Nurofen Forte

Nurofen Forte is a non-steroidal anti-inflammatory drug belonging to the group of propionic acid derivatives.

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Indications Nurofen Forte

Indications for use

• The appearance of headaches and toothaches.
• The occurrence of migraines.
• Presence of painful menstruation.
• The appearance of signs of neuralgia.
• The occurrence of back pain, muscle pain, rheumatic pain and other types of pain.
• The presence of feverish conditions with signs of influenza and colds.

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Release form

Nurofen Forte is produced in the form of biconvex tablets, which are covered with a sugar coating. It is white and has a red overprint on one side of the tablet - "Nurofen 400". The tablets are placed in a blister of twelve pieces each. One blister is packed in a cardboard box and supplied with a leaflet with instructions.

Each tablet contains four hundred milligrams of the active substance - ibuprofen, as well as a certain amount of auxiliary components: sodium croscarmellose, sodium lauryl sulfate, sodium citrate, stearic acid, colloidal silicon anhydride, sodium carmellose, talc, acacia, sucrose, titanium dioxide, macrogol 6000, Opacode S-1-9460 HV brown, industrial methylated spirit, purified water.

Pharmacodynamics

Nurofen Forte has analgesic, antipyretic and anti-inflammatory properties. The active component of the drug - ibuprofen - leads to non-selective blocking of cyclooxygenase 1 and 2. The effect of the drug results from the inhibition of the synthesis of prostaglandins, which are mediators of pain, inflammation and hyperthermic reaction.

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Pharmacokinetics

Nurofen Forte has a low degree of absorption. The maximum concentration of the active component in the blood plasma is observed one or two hours after taking the medication. The percentage of binding to blood proteins reaches ninety percent.

The active substance is capable of slowly penetrating into the joint cavities and is retained in the synovial tissues, where higher concentrations of the drug are created than in the blood plasma. After absorption, approximately sixty percent of the inactive form of the substance is converted into the active form at a slow rate. Ibuprofen is capable of undergoing metabolic processes. It is excreted from the body by the kidneys - unchanged substance, in an amount of up to fifteen percent. A smaller amount of ibuprofen is eliminated from the body through bile. The half-life is two hours.

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Dosing and administration

The medicine is taken orally with water. Adults and children from twelve years of age take one tablet at a time. The patient can take no more than three tablets within twenty-four hours. The maximum daily amount of Nurofen Forte intended for adult patients is one thousand two hundred milligrams, for children from twelve to seventeen years of age - one thousand milligrams.

If symptoms persist after two to three days of taking Nurofen Forte, you should stop using it and consult a specialist.

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Use Nurofen Forte during pregnancy

Nurofen Forte is contraindicated for use during pregnancy. It should be used with great caution during breastfeeding.

Contraindications

Hypersensitivity to any of the components of Nurofen Forte.

The presence of hypersensitivity to acetylsalicylic acid or other nonsteroidal anti-inflammatory drugs. This includes the occurrence of broncho-obstruction, rhinitis, urticaria, as allergic reactions, as well as symptoms of complete or partial intolerance to acetylsalicylic acid with manifestations of rhinosinusitis, urticaria, the occurrence of polyps of the nasal mucosa, the occurrence of bronchial asthma.

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Side effects Nurofen Forte

Gastrointestinal tract – occurrence of gastropathy caused by non-steroidal anti-inflammatory drugs, which is characterized by the following symptoms: abdominal pain, nausea, vomiting, heartburn, loss of appetite, diarrhea, flatulence, constipation. In some cases, ulceration of the mucous membrane of the gastrointestinal tract is possible. Sometimes such ulceration is accompanied by the appearance of tissue perforation and bleeding. Also observed is the appearance of irritation or dryness of the mucous membrane of the oral cavity, the appearance of pain in the mouth, the occurrence of gum ulcers, aphthous stomatitis and pancreatitis.

Hepatobiliary system - occurrence of hepatitis.

Respiratory system – the appearance of shortness of breath and bronchitis.

