Imet

Imet is a drug that belongs to the NSAID category.

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Indications Imeta

The medicine is indicated for the elimination of various inflammations accompanied by pain. Among the pathologies that are treated with this medicine:

• diseases of the musculoskeletal system that have an inflammatory-degenerative nature and are accompanied by moderate or mild pain: such as osteoarthritis, rheumatoid arthritis, and Bechterew's disease;
• moderate or mild pain against the background of musculoskeletal diseases of other origins: exacerbated gout, articular syndrome, and also psoriatic arthritis;
• pain arising from inflammation in the soft tissue area: with bursitis or tendovaginitis;
• for pain in joints or muscles after injuries;
• The medicine is also used to relieve moderate or mild pain of unknown origin: with algomenorrhea, salpingo-oophoritis, and also headaches or toothaches;
• can be used to reduce the temperature that occurs against the background of inflammations of infectious origin;
• It is possible to prescribe it in combination with other drugs that are used to eliminate inflammation in the ENT organs that have an infectious origin and are accompanied by mild or moderate pain or a fever;

It is possible to use the medicine to reduce the elevated temperature in the post-vaccination period.

Release form

Available in tablets. One blister contains 10 tablets. The package contains 1, 2 or 3 blister strips with tablets.

Pharmacodynamics

The active substance of the drug is ibuprofen - a derivative of phenylpropionic acid, which includes a racemic compound of S-, as well as R-enantiomers. Among the properties of the tablets are analgesic, anti-inflammatory and antipyretic. Helps relieve pain in joint diseases, dysmenorrhea, and along with this in the period after surgical interventions. In addition, the active substance helps eliminate toothaches with headaches, as well as muscle pain. For patients suffering from inflammation in the musculoskeletal system, it helps to reduce swelling in the morning with stiffness in the joints, and also increases the range of motion and reduces or eliminates pain.

The drug acts by disrupting the process of eicosatetraenoic acid metabolism (slows down the activity of the COX enzyme). Ibuprofen is a non-selective NSAID that equally slows down both COX isoforms (COX-1 and COX-2). Due to the disruption of the process of eicosatetraenoic acid metabolism, the production of proinflammatory PGs (type E, as well as F) - prostacyclins with thromboxane - is reduced. Due to the decrease in the amount of PGs inside the inflammation site, the process of binding bradykinin, internal pyrogens, and other bioactive elements is weakened, which reduces the activity of the inflammation process and irritation of pain endings. The active component of the drug reduces the number of PGs directly inside the thermoregulatory center in the hypothalamus, lowers the temperature and eliminates fever.

By reducing the production of thromboxane from eicosatetraenoic acid, ibuprofen, like other NSAIDs, is able to exert some antiplatelet effect.

During the study of the substance, it was found that ibuprofen affects the binding of internal interferon. Therefore, when taking Imet, patients experience much less irritation of the gastric mucosa (compared to salicylates).

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Pharmacokinetics

When taken internally, the active ingredient is quickly absorbed from the gastrointestinal tract. Absorption occurs mainly in the small intestine, but some of the substance is also absorbed through the stomach. The maximum plasma level of ibuprofen occurs 1-2 hours after use. The substance has significant synthesis with plasma protein (about 99%). In case of use with food, the period of reaching the peak indicator is extended by 0.5-1 hour, but the level of bioavailability remains the same.

The metabolism of the drug occurs through hydroxylation and carboxylation processes, and subsequently, pharmacologically inactive decay products are formed. The substance does not accumulate inside the body, but, getting into the synovial fluid, it retains the medicinal concentration there for quite a long time.

Excretion occurs mainly through the kidneys in the form of medicinally inactive decay products, and a small portion of the substance is excreted through the liver, also in the form of inactive decay products and, together with this, unchanged active substance. The half-life is approximately 2-2.5 hours, and the drug is completely excreted from the body within 24 hours.

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Dosing and administration

The medicine is taken orally, the tablet should not be crushed or chewed - it should be swallowed whole with water. If necessary, the tablet can be divided in half. To reduce the likelihood and severity of adverse reactions, the medicine should be taken with food or after meals.

The dosage size, as well as the duration of therapy, are prescribed by the doctor - for each patient individually (depending on the individual characteristics of the body and the nature of the disease).

For children aged 12+, when eliminating mild and moderate pain, 200-400 mg of the drug (or 0.5-1 tablet) is often prescribed twice/three times a day. The drug should be taken at intervals of at least 4 hours. No more than 1000 mg (or 2.5 tablets) can be taken per day.

