Ibunorm

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

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

The effectiveness of the drug is largely determined by such a factor as the very short time required for ibuprofen to be maximally absorbed in the digestive tract. The highest concentration of the active substance in the blood plasma is observed after 1-2 hours after entering the body, and its presence in the synovial fluid reaches its maximum 3 hours after administration.

After Ibunorm has provided the required therapeutic effect, its main component ibuprofen is metabolized in the liver, and its excretion from the body in the form of metabolites is carried out by the kidneys. The half-life is approximately 2 hours.

Indications Ibunorm

Indications for the use of Ibunorm may be due to the need for symptomatic treatment of pain of various types and origins.

Thus, the use of the drug produces an active analgesic effect in headaches and toothaches.

In addition, it is an effective remedy for women to reduce the severity of pain that may accompany the menstrual period.

Ibunorm is appropriately used in cases of colds that are accompanied by fever and muscle pain.

Another area of application of the drug is the symptomatology inherent in rheumatic diseases. Ibunorm shows itself well in terms of counteracting such manifestations of rheumatism of various kinds as local inflammation and increased skin temperature in the area of its localization, as well as reducing the severity of pain in the inflammation 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 toothache, headache and menstrual pain, in clinical cases of a number of rheumatic, neuralgic and other diseases. It should also be noted that the drug is intended to relieve symptomatic pain exclusively at the time of administration and is not capable of exerting any influence on the course of the disease.

Release form

Release form Ibunorm is presented in the form of capsules covered with a hard enteric shell. The main active ingredient of this drug is ibuprofen.

The contents present inside the capsules are a mixture of granules and powder, the color of which may vary and be completely white or have a whitish tint. Some agglomerates of particles are also possible.

Depending on the volume of ibuprofen in the capsules - 200 or 400 mg, respectively, they differ in their color. 200-milligram capsules are red, and those capsules in which ibuprofen is 400 mg are distinguished by their white color.

In addition to ibuprofen, the drug contains a number of auxiliary substances. Their composition is also individual for each of these two types of capsules.

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

Capsules with 400 mg of ibuprofen contain potato starch, hypromellose, colloidal anhydrous silicon dioxide, crospovidone, magnesium stearate.

The form of the drug is such that, thanks to its easily soluble shell in the intestine, it promotes its absorption in the body and the beginning of the actualization of its therapeutic effect within the shortest time.

Pharmacodynamics

One of the main characteristic features that distinguishes the pharmacodynamics of Ibunorm is the high rate of absorption in the digestive tract. Within 60 to 120 minutes after the drug is taken orally, it reaches its maximum concentration in the blood plasma. And subsequently, by the 3rd hour after administration, the highest content of its main active component, 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 fact that there is a non-selective 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 given to the effect of inhibiting the processes in which prostaglandins are synthesized. They are the main mediators of inflammation, hyperthermia and pain.

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

Pharmacodynamics Ibunorm, as is typical for all other non-steroidal anti-inflammatory drugs, is characterized by anti-reagent activity.

Pharmacokinetics

Pharmacokinetics Ibunorm is characterized by high rates of its absorption from the gastrointestinal tract. The degree of absorption of the drug is affected by the fact that its intake was preceded by food intake. In such cases, the maximum concentration is achieved in approximately twice as long a time period than when Ibunorm is taken on an empty stomach. After eating, TCmax in blood plasma is from one and a half to 2 hours, while when taken on an empty stomach - 45 minutes, respectively. In higher concentrations, the drug forms a presence in the synovial fluid, TCmax in which is 2-3 hours.

90% bound to plasma proteins, the drug is further metabolized in the liver in presystemic and postsystemic metabolism. Once absorbed, ibuprofen in 60% of the R-form, which is pharmacologically inactive, is gradually converted into the active S-form.

Metabolism occurs with the involvement of the CYP2C9 isoenzyme in this process. The elimination kinetics is characterized by a two-phase nature. Its T12 is from 2 to 2.5 hours. For medicinal retard forms, such a time period can last up to 12 hours.

Excretion occurs through the kidneys – less than 1% unchanged, and to an even lesser extent – with bile.

Dosing and administration

The method of administration and dosage of Ibunorm depend on the dosage form in which the drug is prescribed, mainly on the amount of the main active substance in the capsules. There are two types of capsules containing 200 and 400 mg of ibuprofen, respectively.

For adults and children over 12 years of age, the initial dose is 1-2 capsules once. Later, if necessary, take 1-2 capsules 4 to 6 times a day at equal intervals (4-6 hours).

A single dose of 400 mg involves taking two 200 mg capsules or one 400 mg capsule orally.

There is a limitation regarding the total amount of the drug that can be used in a 24-hour period. No more than 6 capsules of 200 mg should be taken per day, and those containing 400 mg of ibuprofen should be taken 3 times per day.

Ibunorm is taken orally, preferably with food. The capsules should be swallowed whole with water, without chewing.

For elderly patients, the drug is prescribed on the basis of specially prescribed rules, according to which the dose should be selected and the appropriate treatment regimen determined.

In cases where the selected method of administration and doses of Ibunorm do not effectively eliminate the symptoms of the disease after more than 3 days, it may be necessary to clarify the diagnosis and revise the treatment regimen based on new diagnostic data.

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Use Ibunorm during pregnancy

As for whether it is possible to use Ibunorm during pregnancy, it should be noted right away that its use during this period is invariably associated with a certain degree of risk.

