Ibuprofen + Codeine phosphate hemihydrate (Ibuprophenum + Codeini phosphatis hemihydras)

Pharmacodynamics Pharmacokinetics Indications Carefully Contraindications Dosing and Administration Side effects
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Clinical and pharmacological group: & nbsp

Opioid narcotic analgesics

Included in the formulation
  • Nurofen® Plus
    pills inwards 
    Rekitt Benckiser Helsar International Ltd.     United Kingdom
    • АТХ:

    N.02.A.A.59   Codeine in combination with other drugs, excluding psycholeptics

    Pharmacodynamics:

    Combined anesthetic drug.

    Ibuprofen

    Non-selectively suppresses COX1 and COX2, regulating the synthesis of prostaglandins. It indiscriminately suppresses synthetases of prostaglandins. Suppresses the production of anti-inflammatory cytokines. Violates the synthesis of arachidonic acid. Has analgesic, antipyretic and anti-inflammatory effect. Inhibits the aggregation of platelets. With long-term use has a desensitizing effect.

    Codeine phosphate hemihydrate

    Has antitussive and analgesic effect. Affects the μ-opiate receptors of the central nervous system, changes the emotional color of the pain syndrome, activates the antinociceptive (anesthetic) system, inhibits conditioned reflexes, raises the threshold of pain sensitivity, causes euphoria and drowsiness.

    Increases the tone of the vagus nerve, suppresses the cough center, activates the center of the oculomotor nerve, causing a narrowing of the pupil,increases the tone of the bronchi and smooth muscle sphincters of the intestine, bladder, biliary tract, weakens intestinal motility, reduces the secretion of glands of the gastrointestinal tract.

    Penetrates through the blood-brain and placental barrier, enters the breast milk.

    With uncontrolled admission, addiction develops and drug dependence develops.

    Pharmacokinetics:

    Ibuprofen

    After oral administration, up to 98% is absorbed in the gastrointestinal tract. The maximum concentration in the blood plasma is reached after 45 minutes. The connection with plasma proteins is 90%.

    Therapeutic effect develops after the reception. Metabolism in the liver.

    The elimination half-life is 2 hours. Elimination by the kidneys.

    Codeine phosphate hemihydrate

    After oral administration, an empty stomach is absorbed up to 20% in the gastrointestinal tract. The maximum concentration in the blood plasma is achieved after 1.2-1.8 hours. The connection with plasma proteins is 30%.

    The therapeutic effect develops 2-4 hours after admission. Metabolism in the liver with the participation of the isoenzyme CYP2D6 with the formation of dihydromorphine, which has a pronounced analgesic activity.

    The half-life is 3.5-5 hours.Elimination by the kidneys.

    Indications:

    It is used as a high-speed analgesic for pain syndrome of mild and moderate severity: headache and toothache, migraine, neuralgia, algomenorrhea, myalgia, pain of rheumatic genesis.

    ICD-10

    VI.G40-G47.G43   Migraine

    X.J00-J06.J06   Acute upper respiratory tract infections of multiple and unspecified sites

    X.J10-J18.J11   Influenza, virus not identified

    XIII.M30-M36.M35.3   Rheumatic polymyalgia

    XIII.M50-M54.M54.5   Lower back pain

    XIII.M70-M79.M79.1   Myalgia

    XIII.M70-M79.M79.2   Neuralgia and neuritis, unspecified

    XIV.N80-N98.N94.6   Dysmenorrhea, unspecified

    XVIII.R50-R69.R50.9   Fever unstable

    XVIII.R50-R69.R51   Headache

    Contraindications:

    Hemorrhagic diathesis, deficiency of glucose-6-phosphate dehydrogenase, hepatic and renal failure, bronchial asthma, peptic ulcer and duodenal ulcer, visual impairment (scotoma, amblyopia), oppression of hematopoiesis and respiration, hearing loss, vestibular apparatus damage, hypertension, simultaneous administration of MAO inhibitors and the period of 14 days after the end of their use, the age of up to 12 years, pregnancy and lactation, individual intolerance.

    Carefully:

    Peptic ulcer of the stomach and duodenum during remission, colitis, enteritis, gastritis, urticaria, chronic heart failure, hypothyroidism, hyperbilirubinemia, polyps of the nasal mucosa.

    Pregnancy and lactation:

    Recommendations for FDA - Category C. Contraindicated in pregnancy and lactation.

    Dosing and Administration:

    Inside, 1 tablet 3-4 times a day with an interval of at least 4 hours. With severe pain, you can take 2 tablets 3 times a day.

    The highest daily dose: 1200 mg (6 tablets).

    The highest single dose: 400 mg (2 tablets).

    Side effects:

    Central and peripheral nervous system: headache, dizziness, depression, agitation, insomnia, nightmares, hallucinations, convulsions, increased intracranial pressure, aseptic meningitis, dyskinesia.

    Respiratory system: bronchospasm, respiratory depression.

    Hemopoietic system: anemia, agranulocytosis, thrombocytopenia, leukopenia.

    The cardiovascular system: bradycardia, arterial hypertension.

    Digestive system: anorexia, heartburn, nausea, vomiting, flatulence, diarrhea, dry mouth, melena.

    Musculoskeletal system: muscle rigidity.

    Dermatological reactions: a rash.

    Sense organs: diplopia, blurred vision, vestibular dizziness.

    urinary system: acute renal failure, hematuria, proteinuria, cystitis, renal colic, dysuria.

    Allergic reactions.

    Overdose:

    Drowsiness, drowsiness, miosis, headache, gastralgia, depression, hallucinations, coma.

    Treatment is symptomatic, the use of a specific antidote - naloxone: intravenously, intravenously, intravenously, intramuscularly or subcutaneously at a dose of 0.4-2 mg, repeatedly - every 2-3 minutes until a total dose of 10 mg is reached.

    Interaction:

    Strengthens the inhibitory effect of ethanol.

    Simultaneous application with muscle relaxants, drugs that depress the central nervous system, there is an increase in sedation, suppression of the respiratory center.

    With simultaneous use with anticoagulants and antiaggregants, the risk of bleeding increases.

    Strengthens the effects of antipsychotic and hypotensive drugs, barbiturates and tranquilizers.

    Antidiarrhoeal drugs, including loperamide, contribute to the occurrence of constipation, urinary retention and the suppression of the central nervous system.

    Reduces the effects of metoclopramide, domperidone, cisapride.

    Special instructions:

    Incompatible with ethanol.

    The drug can give a positive result in the conduct of doping control.

    During treatment it is not recommended to drive vehicles and work with moving mechanisms.

    Instructions
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