For children aged 12+, a single dose of 200-400 mg of the drug (or 0.5-1 tablet) is prescribed to reduce high temperature. If necessary, the tablet can be taken again after 4 hours. A maximum of 1000 mg of the drug (or 2.5 tablets) is allowed per day.

For children aged 15+ with adults in the treatment of moderate and mild pain, 200-400 mg of the drug is usually prescribed 2-3 times a day. It is necessary to adhere to the regimen of taking at intervals of at least 4 hours. No more than 3 tablets of the drug can be taken per day (dosage 1200 mg).

Adolescents aged 15 and over and adults are prescribed a single dose of 200-400 mg of the medicine per day to reduce high temperature. If necessary, another dose can be taken after 4 hours. No more than 3 tablets (or 1200 mg of the medicine) are allowed per day.

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Use Imeta during pregnancy

Imet may be prescribed in the 1st and 2nd trimesters (exclusively by the attending physician and if there are indications). Before prescribing, the physician must carefully assess the probable benefit for the woman, as well as the possibility of complications in the fetus.

In the 3rd trimester, the use of the drug is completely prohibited, because ibuprofen can provoke premature closure of the fetus's ductus arteriosus. In addition, labor may be delayed, the labor period may be extended, and at the same time the risk of bleeding may increase (both in the mother and the newborn).

A small amount of the drug can pass into breast milk, but this has not been reported to have had any negative effects on babies whose mothers took ibuprofen.

Contraindications

Among the contraindications of the drug:

• intolerance to individual elements of the drug or other drugs from the NSAID category;
• a history of aspirin triad (it consists of bronchial spasms, hypersensitivity to aspirin, and, in addition, allergic rhinitis caused by taking aspirin);
• It is prohibited to use the drug in combination with other drugs included in the NSAID category (including selective COX-2 inhibitors);
• disorders in the functioning of the hematopoietic system, which have an unknown origin, as well as a tendency to bleeding in the gastrointestinal tract and the presence of active bleeding in the patient (including cerebrovascular bleeding);
• hemorrhagic syndrome or peptic ulcer (also their presence in the anamnesis);
• It is prohibited to use tablets in severe stages of renal or hepatic dysfunction, and in addition in severe stages of heart failure;
• Contraindicated for use by children under 12 years of age.

Caution is required when prescribing to elderly people, because the risk of bleeding is higher (including with subsequent fatal outcome). For this category of patients, therapy begins with a minimum single dosage, and then it is gradually increased if necessary until the desired medicinal effect is achieved.

The drug should be prescribed with caution to people with SLE, high blood pressure, Sharp's syndrome, heart failure, and kidney or liver problems. It should also be taken with caution in the period immediately following surgery.

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Side effects Imeta

As a result of taking the medicine, the following side effects may occur:

