Ibunorm

Ibunorm is an anti-inflammatory and antirheumatic drug belonging to the category of non-steroid medications.     

The main active ingredient is ibuprofen. Its effect is that as a result of using the drug, there is a decrease in the intensity of negative phenomena occurring in the body associated with the development of inflammation. It acts as an inhibitor of processes in which prostaglandins are synthesized, which mediate inflammation, pain, and fever.

The effectiveness of the drug is largely due to such a factor as a very short time necessary ibuprofenum for its maximum absorption in the digestive tract. The greatest concentration of active substance in the blood plasma is observed after 1-2 hours after ingestion, and 3 hours after admission, its presence in the synovial fluid reaches its maximum. 

After providing Ibunorm with proper therapeutic action, its main component ibuprofen is metabolized in the liver, and the excretion of it, which looks like a metabolite, is carried out by the kidneys from the body. Half-life occurs in a time equal to approximately 2 hours.     

Indications Ibunorm

Indications for the use of Ibunorm may be due to the need for symptomatic treatment of pain of different properties and origin.    

So the use of the drug produces an active analgesic effect for headache and toothache.

In addition, it is an effective tool for women in order to reduce the strong intensity of pain that can accompany the period of menstruation.

Ibunorm finds proper use in those cases of colds that are accompanied by fever and the occurrence of muscle pain.          

As one more area of application of a preparation it is necessary to name the symptomatology inherent in illnesses of rheumatic character. Ibunorm is well manifested in terms of opposing such manifestations of rheumatism of various kinds as local inflammation and skin temperature increase in the area of its localization, as well as weakening of the intensity of pain in the inflammatory focus.  

Thus, indications for the use of Ibunorm arise mainly in connection with inflammatory processes, as well as the presence of pain syndrome, such as dental, head and menstrual pains, in clinical cases of a number of rheumatic, neuralgic and other diseases. It should also be noted that the drug is intended for the removal of symptomatic pain only at the time of taking and is not able to exert any influence on the course of the disease.       

Release form

Form of release Ibunorm is presented in the form of capsules covered with a solid enteric-dissolving membrane. The main active substance of this drug is ibuprofen.

The contents present inside the capsules are a mixture formed of granules and powder, the color of which can vary and be completely white or have a whitish hue. Particle agglomerates are also possible in a number of ways.

Depending on how much of the capsule contains ibuprofen - 200 or 400 mg respectively, they differ in their color. 200-milligram capsules are red, and those capsules in which ibuprofen 400 mg differ in white.

In addition to ibuprofen, a number of excipients are present in the preparation. Their composition is also individual for each of these two kinds of capsules. 

In capsules, 200 mg excipients are potato starch, hypromelose, anhydrous colloidal silicon dioxide, crospovidone, magnesium stearate, azorubin E 122.          

Capsules with 400 mg of ibuprofen have in their composition potato starch, hypromelose, colloidal anhydrous silicon dioxide, crospovidone, magnesium stearate.

The form of the preparation is such that, thanks to the shell easily dissolving in the intestine, it assists its assimilation in the body and the beginning of actualization of its therapeutic effect within the shortest time.    

Pharmacodynamics

One of the main characteristics that distinguish pharmacodynamics Ibunorm, is the high rate of absorption in the digestive tract. During the period from 60 to 120 minutes after the drug is ingested, it reaches its maximum concentration in the blood plasma. And subsequently, by the 3rd hour after administration, the greatest content of its main active ingredient, ibuprofen, is also formed in the synovial fluid.

The pharmacological action that Ibunorm has in the human body consists of actualizing the anti-inflammatory, antipyretic and analgesic properties of ibuprofen. This is achieved as a result of the indiscriminate blockade of the enzymes COX1 and COX2, which are forms of cyclosigenase. Not the least role in the mechanism of action of the drug is also allocated to the effect of inhibition of the processes it produces in which prostaglandins are synthesized. They are the main mediators of inflammation, hyperthermia and pain.           

The properties of Ibunorm as an analgesic medication are revealed to the fullest extent in cases of its use in pain caused by the presence of some kind of inflammatory processes. 

Pharmacodynamics Ibunorm, as well as it is characteristic of all other non-steroidal anti-inflammatory drugs, is characterized by antireagent activity.

Pharmacokinetics

Pharmacokinetics Ibunorhm is characterized by high rates of its absorption from the gastrointestinal tract. The degree of absorption of the drug is influenced by the fact that its reception was preceded by eating. In such cases, the maximum concentration is achieved approximately twice as long as when Ibunorm is taken on an empty stomach. After eating TCmax in blood plasma is from one and a half to two hours, whereas when taken on an empty stomach it is 45 minutes, respectively. In a greater concentration, the drug forms a presence in the synovial fluid, TCmax in which is equal to 2-3 hours.

