the face, tongue and larynx, shortness of breath, tachycardia, arterial hypotension (anaphylaxis, Quincke's edema or severe anaphylactic shock).
    From the digestive system:
    - infrequently - abdominal pain, nausea, dyspepsia (including heartburn, bloating);
    - rarely - diarrhea, flatulence, constipation, vomiting;
    - very rarely - peptic ulcer, perforation or gastrointestinal bleeding, melena, hematemesis, in some cases fatal, especially in elderly patients, ulcerative stomatitis, gastritis;
    - frequency unknown - exacerbation of colitis and Crohn's disease.
    From the liver and biliary tract: very rarely - liver dysfunction (especially with long-term use), increased activity of liver transaminases, hepatitis and jaundice.
    From the urinary system: very rarely - acute renal failure (compensated and decompensated), especially with long-term use, in combination 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.
    From the nervous system:
    - infrequently - headache;
    - very rarely - aseptic meningitis.
    From the cardiovascular system: frequency unknown - heart failure, peripheral edema, with long-term use there is an increased risk of thrombotic complications (for example, myocardial infarction), increased blood pressure.
    From the respiratory system: frequency unknown - bronchial asthma, bronchospasm, shortness of breath.
    From the skin and subcutaneous tissues: infrequently - itching, urticaria, purpura, exfoliative and bullous dermatoses, incl. toxic epidermal necrolysis (Lyell's syndrome), Stevens-Johnson syndrome, erythema multiforme.
    Other: very rarely - swelling, incl. peripheral.
    Laboratory indicators:
    - hematocrit or hemoglobin (may decrease);
    - bleeding time (may increase);
    - plasma glucose concentration (may decrease);
    - CC (may decrease);
    - serum creatinine concentration (may increase);
    - activity of liver transaminases (may increase).
    If side effects occur, you should stop taking the drug and consult a doctor.

    Contraindications

    - hypersensitivity to ibuprofen or any of the components included in the drug;
    - complete or incomplete combination of bronchial asthma, recurrent nasal polyposis and paranasal sinuses, and intolerance to acetylsalicylic acid or other NSAIDs (including a history);
    - erosive and ulcerative diseases of the gastrointestinal tract (including gastric and duodenal ulcers, Crohn's disease, ulcerative colitis) or ulcerative bleeding in the active phase or in history (two or more confirmed episodes of peptic ulcer or ulcerative bleeding);
    - a history of bleeding or perforation of a gastrointestinal ulcer caused by the use of NSAIDs;
    - severe liver failure or active liver disease;
    - severe renal failure (KK - decompensated heart failure;
    - the period after coronary artery bypass surgery;
    - cerebrovascular or other bleeding;
    - fructose intolerance;
    - hemophilia and other bleeding disorders (including hypocoagulation), hemorrhagic diathesis;
    - III trimester of pregnancy;
    - children's age up to 12 years.
    Precautions for use
    If you have the conditions listed in this section, you should consult your doctor before using the drug.
    - simultaneous use of other NSAIDs, a history of a single episode of gastric ulcer or gastrointestinal ulcer bleeding;
    - gastritis, enteritis, colitis, the presence of Helicobacter pylori infection, ulcerative colitis;
    - bronchial asthma or allergic diseases in the acute phase or in history - bronchospasm may develop;
    - systemic lupus erythematosus or mixed connective tissue disease (Sharpe's syndrome) - increased risk of aseptic meningitis;
    - renal failure, incl. with dehydration (creatinine clearance less than 30-60 ml/min), nephrotic syndrome, liver failure, liver cirrhosis with portal hypertension, hyperbilirubinemia, arterial hypertension and/or heart failure, cerebrovascular diseases, blood diseases of unknown etiology (leukopenia and anemia), severe somatic diseases, dyslipidemia/hyperlipidemia, diabetes mellitus, peripheral arterial disease, smoking, frequent alcohol consumption, phenylketonuria or phenylalanine intolerance, concomitant use of medications that may increase the risk of ulcers or bleeding, in particular oral corticosteroids (including prednisolone ), anticoagulants (including warfarin), selective serotonin reuptake inhibitors (including citalopram, fluoxetine, paroxetine, sertraline) or antiplatelet agents (including acetylsalicylic acid, clopidogrel), I-II trimesters of pregnancy , breastfeeding period, old age.

