Brufen SR - instructions for use, dose, side effects, contraindications

Excipients: xanthan gum - 196.8 mg; povidone - 25.9 mg; stearic acid - 10.3 mg; silicon dioxide colloid - 3.0 mg, hypromellose - 16.0 mg; Opadry white M-1-7111B - 5.0 mg; talc - 3.0 mg; brown ink Opacode S-1- 9460HV - footprints.

Description:

White oblong coated tablets with an overprint "BRUFEN RETARD" red-brown color on one side.

Pharmacotherapeutic group:Non-steroidal anti-inflammatory drug (NSAID)

ATX: & nbsp

M.01.A.E.01 Ibuprofen

Pharmacodynamics:

Ibuprofen is a derivative of propionic acid, a non-steroidal anti-inflammatory drug (NSAID), which has analgesic, anti-inflammatory and antipyretic effects. The therapeutic effect of the drug is due to inhibition of the enzyme cyclooxygenase, which leads to a significant reduction in the synthesis of prostaglandins. These properties provide elimination of symptoms of inflammation, pain and fever.

Experimental data show that the simultaneous use of ibuprofen can inhibit the effect of low doses of acetylsalicylic acid on platelet aggregation. In a single study with a single dose of ibuprofen 400 mg for 8 hours before or 30 minutes after immediate release of immediate-release acetylsalicylic acid (81 mg), a decrease in the effect of acetylsalicylic acid on thromboxane formation or platelet aggregation was observed.However, due to the limitations of these data and the inaccuracy in the extrapolation of data obtained under conditions ex vivo, on the clinical situation, reliable conclusions regarding the continuous use of ibuprofen can not be made. The development of clinically significant effects is considered unlikely with episodic use of ibuprofen.

Pharmacokinetics:

Ibuprofen is a racemic mixture of [+] S- and [-] R-enantiomers. Studies have shown that eating does not have a significant effect on overall bioavailability.

Suction

Ibuprofen is rapidly absorbed in the gastrointestinal tract, the bioavailability is 80 - 90%, time to reach maximum concentration (TSmah) in the blood plasma when using immediate release dosage form -. 2.1 h Prolonged dosage form of 800 mg tablets of ibuprofen provides a gradual release of the active substance , with a slower release rate compared with immediate-release dosage forms and a decrease in the maximum plasma concentration (Cmax) that dos igaetsya approximately 3 hours after application of ibuprofen.As a result of a prolonged absorption phase, the plasma concentrations of ibuprofen are maintained longer in the systemic circulation. In this way, ibuprofen 800 mg tablets with prolonged action should be taken only once a day. A comparison of the pharmacokinetic profile of two 800 mg long-acting ibuprofen tablets and immediate-release ibuprofen tablets at a dose of 400 mg taken four times a day showed that the sustained release dosage form provides a reduction in the range of differences between Cmax and threshold concentrations of tablets with immediate release and ensures maintenance of higher average plasma concentrations at 5, 10, 15 and 24 hours. For immediate-release tablets and sustained-release tablets, the area under the concentration-time curve (AUC) was similar.

Distribution

Ibuprofen binds intensely to blood plasma proteins (99%). The volume of distribution (Vd) of ibuprofen is small and is approximately 0.12-0.2 l / kg in adults. Metabolism

Ibuprofen is rapidly metabolized in the liver with the participation of cytochrome P450 isoenzymes, preferably the isoenzyme CYP2C9,with the formation of two major inactive metabolites - 2-hydroxyibuprofen and 3-carboxybuprofen. When ibuprofen is used, a little less than 90% of the intake dose of ibuprofen can be detected in the urine in the form of oxidative metabolites and their glucuronic conjugates. A small amount of ibuprofen is excreted unchanged in the urine.

Excretion

Elimination of ibuprofen through the kidney is fast and complete. The half-life (T1 / 2) of immediate-release dosage forms is about two hours. Ibuprofen almost completely eliminated from the body 24 hours after admission

the last dose.

Special patient groups

Elderly patients

In elderly patients, in the absence of renal failure, only small, clinically insignificant differences in the pharmacokinetic profile and excretion in the urine are observed compared with young patients. Renal insufficiency

In patients with moderate renal insufficiency, elevated levels of (S) -ibuprofen in blood plasma, increased values of the AUC (S) -ibuprofen index and increased values of the enantiomeric AUC ratio (S / R) were observed compared to healthy control group patients.In patients with terminal stage of renal failure who were on dialysis, the mean free fraction of ibuprofen was about 3% compared to 1% in healthy volunteers. Serious disturbances in kidney function can lead to the accumulation of ibuprofen metabolites. The significance of this effect is unknown. Metabolites can be excreted by hemodialysis.