By 90% undergoing binding to plasma proteins, the drug is further metabolized in the liver in the processes of presystemic and post-systemic metabolism. After being absorbed, ibuprofen in 60% of the R-form, inactive pharmacologically, is gradually converted to the active S-form.  

Metabolism occurs with the involvement of the isoenzyme CYP2C9 in this process. The kinetics of elimination is characterized by biphasic activity. Her T1 \ 2 is from 2 to 2 and a half hours. For medicinal retard-forms, such a time period can last up to 12 hours.      

Excretion is performed by the kidneys - less than 1% unchanged, and to an even lesser extent - together with bile. 

Dosing and administration

The way of administration and dose of Ibunorma depends on the form of the drug in which the drug is administered, mainly on the amount of the active substance in the capsules. There are two types of capsules containing 200 and 400 mg of ibuprofen, respectively. 

For adults and children older than 12 years of age, the initial dose is prescribed in the amount of 1-2 capsules once. In the future, if there is such a need, 1-2 capsules should be taken 4 to 6 times during the day at regular intervals (4-6 hours).     

A single dose of 400 mg involves the ingestion of two capsules of 200 mg or one 400-milligram capsule.    

There is a restriction regarding the total amount of the drug permissible for use during a time equal to 24 hours. Capsule 200 mg should not be taken more than 6 pieces per day, and those in which ibuprofen 400 mg, respectively - 3. 

The ibunorm is taken internally, mainly with the ingestion of food. Capsules should be swallowed, washed down with water, wholly, without chewing.

For patients in old age, the drug is administered on the basis of special prescribed rules, according to which the dose should be selected and the proper treatment regimen determined.        

In cases where the selected route of administration and doses of Ibunorm after more than 3 days do not lead to effective elimination of the symptoms of the disease, it may be necessary to clarify the diagnosis and, on the basis of new diagnostic data, reconsider the treatment regimen.   

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Use Ibunorm during pregnancy

As to whether it is possible to use Ibunorm during pregnancy, it should immediately be noted that its use during this period invariably involves a certain degree of risk.

Like all other substances that inhibit the processes of prostaglandin synthesis, ibuprofen, as the main active active ingredient of the drug, can have a negative impact on both the woman nurturing the child and the processes of intrauterine growth and development of the fetus. From the data of epidemiological studies, it is clear that there is an increased likelihood of the onset of spontaneously interrupted pregnancy. In addition, the use of the drug during the early stages of pregnancy can lead to the possibility of developing cardiac malformations. The objective level of such a danger, it is generally believed, is directly dependent on the extent to which the dosage is increased and how long the course of treatment is prolonged for how long.                    

In the first and second trimesters, Ibunorm can be justified only when the medical expert concludes that the expected positive effect of using it for a future mother is significantly superior to the possibility of all adverse effects on the fetus. Therefore, at the stage of pregnancy planning and in the first two trimesters, the dose should be minimal, and the treatment courses should be as short as possible.

With the onset of the 3rd trimester, the drug falls under the rule of categorical exclusion from the list of medications acceptable at this time of pregnancy.

When breastfeeding, the active components of Ibunorm, together with metabolites, can form a low concentration in the composition of breast milk. To date, there is no real data on the unconditional harmful effects on infants. Thus, the use of Ibunorm during pregnancy and during lactation is allowed for a short-term treatment of the fever of pain relief when it is administered at the recommended dosage. As a rule, there is no need to refuse breastfeeding.

Contraindications

Contraindications to the use of Ibunorm include a number of cases in which the use of the drug is unacceptable, or due to certain factors, care must be taken.

First of all, it calls for the need to exclude the drug from prescribed medications, the patient's hypersensitivity to ibuprofen or any of the components of Ibunorm.   

The condition, due to which the use of the drug is contraindicated, is the presence in the patient's history of an asthma, bronchospasm, skin rash or rhinitis caused by the use of acetylsalicylic acid or other non-steroidal anti-inflammatory drugs.     

It is recommended to develop in time the adoption of Ibunorm and the use of other anti-inflammatory non-steroid drugs, including COX-2, selective inhibitors of cyclooxygenase-2.   

It causes the inadmissibility of the use of the drug anamnesis burdened by perforation or gastrointestinal bleeding caused by non-steroidal anti-inflammatory drugs. 

Contraindications Ibunorma also includes a gastric ulcer or bleeding at the present time, or who enter into an anamnesis with two or more distinct episodes of ulcerous exacerbation or bleeding.  

Abstain from the use of the drug should be in violation of cardiac activity and kidney and liver functioning, such as severe cardiac, hepatic and renal insufficiency, cardiac ischemia.    

In the category of unacceptable to the use of Ibunorm in cerebrovascular and other active forms of bleeding. This includes disorders of the hematopoietic function that have an unexplained etiology.  