    Use during pregnancy and breastfeeding
    The use of the drug is contraindicated in the third trimester of pregnancy. You should avoid using the drug in the first and second trimesters of pregnancy; if you need to take the drug, you should consult your doctor.
    There is evidence that ibuprofen can pass into breast milk in small quantities without any adverse effects on the health of the nursing infant, so there is usually no need to stop breastfeeding when taken for a short period of time. If long-term use of the drug is necessary, you should consult a doctor to decide whether to stop breastfeeding for the period of use of the drug.
    Information for women planning pregnancy: these drugs suppress COX and prostaglandin synthesis, affect ovulation, disrupting female reproductive function (reversible after discontinuation of treatment).

    Overdose

    In children, symptoms of overdose may occur after ingestion of more than 400 mg/kg body weight of vine. In adults, the dose-dependent effect of overdose is less pronounced. T1/2 of the drug in case of overdose is 1.5-3 hours.
    Symptoms: nausea, vomiting, epigastric pain or, less commonly, diarrhea, tinnitus, headache and gastrointestinal bleeding. In more severe cases, manifestations from the central nervous system are observed: drowsiness, rarely - agitation, convulsions, disorientation, coma. In cases of severe poisoning, metabolic acidosis and an increase in prothrombin time, renal failure, liver tissue damage, decreased blood pressure, respiratory depression and cyanosis may develop. In patients with bronchial asthma, exacerbation of this disease is possible.
    Treatment: symptomatic, with mandatory maintenance of airway patency, monitoring of ECG and vital signs until the patient’s condition is normalized. Oral use of activated charcoal or gastric lavage is recommended within 1 hour after taking a potentially toxic dose of ibuprofen. If ibuprofen has already been absorbed, an alkaline drink may be prescribed in order to remove the acidic derivative of ibuprofen by the kidneys, forced diuresis. Frequent or prolonged seizures should be treated with IV diazepam or lorazepam. If bronchial asthma worsens, the use of bronchodilators is recommended.

    special instructions

    It is recommended to take the drug for the shortest possible course and in the minimum effective dose necessary to eliminate symptoms.
    During long-term treatment, monitoring of the peripheral blood picture and the functional state of the liver and kidneys is necessary. When symptoms of gastropathy appear, careful monitoring is indicated, including esophagogastroduodenoscopy, a complete blood count (hemoglobin determination), and a stool test for occult blood. If it is necessary to determine 17-ketosteroids, the drug should be discontinued 48 hours before the study. During the treatment period, ethanol intake is not recommended.
    Patients with renal failure should consult a doctor before using the drug, as there is a risk of deterioration in the functional state of the kidneys.
    Patients with arterial hypertension, incl. history, and/or chronic heart failure, you should consult your doctor before using the drug, since the drug may cause fluid retention, increased blood pressure and edema.
    Impact on the ability to drive vehicles and operate machinery
    Patients who experience dizziness, drowsiness, lethargy, or blurred vision while taking ibuprofen should avoid driving or operating machinery.

    Nurofen Forte - acts as an anesthetic, relieves inflammation and increased body temperature. The active substance is, the main task of which is to be a barrier to some reactions that occur in the body and accompany various kinds of diseases. The job of ibuprofen is to delay the synthesis of substances responsible for pain and inflammation.

    The maximum amount of ibuprofen in the blood is reached two hours after taking it. It is excreted naturally by the kidneys and along with bile.

    What does the prefix “Forte” mean in the name of the medicine?

    “Forte” in the name of the medicine means that the tablet has a special coating that is soluble only in the intestines, not in the stomach. This allows the medicine to reach the intestines, more precisely, to the duodenum, and only dissolve there and begin to act, of course, faster than it would happen in the stomach.

    The prefix “forte” means that this medicine will not be digested in the stomach, losing up to 50% of its effectiveness. The numbers in the name of the drug Nurofen Forte 400 mean that 1 tablet of this drug contains 400 mg of the active substance, in our case, ibuprofen.

    What Nurofen does:

    1. Relieves any pain (tooth, headache, joint);
    2. Reduces elevated body temperature;
    3. Stops the inflammatory process.