Liver failure

The presence of alcoholic liver disease with mild or moderate hepatic insufficiency did not have a significant effect on the pharmacokinetic parameters.

In patients with cirrhosis of the liver and moderate hepatic insufficiency (6-10 points on the Child-Pugh scale) treated with racemic ibuprofen, an increase in T1 / 2 was observed, on average by a factor of 2, and the value of the enantiomeric ratio of AUC (S / R) was significantly lower in comparison with healthy patients of the control group, which indicates a violation of the metabolic transformation of (R) -ibuprofen into the active (S) -enantiomer.

Indications:

Inflammatory and degenerative diseases: rheumatoid arthritis, including juvenile rheumatoid arthritis or Still's syndrome, osteoarthrosis, articular syndrome with exacerbation of gout, psoriatic arthritis, Bechterew's disease (ankylosing spondylitis), spondylosis.

Diseases of the periarticular tissues, including rheumatic: humeropathy periarthritis (capsulitis), bursitis, tendinitis, tenosynovitis, tenosynovitis, back pain, sciatica.

Damage of soft tissues: traumatic inflammation of soft tissues and musculoskeletal system, dislocations and distension, hematomas.

Weakening of the pain syndrome of mild or moderate severity with: headache, toothache, primary dysmenorrhea, postoperative pain, migraine, panniculitis, neuralgia, myalgia.

Inflammatory processes in the small pelvis: adnexitis, algodismenorea.

Contraindications:

- hypersensitivity to the active substance or to any of the excipients;

- complete or incomplete combination of bronchial asthma, recurrent nasal polyposis and paranasal sinuses and intolerance to acetylsalicylic acid (ASA) or other NSAIDs (including in the anamnesis);

- severe heart failure;

severe hepatic impairment;

active liver disease;

- severe renal failure (CC less than 30 ml / min);

progressive kidney disease;

- hemophilia and other disorders of blood clotting (incl.hypocoagulation), hemorrhagic diathesis;

- gastrointestinal bleeding or perforations in the history, associated with the previous use of NSAIDs;

- Ulcerative colitis, Crohn's disease, relapsing peptic ulcer or gastrointestinal bleeding (determined by two or more separate episodes of confirmed ulcer or bleeding), including in the anamnesis;

- condition after aortocoronary shunting;

- confirmed hyperkalemia;

- Inflammatory bowel disease;

- intracranial hemorrhage;

- pregnancy (III trimester);

- the period of breastfeeding;

- Children under 12 years old.

Carefully:A single episode of an erosive-ulcerative disease of the gastrointestinal tract in a history (including peptic ulcer of the stomach and duodenum); simultaneous administration of oral GCS (including prednisolone), anticoagulants (including warfarin), antiaggregants (including clopidogrel), selective serotonin reuptake inhibitors (including citalopram, fluoxetine, paroxetine, sertraline); long-term use of NSAIDs; The bronchial asthma, chronic rhinitis or allergic diseases (incl.in the anamnesis); hepatic insufficiency and / or chronic renal failure (creatinine clearance 30-60 ml / min); heart failure; arterial hypertension; cardiac ischemia; cerebrovascular diseases; dyslipidemia / hyperlipidemia; diabetes; diseases of peripheral arteries; smoking; infection H. pylori; frequent use of alcohol; severe physical illness; systemic lupus erythematosus or other autoimmune diseases of connective tissue (increased risk of developing aseptic meningitis); blood diseases of unclear etiology (leukopenia and anemia); cirrhosis of the liver with portal hypertension; nephrotic syndrome; hyperbilirubinemia; gastritis; enteritis; colitis; state of dehydration; pregnancy (I-II term), the elderly.

Pregnancy and lactation:

Reproductive function, pregnancy and childbirth

In the I - II trimesters of pregnancy, the drug Brufen CP can be taken only if absolutely necessary, if the potential benefit to the mother exceeds the potential risk to the fetus and the baby. The use of the drug Brufen CP in the III trimester of pregnancy is contraindicated, and, as with all inhibitors of prostaglandin synthesis, carries the following risks to the fetus:

- cardiopulmonary toxicity (premature closure of arterial

duct and arterial hypertension);

- impaired renal function, with the further possibility of developing renal failure and reducing the volume of the amniotic fluid.