Contraindications to the use of Ibunorm besides this are violations of dehydration due to vomiting, diarrhea or the use of an insufficient amount of fluid.

Side effects Ibunorm

Side effects Ibunorm used in the short-term treatment are the reactions of hypersensitivity to the drug.

Among them there is the emergence of anaphylaxis or nonspecific allergic reactions. There are also manifestations of respiratory reactions in the form of exacerbations of bronchial asthma, dyspnoea and bronchospasm. Due to the use of Ibunorm, skin rashes, skin itching, hives and purpura may appear. In rare cases, there is a development of bullous or exfoliative dermatitis, erythema multiforme and epidermal necrolysis.

The use of the drug in long-term courses of treatment for chronic conditions is able to further expand the number of side effects caused.

In rare cases, they find a mapping in general disorders due to hypersensitivity. With these severe reactions, the face, tongue and larynx swell, shortness of breath, rapid heart rate, decreased blood pressure, possible anaphylactic phenomena, development of Quincke edema, shock, bronchospasm, astatic complications of aseptic meningitis. 

The digestive system and the gastrointestinal tract can occasionally give a negative response to the use of Ibunorm in the form of abdominal pain, nausea, dyspepsia, vomiting, diarrhea, constipation and flatulence.  

Very rarely, side effects occur as the appearance of heartburn peptic ulcers, ulcerative stomatitis, gastrointestinal bleeding or perforation. In some cases, it can cause a fatal outcome, the risk of which is particularly high in patients in old age.

The central nervous system prone to negative effects of the drug responds with the appearance of a headache, perhaps dizziness, nervousness, the appearance of anxiety, insomnia or, on the contrary, drowsiness, instability of the emotional sphere, depressive state.  

When any side effects of Ibunorm are observed, they are the justification for the need to stop the drug immediately and seek medical advice.  

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Overdose

The fact that there is an overdose of Ibunorm, as a rule, is evidenced by the appearance of a complex of specific characteristic symptoms.  

This symptomatology is manifested in the occurrence of nausea, vomiting, pain in the abdominal region, headache and dizziness, ringing in the ears. There is a state of drowsiness, due to nystagmus, visual perception is disturbed.

Very infrequent are cases in which loss of consciousness occurs, arterial hypotension develops, renal failure and metabolic acidosis are not excluded.

The treatment provided for an overdose of the drug is symptomatic, supportive. The main goal of the related medical activities is to ensure the activity of all vital functions. The accepted medical measures are aimed at bringing the organism to the state of normalization of its vital activity.

As one of the primary actions, it is advisable to wash the stomach and give the patient to take activated charcoal inside.

To do all this is necessary if possible in the 1st hour after the potentially toxic dose of the drug has been taken. Malicious toxic properties Ibunorm acquires after ingestion in a person in excess of 400 mg / kg.

Overdose requires immediate action also because there is no specific antidote for Ibunorm.   

Interactions with other drugs

Interactions Ibunorm with other drugs are regulated by the rules common to all anti-inflammatory non-steroid drugs.

The use of corticosteroids simultaneously with it causes an increase in the likelihood of gastrointestinal ulceration, and in addition this combination can provoke bleeding. 

A weighted approach requires the administration of the drug in combination with medicinal agents of diuretic and antihypertensive properties, since the therapeutic effect of the latter may be weakened.   

The combination of Ibunorm and selective and antiplatelet serotonin inhibitors can lead to gastrointestinal bleeding.   

Combined with the drug in one treatment plan, cardiac glycosides are able to act as a factor triggering an exacerbation of heart failure and cause the presence in the blood plasma of an increased content of glycosides.   

As a result of interaction with anticoagulants (warfarin, etc.), the anticoagulant effect is enhanced.
As evidenced by confirmed data, when zidovudine is used with Ibunoorm, in patients with HIV infection, this causes an increased risk of hematomas and hematosis.

If quinolone antibiotics are used concurrently with the drug, there is an increased likelihood that seizures may occur. 

In the treatment of Ibunorm, it is required to exclude the association of acetylsalicylic acid with it, since in this case the possibility of developing all side effects increases.    

Interactions Ibunorhm with other drugs, as we can see, differ in the most diverse character and are able to form all sorts of combinations. To achieve the most effective integrated use of various drugs, the choice of treatment regimen should be handed over to a competent medical specialist.  

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Storage conditions

Conditions of storage Ibunorm prescribe that the drug should be placed in such an environment surrounding it, in which a constant temperature regime not exceeding 25 degrees Celsius is maintained.

An important point is also that only the original packaging in which it was placed by the manufacturer is able to fully ensure its preservation in the optimal state.

In addition, the traditional for all medicines is the recommendation of their storage in places where they can not fall into the hands of children.   

Shelf life

Shelf life of the drug is 3 years from the date of manufacture indicated on the package.

It is not allowed to use Ibunorm after a specified period of time.