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Structure of the Nurofen Plus
The instruction demonstrates that active components an ibuprofen and codeine (a form of Codeini phosphas of a gemigidrat), and also additional components are a part of this medicine: glycollate of sodium of starch, MKTs, corn starch, gipromelloz, talc, opaspry M-1-7111B.
The nurofen Plus is issued in tablets. Tablets have the capsule form, they biconvex, coated. On the one hand tablets are the beaten-out text of "N+". Are packed into blisters on 2, 4, 6 or 12 tablets, put in a cardboard box on 1 silt 2 blisters.
The medicine Nurofen Plus – the combined drug which influence is caused by action of those components which are its part. Means works as febrifugal, antiinflammatory, anesthetizing and antibechic.
The component an ibuprofen is NPVS, substance is derivative acids fenilpropionovy. The ibuprofen in an organism oppresses synthesis of prostaglandins, blocking cyclooxygenase enzyme.
Codeini phosphas is an alkaloid of opium of a phenanthrene row, This substance is an agonist of opioid receptors. Substance reduces the level of excitability of the tussive center. Also its anesthetizing influence becomes more active at reception with an ibuprofen.
Pharmacokinetics and pharmacodynamics
High extent of absorption, communication with proteins of plasma — for 90% is noted. Slowly gets in joints, is defined in synovial fabric, and concentration in it higher, than in plasma. Time of semi-removal of an ibuprofen is equal to 2 hours, codeine – to 3 hours. It is subject to a metabolism. Leaves an organism through kidneys, smaller quantity – with bile.
Indications to use
The Nurofen Plus is applied at the following diseases and states:
- at tooth and headache;
- at migraine;
- at painful periods;
- at neuralgia;
- in case of development of dorsodynias, rheumatic and muscular pain;
- at fever in the period of flu and catarrhal diseases.
It is not necessary to accept the Nurofen Plus at such states and diseases:
- high sensitivity of the patient to an ibuprofen or to other components of this means;
- respiratory insufficiency, heart failure;
- erosion and ulcers of the alimentary system in a condition of an aggravation;
- arterial hypertension (at a heavy current);
- high VChD;
- state after ChMT;
- urticaria, bronchial asthma or rhinitis which were provoked by treatment by salicylates or other NPVS;
- leukopenia, hemophilia, conditions of hypocoagulation;
- diseases of an optic nerve, the broken color sight scotoma, an amblyopia;
- disturbances of functions of a liver, kidneys;
- pathology of a vestibular mechanism, deterioration in hearing;
- lock in a chronic form;
- pregnancy period;
- age till 12 flyings.
Carefully appoint tablets to people at advanced age, and also to patients with a hypothyroidism, a peptic ulcer and bleedings from a gastrointestinal tract in the anamnesis, diseases of kidneys, a liver, heart failure in a chronic form, blood diseases, bronchial asthma and allergic manifestations.
If means is applied for 2-3 days, then development of negative effects is improbable. At more long therapy the Nurofen Plus such side effects can be shown:
- System of digestion: nausea and vomiting, anorexia, heartburn, feeling of discomfort in epigastriums, a meteorism, diarrhea, an exacerbation of stomach ulcer, disturbance in work of a liver;
- Nervous system: headaches, deterioration in hearing, dizziness, sleeplessness, drowsiness manifestations, excitement, depression;
- Heart and vessels: increase of indicators of the ABP, heart failure, tachycardia;
- Hemopoiesis: thrombocytopenia, leukopenia, anemia, agranulocytosis;
- Urinary system: hypostases, disturbance of work of kidneys;
- Allergy: rash, urticaria, itch, Quincke's edema;
- Other manifestations: strong sweating, suppression of a tussive reflex, respiratory depression, bronchospasm.
At the long period of treatment and use of the tablets Nurofen Plus in high doses at the patient an ulceration mucous a gastrointestinal tract, different types of bleeding, deterioration in sight can develop.
Application instruction (Way and dosage)
It is necessary to accept means inside, after reception to wash down with liquid.
Adults and teenagers after 12 flyings accept 1-2 tablets three-four times a day. If necessary accept a high dose of drug — 400 mg three times a day, but at the same time it is impossible to drink more than 6 pieces within a day.
If symptoms of a disease remain for two-three days, then therapy it is necessary to suspend and address the specialist.
At reception of too high doses the Nurofen Plus at the patient development of the following symptoms is possible: vomitings, nausea, feelings of block, depression, drowsiness, headache, sonitus. In hard cases the coma, fibrillation of auricles, an apnoea can develop. It is important to carry out quickly a gastric lavage as these actions are effective only in the first hour after reception of high doses of HP. Further reception of alkaline drink, tablets of absorbent carbon, carrying out an artificial diuresis, symptomatic treatment is shown.
If at the patient after overdose respiratory depression is noted, reception of Naloxonum — the specific opioid antagonist is shown.
Interaction of the drug Nurofen Plus with such drugs is noted:
- with Acetylsalicylic acid, and also with other NPVS as the ibuprofen lowers anti-aggregation and antiinflammatory effect of acetylsalicylic acid; also there is a risk of manifestation of acute coronary insufficiency;
- with thrombolytic drugs and anticoagulating means (the probability of bleedings increases);
- with Tsefotetan, Tsefamandol, Plikamitsin, Valproic acid, Tsefoperazon (frequency of manifestation of a prothrombinopenia increases);
- with HP which block canalicular secretion (removal decreases and concentration of an ibuprofen in plasma increases);
- with Cyclosporine and drugs of gold (impact of an ibuprofen on synthesis of PG in kidneys becomes more active in view of what nephrotoxicity increases, the risk of hepatotoxic manifestations also increases);
- with inductors of a microsomal oxidation (the risk of hepatotoxic manifestations grows);
- with vazodilatator (hypotensive activity decreases);
- with inhibitors of a microsomal oxidation (the probability of hepatotoxic influence decreases);
- with the Hydrochlorothiazide and Furosemide (natriuretic activity decreases);
- with uricosuric drugs (their efficiency goes down);
- with antiagregant (their effect amplifies);
- with glucocorticoids, ethanol, mineralokortikoida, estrogen (their side effects amplify);
- with hypoglycemic peroral drugs, derivatives of insulin and a sulfonilmochevina (their action amplifies);
- with antacids and Colestyraminum (absorption goes down);
- with Digoxin, the Methotrexate, lithium drugs (concentration of drugs grows in blood);
- with caffeine (the analgesic effect increases).
Terms of sale
The nurofen Plus can be got without recipe.
To keep in the dry place, at t up to 25 degrees.
Period of validity
The nurofen Plus is stored by 3 years.
If prolonged treatment is carried out by drug, it is necessary to define indicators of peripheral blood surely.
If there is a need to define 17 ketosteroids, it is necessary to cancel the Nurofen Plus in 48 hours prior to analyses.
During treatment it is necessary to abstain from that activity which demands speed of reaction.
At development of collateral manifestations it is necessary to address the specialist at once.
Coincidence on the ATH code of the 4th level:
Analogs of means the Nurofen Plus – other drugs with an ibuprofen. It is HP the Nurofen Plus N, Ibufenum, the Ibuprofen and other drugs relating to NPVS group.
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