During childbirth ibuprofen, like all inhibitors of prostaglandin synthesis, subject the mother and newborn to the following risks:

- increased bleeding time;

- inhibition of contractile activity of the uterus, which can lead to a delay or an increase in the duration of labor.

In this regard, it is not recommended to take ibuprofen during the period of labor. The use of ibuprofen can adversely affect female fertility and is not recommended for women planning a pregnancy.

In case of ibuprofen administration, women planning pregnancy, as well as in I or II trimesters of pregnancy should, as far as possible, reduce doses and shorten the duration of ibuprofen therapy. For women who have a conception problem or are undergoing infertility examinations, consideration should be given to the possibility of reversing ibuprofen therapy.

Breastfeeding period

Due to the limited data on the penetration of ibuprofen into breast milk at very low concentrations, the use of Brufen CP during breastfeeding is not recommended.

Dosing and Administration:

Inside, after eating. Tablets should be swallowed whole, without chewing, drink plenty of water.

Adults and children aged 12 years and over: the recommended dose is 2 tablets Brufen CP once a day, preferably at bedtime. In severe and acute conditions, the maximum daily dose is 3 tablets with a separate intake. The maximum daily dose is 2400 mg.

Elderly patients: with normal kidney and liver function correction of the dosing regimen in elderly patients is not required. If the kidney and / or liver function is impaired, the dose should be selected individually. In this group of patients, dosing should be done with caution.

Side effects:

Side effects observed with ibuprofen administration are characteristic for the whole class of NSAIDs. Undesirable effects can be minimized by applying minimum effective dose for a short period of time necessary to eliminate symptoms.

All adverse reactions evaluated as having at least the possible association with the use of ibuprofen are presented according to organ systems and frequency of occurrence: very often (≥1/10), often (from ≥ 1/100 to <1/10), infrequently (from ≥ 1/1000 to <1/100), rarely (from ≥ 1/10000 to <1/1000), very rarely (<1/10000) and the frequency is unknown (it is impossible to estimate the frequency based on the available data).

System of organs	Frequency	Undesirable effect
Infectious diseases¹	Infrequently	Rhinitis
Infectious diseases¹	Rarely	Aseptic meningitis
Violations of the blood and lymphatic system	Rarely	Anemia (including hemolytic, aplastic) Thrombocytopenia Neutropenia Agranulocytosis Leukopenia
Immune system disorders	Rarely	Anaphylactic reaction
Disorders of the psyche	Infrequently	Insomnia Anxiety
	Rarely	Depression Confusion of consciousness
	Frequency unknown	Hallucinations
Disturbances from the nervous system	Often	Headache Dizziness
	Infrequently	Paresthesia Drowsiness
	Rarely	Optic neuritis
Disturbances on the part of the organ of sight	Infrequently	Visual impairment
Disturbances on the part of the organ of sight	Rarely	Toxic Optical Neuropathy
Hearing disorders and labyrinthine disorders	Infrequently	Hearing impairment Tingle or tinnitus Vertigo
Infringements from hearts	Highly rarely	Exacerbation of heart failure Myocardial infarction
Infringements from vessels³	Highly rarely	Increased blood pressure
Disturbances from the respiratory system, chest organs and mediastinum	Infrequently	Exacerbation of bronchial asthma Bronchospasm Dispnoe
Disturbances from the gastrointestinal tract (GIT)	Often	Dyspepsia Diarrhea Nausea Vomiting (including bloody) Abdominal pain Flatulence Constipation Melena Gastrointestinal bleeding
	Infrequently	Gastritis Gastric and / or duodenal ulcers Ulceration of the oral mucosa Perforation of the gastrointestinal mucosa
	Highly rarely	Pancreatitis
	Frequency unknown	Exacerbation of colitis and Crohn's disease Aphthous stomatitis
Disturbances from the liver and bile ducts	Infrequently	Hepatitis Jaundice Impaired liver function
Disturbances from the liver and bile ducts	Rarely	Liver failure
Disturbances from the skin and subcutaneous tissues2	Often	Skin rash
	Infrequently	Hives Itchy skin Hemorrhagic rash Angioneurotic edema Photosensitivity
	Rarely	Multiforme exudative erythema Bullous dermatosis (incl.Stevens-Johnson syndrome) Toxic epidermal necrolysis (Lyell's syndrome)
Disorders from the kidneys and urinary tract	Infrequently	Tubulointerstitial nephritis (including allergic nephritis) Nephrotic syndrome Renal insufficiency
General disorders	Often	Increased fatigue
General disorders	Rarely	Edema

1 - when using NSAIDs, cases of exacerbation of inflammation caused by infections (for example, the development of necrotizing fasciitis) are described. If ibuprofen is showing signs of infection in the patient or the infection progresses, the doctor should be consulted immediately.