• cardiovascular system: development of heart failure, arrhythmia or increased blood pressure. Isolated cases (in case of taking drugs in large doses) of myocardial infarction develop;
• organs of the hematopoietic system: development of pancyto-, thrombocyto- or leukopenia, as well as agranulocytosis or anemia. As a result of the disorder in the hematopoietic system, pain in the throat, erosions in the oral mucosa, muscle pain, an increase in temperature and the development of depression may appear. In addition, bleeding of unknown origin (including hemorrhages into the skin), as well as nosebleeds and hematomas may appear. If prolonged use of drugs is required, it is recommended to regularly monitor the hemogram;
• PNS and CNS organs: development of dizziness and headaches, problems with wakefulness and sleep patterns, feeling of irritability, severe fatigue. At the same time, psychotic reactions, a feeling of emotional lability or causeless anxiety may appear, and depression may develop. Seizures or psychomotor agitation are observed sporadically;
• sensory organs: as a result of prolonged use of tablets, vision may be impaired (decreased clarity, dryness of the mucous membranes of the eyes may develop, and in addition, color perception may be impaired). In addition, hearing disorders and tinnitus may be observed;
• Gastrointestinal organs: vomiting, epigastric pain, heartburn, nausea, bowel disorders (both constipation and diarrhea) and digestion, bloating, dry mouth. In some cases, gastrointestinal bleeding, development of gastric ulcers (or duodenal ulcers), sometimes accompanied by bleeding and perforation, and ulcerative stomatitis were observed. In addition, exacerbation of regional enteritis and colitis, as well as the development of pancreatitis, gastritis or esophagitis were occasionally observed. Duodenitis developed as a result of treatment in isolated cases. If gastrointestinal bleeding begins (symptoms include black stool, vomiting resembling coffee grounds in color, and severe epigastric pain), the drug must be discontinued and a doctor should be consulted;
• liver: acute stage of liver failure, liver intoxication, liver dysfunction, as well as hepatitis and hepatorenal syndrome;
• urinary system organs: development of edema (usually occurs in people with renal failure or high blood pressure), tubulointerstitial nephritis, cystitis, oliguria, nephrotic syndrome, polyuria, as well as hyperuricemia and medullary necrosis. Glomerular nephritis or hematuria are observed sporadically. If a long course of Imet therapy is required, it is necessary to regularly monitor kidney function;
• skin reactions: development of Lyell's syndrome or Stevens-Johnson syndrome, dry skin, hair loss, and also photophobia;
• parasitic diseases and infections: infectious processes (for example, necrotic fasciitis) develop or worsen occasionally, the cause of which may be the use of NSAIDs. If a new infectious process begins to develop or an old one worsens, you should consult your doctor to stop taking the drug and prescribe antibacterial treatment. Signs of serous meningitis (such as headaches, vomiting, hyperthermia, impaired consciousness, nausea, and tension in the muscles of the back of the head) have been observed occasionally after taking the tablets. Similar symptoms often develop in people with autoimmune pathologies (such as Sharp's syndrome or SLE);
• allergic reactions: itching, skin rashes, urticaria, runny nose, erythema multiforme, and also anaphylactoid reactions (such as decreased blood pressure and swelling of the larynx and tongue), reaching anaphylaxis. People with hypersensitivity may experience bronchospasms, as well as attacks of bronchial asthma. If the patient develops allergic reactions, the drug should be discontinued and a doctor should be consulted immediately, because in some cases the person may need emergency medical care;
• Others: Long-term use of drugs in high doses may increase the risk of developing a stroke or ATE.

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Overdose

As a result of taking tablets in high doses, disorders in the central nervous system develop (headaches, slowing of psychomotor reactions, dizziness, feeling of drowsiness, and ringing in the ears; myoclonic seizures may occur in children). At the same time, due to an overdose, the following may occur: vomiting (sometimes the color of coffee grounds, due to bleeding in the gastrointestinal tract), nausea, pain in the epigastrium, asthma attacks, as well as disorders in the liver or kidneys. If the dosage continues to increase, suppression of respiratory function, cyanosis, a drop in blood pressure, nystagmus, the development of acute renal failure, metabolic acidosis, and also fainting and coma will begin.

There is no specific antidote, so to eliminate the manifestations of an overdose, you need to wash out the stomach, take enterosorbents and use symptomatic treatment. If breathing has stopped, you should immediately begin resuscitation procedures.

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Interactions with other drugs

As a result of the combination of the drug with ACE inhibitors and β-blockers, the hypotensive properties of the latter are reduced.

Combined use with hypothiazide, furosemide and other diuretic drugs weakens their pharmacological properties.

Ibuprofen enhances the properties of anticoagulants, so if these drugs are used simultaneously, the likelihood of gastrointestinal bleeding increases.

When used together with GCS, the likelihood of developing negative reactions from the digestive tract may increase.

The active component of the drug displaces the following drugs from the synthesis process with plasma protein (when combined with them): indirect anticoagulants, antidiabetic drugs (oral), hydantoin derivatives and sulfonylureas.

Combined use with hydrochlorothiazide, amlodipine and captopril slightly weakens their hypotensive properties.

Combination with ibuprofen increases the toxic effect of methotrexate, as well as baclofen.

Aspirin reduces plasma levels of ibuprofen.

Concomitant use with warfarin increases the duration of bleeding, and with it the development of hematomas and microhematuria.

Combination with cholestyramine weakens the absorption of the active substance Imet in the gastrointestinal tract.

Combined use with lithium drugs provokes an increase in lithium levels in plasma. At the same time, the drug, when used simultaneously, increases the concentration of digoxin with phenytoin in plasma.

Magnesium hydroxide enhances the initial absorption of ibuprofen within the gastrointestinal tract.

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Storage conditions

The medicine is stored in a place protected from direct sunlight and moisture, inaccessible to children. Temperature indicators are within 15-30 ^o C.

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Shelf life

The medicine is suitable for use for 3 years from the date of manufacture.