Ibuprofen - instructions for use, dose, side effects, contraindications

Non-selective reversible cyclooxygenase inhibitor, an enzyme that catalyzes the reaction of the conversion of arachidonic acid to prostaglandin H₂, which is the precursor of the remaining prostaglandins, thromboxane A₂ and prostacyclin. Has anti-inflammatory and analgesic, as well as antipyretic effect. It inhibits the aggregation of platelets.

Ibuprofen also inhibits the synthesis of leukotrienes, reduces bradykinin activity, stabilizes lysosomal membranes. With articular syndrome reduces the severity of arthralgia (at rest and during movement), morning stiffness and swelling of the joints, helps reduce the degree of their functional insufficiency.

Pharmacokinetics:

After oral administration, up to 80% is absorbed in the gastrointestinal tract. The maximum concentration in the blood plasma is achieved in 1-2 hours.

After absorption, about 60% of the pharmacologically inactive R-form is slowly transformed into an active S-form. The connection with plasma proteins is 99%. The therapeutic concentration persists longer in the synovial fluid than in the blood plasma. The onset of action of the drug with pain syndrome occurs after 0.5 hours and reaches a maximum after 2-4 hours, lasts for 4-6 hours.

Metabolism in the liver.

The half-life is 6-7 days. Elimination by the kidneys.

Indications:

It is used to treat rheumatism,rheumatoid arthritis, osteoarthritis, ankylosing spondylitis, sciatica, lumbago, tendovaginitis, synovitis, bursitis, trauma of the musculoskeletal system and soft tissues, pain syndrome of various genesis (including postoperative period), primary algodismorrhoea. Used for febrile conditions accompanying colds, for relief of pain syndrome of mild or moderate severity with arthralgia, myalgia, migraine, neuralgia, headache and toothache, as well as with algodismenorea.

ICD-10

VI.G40-G47.G43 Migraine

VI.G40-G47.G44.2 Headache of intense type

VI.G50-G59.G54.5 Neuralgic amyotrophy

VIII.H90-H95.H92.0 Otalgia

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

XVIII.R50-R69.R52.9 Pain, unspecified

XVIII.R50-R69.R51 Headache

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

XIII.M20-M25.M25.5 Pain in the joint

XIII.M05-M14.M06.9 Rheumatoid arthritis, unspecified

XIII.M05-M14.M07.3 * Other psoriatic arthropathies (L40.5 +)

XIII.M05-M14.M10.9 Gout, unspecified

XIII.M05-M14.M13.9 Arthritis, unspecified

XIII.M15-M19.M19.9 Osteoarthritis, unspecified

XIII.M40-M43.M42 Osteocondritis of the spine

XIII.M45-M49.M45 Ankylosing spondylitis

XIII.M45-M49.M47 Spondylosis

XIII.M50-M54.M54.1 Radiculopathy

XIII.M50-M54.M54.4 Lumbago with sciatica

XIII.M50-M54.M54.3 Sciatica

XIII.M65-M68.M65.9 Synovitis and tenosynovitis, unspecified

XIII.M70-M79.M71 Other bursopathies

XIII.M70-M79.M79.0 Rheumatism, unspecified

XIII.M70-M79.M79.1 Myalgia

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

XIV.N70-N77.N70 Salpingitis and oophoritis

XIV.N70-N77.N73.9 Inflammatory diseases of female pelvic organs, unspecified

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

XVIII.R50-R69.R50.0 Fever with chills

Contraindications:

The risk of angioedema, bronchospastic syndrome, gastric and duodenal ulcer, ulcerative colitis, gastritis, individual intolerance, bleeding in the gastrointestinal tract, phenylketonuria, glucose-6-phosphate dehydrogenase deficiency, portal hypertension, anemia, leukopenia, individual intolerance, child age up to 12 years (for tablets and capsules).

Carefully:

Severe renal and hepatic insufficiency.

Pregnancy and lactation:

Recommendations for FDA - Category B. Contraindicated in I and II trimester, with caution in III trimester and lactation.

Dosing and Administration:

Use in children

20 mg / kg in 3-4 divided doses. With juvenile rheumatoid arthritis, the dose is doubled, to 40 mg / kg per day.

From 3 months of age to 2 years: rectal suppository as an antipyretic.

Adults and children over 12 years of age

Inside, 200 mg 3-4 times a day, with an acute process, the dose increases to 400 mg (2 tablets) 4 times a day.

Outer: in the form of ointment or gel (5%) rub into the skin 2-3 times a day.

The highest daily dose: 1600 mg.

The highest single dose: 400 mg.

Side effects:

Central and peripheral nervous system: dizziness, drowsiness, confusion, hallucinations.

The system of hematopoiesis: rarely - thrombocytopenia.

Digestive system: nausea, heartburn, diarrhea.

Urinary system: rarely - oliguria.

Sense organs: amblyopia, tinnitus, reduced hearing acuity.

Allergic reactions.

Overdose:

Pain in epigastrium, nausea, vomiting, drowsiness. Rarely - gastrointestinal bleeding, muscle twitching, respiratory depression, coma.

Symptomatic therapy.

Interaction:

Increases the effectiveness of oral hemocoagulants.

With simultaneous use with barbiturates, narcotic analgesics, caffeine, phenothiazine derivatives, diphenhydramine, phenacetin, analgesic effects are enhanced.

Anti-inflammatory effect increases salicylates and metamizol sodium.

Special instructions:

Coagulogram monitoring with prolonged use of the drug.During treatment with the drug should refrain from driving the car and works requiring increased concentration of attention.

Instructions

Ibuprofen (Ibuprophenum)