Like all other substances that inhibit prostaglandin synthesis processes, ibuprofen as the main active active ingredient of the drug can have a negative effect on both the woman bearing the child and the processes of intrauterine growth and development of the fetus. From the data of epidemiological studies it is obvious that there is an increased probability of the occurrence of spontaneous abortion. In addition, the use of the drug during the early stages of pregnancy can entail the possibility of developing heart defects. The objective level of such a danger, as is commonly believed, is directly dependent on how much the dosage is increased and for how long the course of treatment is extended.

In the 1st and 2nd trimesters, the use of Ibunorm can only be justified in cases where a medical specialist has concluded that the expected positive effect of its use for the expectant mother significantly exceeds the possibility of any adverse effects on the fetus. Based on this, 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 drugs permitted at this stage of pregnancy.

During breastfeeding, the active components of Ibunorm together with metabolites can form a low concentration in breast milk. To date, there is no reliable data on the unconditional harmful effect on infants. Thus, the use of Ibunorm during pregnancy and lactation is allowed for short-term treatment of fever and pain relief when it is used in compliance with the recommended doses. 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, caution is required.

First of all, the presence of hypersensitivity in the patient to ibuprofen or any other components of Ibunorm calls for the need to exclude the drug from the list of prescribed medications.

The condition that contraindicates the use of the drug is the presence in the patient's medical history of asthma, bronchospasm, skin rashes or rhinitis that occurred due to the use of acetylsalicylic acid or other non-steroidal anti-inflammatory drugs.

It is recommended to separate the intake of Ibunorm and the use of other non-steroidal anti-inflammatory drugs, including COX-2 - selective cyclooxygenase-2 inhibitors.

A history of perforation or gastrointestinal bleeding caused by nonsteroidal anti-inflammatory drugs makes the use of the drug unacceptable.

Contraindications to Ibunorm also include gastric ulcer or bleeding at present, or which are included in the anamnesis with two or more clear episodes of ulcer exacerbation or bleeding.

The use of the drug should be avoided in cases of cardiac, renal and hepatic dysfunction, such as severe cardiac, hepatic and renal failure, cardiac ischemia.

The category of unacceptable for use includes Ibunorm in cerebrovascular and other active forms of bleeding. This also includes disorders of the hematopoietic function of unknown etiology.

Contraindications to the use of Ibunorm also include dehydration disorders due to vomiting, diarrhea or insufficient fluid intake.

Side effects Ibunorm

Side effects of Ibunorm used as part of short-term treatment include hypersensitivity reactions to the drug.

Among them, the occurrence of anaphylaxis or non-specific allergic reactions is noted. There are also manifestations of respiratory reactions in the form of exacerbations of bronchial asthma, dyspnea and bronchospasm. Due to the use of Ibunorm, skin rashes, itching, urticaria and purpura may occur. In rare cases, the development of bullous or exfoliative dermatitis, erythema multiforme and epidermal necrolysis is observed.

The use of the drug in long-term treatment courses for chronic conditions can further expand the range of side effects caused.

In rare cases, they are reflected in general disorders due to hypersensitivity. In these severe reactions, the face, tongue and larynx swell, shortness of breath, rapid heartbeat, decreased arterial pressure, possible anaphylactic phenomena, development of Quincke's edema, shock, occurrence of bronchospasm, astatic complications aseptic meningitis.

The digestive system and gastrointestinal tract may 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 such as heartburn, peptic ulcers, ulcerative stomatitis, gastrointestinal bleeding or perforation. In some cases, this can cause a fatal outcome, the risk of which is especially high in elderly patients.

The central nervous system exposed to the negative effects of the drug responds with the appearance of headaches, possibly dizziness, nervousness, anxiety, insomnia or, on the contrary, drowsiness, instability of the emotional sphere, and depressive state.

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

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Overdose

The occurrence of an overdose of Ibunorm is usually indicated by the appearance of a complex of specific characteristic symptoms.

These symptoms manifest themselves in the occurrence of nausea, vomiting, pain in the abdominal area, headache and dizziness, ringing in the ears. The appearance of a state of drowsiness is noted, as a result of nystagmus, visual perception is impaired.

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

Treatment provided for overdose of the drug is symptomatic and supportive. The main goal of related medical measures is to ensure the activity of all functions of vital importance. The treatment measures taken are aimed at bringing the body to a state of normalization of its vital activity.

As one of the first steps, it is advisable to wash out the stomach and give the patient activated charcoal to take orally.

All this must be done, if possible, within 1 hour after a potentially toxic dose of the drug has been taken. Ibunorm acquires harmful toxic properties after entering the human body in quantities exceeding 400 mg/kg.

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

Interactions with other drugs

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

The simultaneous use of corticosteroids increases the likelihood of gastrointestinal ulceration, and in addition, this combination can provoke bleeding.

A balanced approach is required when prescribing the drug in combination with diuretic and antihypertensive medications, since the therapeutic effect of the latter may be weakened.

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

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

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

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

When treating with Ibunorm, it is necessary to avoid combining it with acetylsalicylic acid, since in this case the possibility of developing all sorts of side effects increases.

The interactions of Ibunorm with other drugs, as we can see, are of the most diverse nature and are capable of forming all sorts of combinations. In order to achieve the most effective complex use of various drugs, the matter of choosing a treatment regimen should be entrusted to a competent medical specialist.

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Storage conditions

Storage conditions for Ibunorm require that the drug be kept in an environment where a constant temperature regime not exceeding 25 degrees Celsius is maintained.

It is also important to note that only the original packaging in which it was placed by the manufacturer can fully ensure its preservation in optimal condition.

In addition, it is traditional for all medicines to be stored in places where they cannot fall into the hands of children.

Shelf life

The shelf life of the drug is 3 years from the date of manufacture indicated on the packaging.

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