2 - In exceptional cases, serious skin infection and soft tissue disorders may occur when infected with chicken pox.

3 - Clinical and epidemiological studies indicate that the use of ibuprofen (at a high dose of 2,400 mg per day) and with long-term treatment may be associated with a slight increase in the risk of developing arterial thrombotic complications, including myocardial infarction or stroke (see section "Special instructions").

Overdose:

Toxicity: in children and adults with ibuprofen in doses less than 100 mg / kg signs and symptoms of toxicity are usually absent. However, in some cases, symptomatic therapy may be required. In children, the onset of symptoms of toxicity was observed after taking ibuprofen at doses of 400 mg / kg or more. In most patients with an overdose of ibuprofen, symptoms appear 4 to 6 hours after ingestion.

Symptoms: the most frequently reported symptoms of overdose such as nausea, vomiting, abdominal pain, blocking and drowsiness. Disorders from the central nervous system (CNS) include headache, tinnitus, dizziness, depression, convulsions and unconsciousness. Also, nystagmus, metabolic acidosis, hypothermia, renal dysfunction, gastrointestinal bleeding, coma, respiratory arrest, suppression of CNS activity and the respiratory system were rarely reported. There have been reports of cardiovascular toxicity, including arterial hypotension, bradycardia and tachycardia. In cases of significant overdose, it is possible to develop acute renal failure and liver damage.Overdose of large doses of the drug Brufen CP, As a rule, it is well tolerated if no other drugs are taken at the same time.

Treatment: there is no specific antidote. When an overdose is recommended, gastric lavage (within the first hour after admission) and maintenance therapy. In the presence of symptoms from the gastrointestinal tract - antacid preparations. With the development of arterial hypotension - intravenous infusion and, if required, inotropic support. Drinking, forced diuresis and symptomatic therapy (correction of CBS, electrolyte balance, blood pressure).

Interaction:

Due to reports of drug interactions in some patients, the drug Brufen CP should be used with caution in patients taking any of the following medicines:

The simultaneous use of ibuprofen with the following drugs:	Possible effects
Other NSAIDs, including selective inhibitors of cyclooxygenase-2	It should avoid concomitant use with other NSAIDs, including selective inhibitors of cyclooxygenase-2, because of the possible additive effect.
Cardiac glycosides	NSAIDs can worsen the course of heart failure, reduce the rate of glomerular filtration and increase the concentration of cardiac glycosides in blood plasma.
Glucocorticosteroids	When using NSAIDs, the risk of developing a gastrointestinal ulcer or bleeding increases.
Anticoagulants	NSAIDs can enhance the action of anticoagulants, such as warfarin or heparin. In the case of simultaneous use, it is recommended to control blood coagulation parameters.
Probenecid	Preparations containing probenecid may delay the excretion of ibuprofen.
Antiplatelet agents and selective serotonin reuptake inhibitors (SSRIs) (eg, clopidogrel, ticlopidine)	When using NSAIDs, the risk of developing gastrointestinal bleeding increases.
Acetylsalicylic acid	As with other drugs containing NSAIDs, simultaneous use of ibuprofen and acetylsalicylic acid is not recommended, as the likelihood of undesirable effects increases. Experimental data show that the simultaneous use of ibuprofen can inhibit the effect of low doses of acetylsalicylic acid on platelet aggregation.However, due to the limitations of these data and the inaccuracy in extrapolating the data obtained under ex vivo conditions to the clinical situation, reliable conclusions regarding the continuous use of ibuprofen can not be made. The development of clinically significant effects is considered unlikely with episodic use of ibuprofen.
Lithium preparations	NSAIDs may decrease lithium excretion.
Hypotensive drugs, beta-blockers and diuretics	NSAIDs can reduce the antihypertensive effect of antihypertensive drugs, including ACE inhibitors, angiotensin II receptor antagonists, beta-blockers and diuretics. Also, diuretics can increase the risk of nephrotoxic action of NSAIDs.
Methotrexate	NSAIDs can inhibit the tubular secretion of methotrexate and decrease the clearance of methotrexate.
Cyclosporin	When using NSAIDs, the risk of nephrotoxicity increases.
Tacrolimus	With the simultaneous use of NSAIDs and tacrolimus may increase the risk of nephrotoxicity.
Zidovudine	With the simultaneous use of NSAIDs and zidovudine, the risk of hematological toxicity increases. There is evidence of an increased risk of hemarthrosis and hematomas in HIV-positivepatients with hemophilia who received simultaneous treatment with zidovudine and ibuprofen.
Antibiotics of the quinolone series	Animal studies indicate that NSAIDs may increase the risk of seizures associated with the use of quinolone group antibiotics. Patients taking NSAIDs and quinolones may be at increased risk for seizures.
Inhibitors of the isoenzyme CYP2C9	The simultaneous use of ibuprofen and inhibitors of the isoenzyme CYP2C9 can enhance the action of ibuprofen (the substrate of the isoenzyme CYP2C9). In a study using voriconazole and fluconazole (inhibitors of the isoenzyme CYP2C9), an increase in the content of 8 (+) - ibuprofen in the body by approximately 80-100% was shown. When used simultaneously with inhibitors of the CYP2C9 isoenzyme, the possibility of reducing the dose of ibuprofen should be considered, particularly when using ibuprofen in high doses with voriconazole or fluconazole.
Sulfonylurea preparations	NSAIDs can enhance the action of sulfonylurea drugs. There have been reports of rare cases of hypoglycemia in patients taking both sulfonylurea preparations and ibuprofen.
Kolestyramine	The simultaneous use of ibuprofen and colestyramine can reduce the absorption of ibuprofen in the gastrointestinal tract. However, the clinical significance of this phenomenon is unknown.
Aminoglycosides	NSAIDs can reduce the excretion of aminoglycosides.
Extracts of medicinal herbs	The simultaneous use of NSAIDs and the extract of ginkgo biloba may increase the risk of bleeding.
Mifepristone	In connection with the anti-prostaglandin properties of NSAIDs, including acetylsalicylic acid, it is theoretically possible to reduce the effectiveness of the drug. Limited evidence suggests that the simultaneous use of NSAIDs on the day of prostaglandin does not adversely affect the efficacy of mifepristone or the effect of prostaglandins on the cervix or uterine contraction and does not reduce the clinical effectiveness of medical abortion.

Special instructions:

Gastrointestinal bleeding, ulcer and perforation

Brufen CP should be used with caution in patients with a pentinal ulcer and other gastrointestinal diseases in the history, as possible exacerbation of these conditions.

With the use of all NSAIDs, any cases of gastrointestinal bleeding, ulcers, or perforations have been reported at any time. These adverse events can be life-threatening and can occur if there are / or no warning signs or serious gastrointestinal illnesses in the anamnesis. The risk of gastrointestinal bleeding, ulceration, or perforation increases with an increase in the dose of the drug Brufen CP in patients with peptic ulcer disease, especially complicated by bleeding or perforation in the history, and in elderly patients. In these patients, treatment should be started with the lowest dose. In this group of patients, as well as in patients requiring concomitant low-dose acetylsalicylic acid therapy or other drugs that may increase the risk of gastrointestinal disease, combination therapy with gastroprotectors (eg misoprostol or proton pump inhibitors) should be considered.

Avoid simultaneous use of Brufen CP and other NSAIDs, including selective cyclooxygenase-2 (COX-2) inhibitors, due to an increased risk of ulceration or bleeding (see "Interactions with Other Drugs").

In the initial phase of treatment, patients with gastro-intestinal diseases in history, especially elderly patients, should report the occurrence of any unusual symptoms in the abdomen (especially gastrointestinal bleeding).

Should be used with caution Brufen CP patients concomitantly receiving drugs that may increase the risk of ulceration or bleeding, such as steroids for oral anticoagulants (including warfarin), Selective serotonin reuptake inhibitors or antiplatelet drugs, including acetylsalicylic acid (see section "Interaction with other drugs").

In the event of gastrointestinal bleeding or ulceration therapy with CP Brufen it should be discontinued.

Respiratory disorders

Caution must be exercised when using the drug Brufen CP patients with bronchial asthma, chronic rhinitis or allergic diseases, including history, as reported instances of bronchospasm, urticaria or angioedema when applying Brufen CP in this group of patients.