    The last property is extremely necessary when you feel that you are sick, but still don’t know why. Until the exact diagnosis is determined (visiting a doctor, tests), with the help of Nurofen you can stop the inflammatory process in the body. And the fact that it is there is evidenced by an increased body temperature.

    Indications for use

    According to the instructions for use, Nurofen Forte is taken for negative feelings during illnesses such as:

    • Infectious diseases of the respiratory tract (upper);
    • Headache of various etymologies;
    • Increased body temperature during ARVI, influenza and other colds;
    • Neuralgia;
    • Rheumatoid, joint and rheumatic pain;
    • Dysmenorrhea;
    • Fever of various etymologies.



    Here is the answer to the question - what does Nurofen Forte help with? This drug helps very well against debilitating back pain. Nurofen is able to relieve pain for 8 hours.

    Dosage

    Patients over twelve years of age and adults Nurofen Express Forte, according to the instructions for use, should take 1 tablet per day - for pain of various etiologies and every 4 hours - to reduce the temperature. But no more than 3 tablets per 24 hours for adults and 2.5 tablets (1 g) for adolescents aged 12 to seventeen years.

    By-effect

    The following consequences may occur from taking Nurofen Forte Express 400:

    • Nausea;
    • Vomit;
    • Diarrhea;
    • Increased gas formation;
    • Increased activity of liver transaminases;
    • The occurrence of erosion and ulcers in the gastrointestinal tract (rare);
    • Ulcers on the gums;
    • Pancreatitis;
    • Drowsiness or overexcitement;
    • Allergic rhinitis;
    • Quincke's edema;
    • Allergies in the form of a rash;
    • Bronchospasms;
    • Anaphylactic shock;
    • Reduced blood glucose concentration (possible).



    However, all of the above occurs extremely rarely.

    What's included

    The main active ingredient is ibuprofen;

    Excipients:

    1. Corn starch;
    2. Gelatin;
    3. Sodium citrate.

    Cost and precautions for drug compatibility

    The price of Nurofen Forte is approximately 300-400 rubles, plus or minus 20 rubles. Country of origin: the Netherlands. Nurofen Express Forte from England will cost approximately 500 rubles per package of 20 tablets. This is an affordable and effective medicine. Available without a prescription.

    Nurofen's interaction with other medications may cause more harm than good. Therefore, Nurofen Forte should not be taken with the following drugs or can be taken, but under the supervision of a doctor:

    1. Aspirin;
    2. Non-steroidal anti-inflammatory drugs;
    3. Thrombolytic agents;
    4. Anticoagulants;
    5. Antihypertensive drugs;
    6. Diuretics;
    7. Antiplatelet agents;
    8. SSRIs;
    9. Cardiac glycosides;
    10. Methotrexate;
    11. Lithium preparations;
    12. Cyclosparin;
    13. Mifepristone;
    14. Tocrolimus;
    15. Zidovudine;
    16. Antibiotics (quinoline series).

    Experts do not recommend taking this medicine together with acetylsalicylic acid and other antipyretics. Also in such conditions, the development of acute coronary insufficiency is possible.

    Nurofen should not be taken together with anticoagulants (streptokinase, urokinase, alteplase). Otherwise, internal bleeding may occur.

    In what cases is the use of Nurofen dangerous?

    There are a number of contraindications for the use of this drug, namely:

    • Erosion and ulcers of the gastrointestinal tract;
    • Internal gastrointestinal bleeding;
    • Time after coronary artery bypass surgery;
    • Liver or kidney failure;
    • Intracranial injuries and hemorrhages;
    • Pregnancy;
    • Breastfeeding period;
    • Children under 6 years old;
    • Hypersensitivity to the components of the drug;
    • Hypersensitivity to acetylsalicylic acid.

    This medicine should be taken with caution and under medical supervision:

    • To old people;
    • Those who have been diagnosed with heart failure;
    • For diabetes mellitus;
    • For diseases of peripheral arteries;
    • Smoking and drinking alcohol;
    • With cirrhosis of the liver;
    • With hyperbilirubinemia;
    • For gastritis, colitis and enteritis;
    • For anemia and leukopenia.

    Analogues of Nurofen Forte

    Analogs of the drugs Nurofen Forte and Nurofen Forte Express can be called all medicines in which the active ingredient is ibuprofen, namely.