Sensory organs – occurrence of hearing impairments, expressed in its decrease, appearance of ringing or noise in the ears; occurrence of visual impairments, manifested in toxic damage to the optic nerve, blurred vision or double vision, appearance of scotoma, dryness and irritation of the eyes, swelling of the conjunctiva and eyelids, having an allergic origin.

Central and peripheral nervous system – headaches, dizziness, insomnia, anxiety, nervousness, irritability, signs of psychomotor agitation, drowsiness, depression, confusion, hallucinations. In rare cases, signs of aseptic meningitis may occur.

Cardiovascular system – occurrence of heart failure, tachycardia, increased blood pressure.

Urinary system – occurrence of acute renal failure, allergic nephritis, nephrotic syndrome accompanied by edema, polyuria, cystitis.

Allergic manifestations – the appearance of an erythematous skin rash or urticaria, the appearance of skin itching, Quincke's edema, anaphylactic reactions, anaphylactic shock, bronchospasm or dyspnea, fever, erythema multiforme exudative, toxic epidermal necrolysis, eosinophilia, allergic rhinitis.

Hematopoietic organs – occurrence of anemia (including its hemolytic and aplastic forms), thrombocytopenia, thrombocytopenic purpura, agragulocytosis, leukopenia.

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Overdose

The appearance of abdominal pain, nausea and vomiting, lethargy, drowsiness, depression, headache, tinnitus, metabolic acidosis, coma, acute renal failure, decreased blood pressure, bradycardia, tachycardia, atrial fibrillation, respiratory arrest.

In this case, it is necessary to resort to gastric lavage within the first hour after taking Nurofen Forte. It is also necessary to prescribe activated carbon, alkaline drinks, forced diuresis and symptomatic therapy.

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Interactions with other drugs

It is not recommended to use Nurofen Forte simultaneously with acetylsalicylic acid and other non-steroidal anti-inflammatory drugs.

Anticoagulants and thrombolytic drugs - Alteplase, Streptokinase, Urokinase - when taken together with medications increase the risk of severe bleeding from the gastrointestinal tract.

With the simultaneous administration of cefamandole, cefaperazone, cefotetan, valproic acid and plicamycin, the incidence of hypoprothrombinemia increases.

The action of cyclosporine and gold preparations leads to an increase in the effect of ibuprofen on the production of prostaglandins, which is carried out by the kidneys. Such a combined action of the drugs leads to an increase in nephrotoxicity. The active component of the drug stimulates an increase in the plasma concentration of cyclosporine, which can cause a hepatotoxic effect.

Medicines that can block tubular secretion lead to a decrease in excretion and an increase in the amount of ibuprofen in the blood plasma.

Medicines that are inducers of microsomal oxidation contribute to an increase in the production of active hydroxylated metabolites. This increases the possibility of the patient getting a severe degree of intoxication. This concerns phenytoin, ethanol, barbiturates, phenylbuzatone and tricyclic antidepressants.

Drugs capable of blocking microsomal oxidation, when taken together, can lead to a decrease in the hepatotoxic effect.

Simultaneous use of the drug and vasodilators leads to a decrease in the effectiveness of uricosuric drugs. The same intake together with natriuretic drugs - furosemide and hydrochlorothiazide - leads to a decrease in the effectiveness of the latter.

When taken together, the effectiveness of uricosuric drugs is reduced, but the effectiveness of anticoagulants, antiplatelet agents and fibrinolytics is increased.

Concomitant use of the drug increases the side effects of such drugs as mineralocorticoids, glucocorticoids, estrogens, ethanol. Oral hypoglycemic drugs and insulin also increase the effect. Concomitant use leads to a decrease in the absorption of antacids and cholestyramine.

When used simultaneously, there is an increase in the concentration of substances such as digoxin, lithium preparations and methotrexate in the blood plasma.

Taking caffeine increases the pain-relieving effect of the medication.

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Storage conditions

Nurofen Forte – at a temperature not exceeding twenty degrees Celsius and in a place inaccessible to children.

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Shelf life

Nurofen Forte – thirty-six months from the date of manufacture.

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