Heart failure, renal and hepatic impairment

Care should be taken when using the drug Brufen CP in patients with renal, hepatic or heart failure, since the use of NSAIDs may lead to impaired renal function. Simultaneous therapy with several analgesics further increases this risk. In patients with renal, hepatic or heart failure, the minimum effective dose should be administered within the shortest period of time and monitor renal function, especially with prolonged treatment.

Cardiovascular and cerebrovascular disorders

Care should be taken to use the drug Brufen CP in patients with heart failure or hypertension in the anamnesis, since ibuprofen has been reported on cases of edema.

Data from epidemiological studies indicate that the use of ibuprofen at a high dose (2,400 mg per day) and with long-term treatment may be associated with a slight increase in the risk of developing arterial thrombotic complications, including myocardial infarction or stroke.In the course of epidemiological studies, it has not been proven that the use of ibuprofen in a low dose (<1200 mg / day) is associated with an increased risk of developing arterial thrombotic complications, in particular myocardial infarction.

Therapy with Brufen CP in patients with uncontrolled hypertension, heart failure, ischemic heart disease, peripheral arterial disease and / or cerebrovascular disease should be performed only after a thorough assessment of the benefit / risk. Such an assessment should also be made before the appointment of long-term treatment to patients with risk factors for developing cardiovascular diseases (such as hypertension, hyperlipidemia, diabetes, smoking).

Dermatological disorders

When using NSAIDs, very rare cases of serious skin reactions, including life-threatening ones, including exfoliative dermatitis, Stevens-Johnson syndrome and toxic epidermal necrolysis, have been reported. At the initial stage of therapy, patients are most at risk of developing these reactions. In most cases, the reaction develops during the first month of treatment.At the first appearance of skin rash, lesions of the mucosa or any other signs of hypersensitivity, the use of the drug Brufen CP should be discontinued.

Renal impairment

Care should be taken to begin therapy with Brufen CP in patients with significant dehydration. There is a risk of developing kidney failure, especially in children and adolescents with dehydration.

Prolonged use of ibuprofen, like other NSAIDs, led to the development of medullary necrosis of the kidney and other pathological changes in the kidneys. Renal toxicity was also observed in patients with renal prostaglandins playing a compensatory role in maintaining renal perfusion. The use of NSAIDs in this group of patients can lead to a dose-related decrease in prostaglandin production and, in a secondary way, renal blood flow, which can cause renal failure. Patients with impaired renal function, heart failure, impaired liver function, taking diuretics, ACE inhibitors, and elderly patients are at increased risk of this reaction.After the abolition of NSAIDs, as a rule, the condition is restored before the start of treatment.

Hematologic disorders

Brufen CP, like other NSAIDs, can inhibit platelet aggregation and increase bleeding time in healthy patients.

Aseptic meningitis

In rare cases, the development of aseptic meningitis has been observed in patients receiving ibuprofen therapy. Although the emergence of aseptic meningitis is most likely in patients with systemic lupus erythematosus and associated connective tissue diseases, there have been reports of aseptic meningitis in patients who do not have this chronic disease.

Elderly patients

In elderly patients, the use of NSAIDs may be accompanied by an increased incidence of adverse reactions, especially perforation and gastrointestinal bleeding, which can be life threatening.

Effect on the ability to drive transp. cf. and fur:It can affect the speed of the reaction. During the treatment period, care must be taken when driving vehicles and engaging in other potentially hazardous activities,requiring increased concentration of attention and speed of psychomotor reactions.

Form release / dosage:

The tablets of the prolonged action covered with a cover, 0,8 g.

Packaging:For 7, 10 or 14 tablets in a blister of PVC / A1-foil or 60 or 100 tablets in a plastic bottle of white color, made of high density polyethylene, which is closed with a screw cap white. For 1, 2, 3, 4, 5 or 6 blisters or 1 bottle together with instructions for use in a cardboard bundle.

Storage conditions:At a temperature of no higher than 25 ° C. Keep out of the reach of children.

Shelf life:3 years. Do not use the drug after the expiration date.

Terms of leave from pharmacies:On prescription

Registration number:П N011126

Date of registration:12.08.2011

Expiration Date:Unlimited

The owner of the registration certificate:Abbott GmbH & Co. KGAbbott GmbH & Co. KG Germany

Manufacturer: & nbsp

ABBOTT, GmbH & Co. KG. KG Germany

Representation: & nbspABBOTT LABORATORIES LLC ABBOTT LABORATORIES LLC Russia

Information update date: & nbsp11.03.2017

Illustrated instructions

Instructions

Brufen SR (Brufen SR)