Next Uno Express capsule 200 mg 10 pcs. (Ibuprofen, Paracetamol)

Pharmacological action of

Pharmacotherapeutic group:

NSAIDs

ATX:

M.01.AE01 Ibuprofen

Pharmacodynamics:

Mechanism of action of ibuprofen, a derivative of propionic acid from the non-steroid group, (non-steroid drug) due to inhibition of the synthesis of prostaglandins - mediators of pain, inflammation and hyperthermia. It indiscriminately blocks cyclooxygenase 1 (COX-1) and cyclooxygenase 2 (COX-2), as a result of which it inhibits prostaglandin synthesis. It has a quick directed action against pain (analgesic), antipyretic and anti-inflammatory effect. Ibuprofen inversely inhibits platelet aggregation.

Pharmacokinetics:

Ibuprofen is absorbed from the digestive tract by approximately 80%. Absorption decreases slightly when taking the drug after a meal. The time to reach maximum concentration (TCmax) when taken on an empty stomach is 45 minutes, when taken after meals - 1.5-2 hours, in synovial fluid - 2-3 hours.

Ibuprofen binds to blood proteins by 90%, mainly with albumin. It undergoes a presystem and post-system metabolism in the liver. After absorption, about 60% of the pharmacologically inactive R-form of ibuprofen slowly transforms into the active S-form. The isoenzyme of CYP2C9 takes part in the metabolism of the drug. It has a two-phase elimination kinetics with a half-life (T1 / 2) of 2-2.5 hours. It is excreted by the kidneys (unchanged no more than 1%) and to a lesser extent with bile.

Indications

Used for headache, migraine, toothache, painful menstruation, neuralgia, back pain, muscle and rheumatic pain in case of fever with flu and colds.

Intended for symptomatic therapy, reducing pain and inflammation at the time of use, does not affect the progression of the disease.

Contraindications

- Hypersensitivity to ibuprofen and other components of the drug

- erosive and ulcerative diseases of the gastrointestinal tract (including peptic ulcer, peptic ulcer, peptic ulcer) complete or incomplete combination of bronchial asthma, recurring polyposis of the nose and paranasal sinuses and intolerance to acetylsalicylic acid or other NSAIDs (including history)

- blood clotting disorders (including hemophilia, elongation bleeding time, bleeding tendency, bleeding diathesis)

- Children up to age 12 years

- III trimester pregnancy, breastfeeding period

- active gastrointestinal bleeding

- intracranial hemorrhage

- history of bleeding or perforation of a gastrointestinal ulcer, provoked by the use of NSAIDs

- severe heart failure

- severe renal failure / ml rc - sr less than 30 min

- severe liver failure or active liver disease

- condition after coronary artery bypass grafting

- confirmed hyperkalemia

- fructose intolerance .

With caution:

With caution, the drug is used for cirrhosis of the liver with portal hypertension, hyperbilirubinemia, peptic ulcer and duodenal ulcer (history), gastritis, enteritis, colitis of hepatic porphyria, liver and / or renal failure, nephrotic syndrome of chronic heart failure, arterial hypertension, blood coagulation disorders, blood diseases of unknown etiology (leukopenia and anemia), old age, pregnancy (I-II trimester), coronary heart disease, cerebrovascular disease, dyslipidemia / hyperlipidemia, sugar diabetes, peripheral artery disease, smoking, chronic renal failure (CC 30-60 ml / min), the presence of Helicobacter pylory infection, prolonged use of NSAIDs, frequent use of alcohol i, severe somatic diseases, systemic lupus erythematosus, or other autoimmune diseases of the connective tissue (increased risk of developing aseptic meningitis), concomitant use of oral corticosteroids (including prednisone), anticoagulants (including warfarin), antiplatelet agents (including including clopidogrel), selective serotonin reuptake inhibitors (including citalopram, fluoxetine. paroxegin. sertraline).

Use during pregnancy and lactation

In animal studies, no adverse effect of ibuprofen on the fetus was found. In the absence of a sufficient number of well-controlled observations in humans, the drug should be used in the first and second trimesters of pregnancy only in cases of urgent need, if the potential benefit to the mother outweighs the potential risk to the fetus and baby.

Ibuprofen inhibits uterine muscle contraction. The effect of ibuprofen on the fetus can cause premature closure of the botallal duct, which can lead to the development of pulmonary hypertension in the newborn. Ibuprofen should not be used at the end (third trimester) of pregnancy.

No isolation of ibuprofen with breast milk was detected. However, due to the limited volume of these studies and the possible adverse effect of inhibition of prostaglandin synthesis in the newborn, it is not recommended to use the drug during breastfeeding.

Special instructions

During treatment, monitoring of the picture of peripheral blood and the functional state of the liver and kidneys is necessary.

When symptoms of gastropathy appear, careful monitoring is indicated, including esophagogastroduodenoscopy, a blood test with hemoglobin determination, hematocrit, fecal occult blood test.

To prevent the development of NSAIDs, gastropathy is recommended to be combined with prostaglandin E (misoprostol) preparations.

If it is necessary to determine 17-ketosteroids, the drug should be discontinued 48 hours before the study.

Before starting therapy, patients with a history of arterial hypertension and / or with heart failure should be careful and consult a specialist, since in such patients fluid retention, arterial hypertension, and edema associated with NSAIDs were noted.

Prolonged use may increase the risk of acute coronary disease or stroke.

In patients with a history of bronchial asthma or allergic diseases, the drug may cause an attack or bronchospasm.

Ethanol is not recommended during treatment.

Ibuprofen has an antiplatelet effect (weaker compared with acetylsalicylic acid), which requires caution in the appointment of patients with blood clotting disorders, as well as taking anticoagulants.

It is recommended that you take the drug as soon as possible and at the minimum effective dose necessary to eliminate the symptoms.

Drugs that suppress cyclooxygenase and prostaglandin synthesis can affect ovulation, disrupting female reproductive function (reversible after discontinuation of treatment).

Impact on the ability to drive transp. Wed and fur .:

During the treatment period, it is necessary to refrain from those types of activities where increased attention and speed of mental and motor reaction is required.

Composition

1 capsule contains:

Active ingredient:

ibuprofen - 200,000 mg.

Excipients:

-tocopherol acetate - 0.372 mg,

povidone 17 PF - 30,000 mg,

macrogol 600 - 414.628 mg.

Composition of the gelatin capsule shell:

gelatin,

sorbitol non-crystallizing solution,

glycerol,

methyl parahydroxybenzoate,

purified water,

dye red charming E-129.

Description:

Soft gelatin capsules oval in shape, with a seam, transparent, red. The contents of the capsules is a colorless or pinkish clear liquid.

Dosage and administration

NextВ® Uno Express is prescribed for adults and children over 12 years old by mouth after meals, 200 mg (1 capsule) 3-4 times a day. Capsules should be washed down with a glass of water.

To achieve a quick therapeutic effect, the dose can be increased to 400 mg (2 capsules) 3 times a day. When the therapeutic effect is achieved, the daily dose of the drug is reduced to 600-800 mg.

The maximum daily dose for adults is 1200 mg (do not take more than 6 capsules in 24 hours).

The maximum daily dose for children 12-18 years old is 800 mg.

A repeated dose should be taken no earlier than 4 hours later.

If, after using the drug for 5 days, the pain syndrome or for 3 days, the increased body temperature persists or intensifies, you should stop taking it and consult your doctor.

Side effects

When using the drug Next® Uno Express for 2-3 days, side effects are practically not observed.

In case of prolonged use, the following side effects may occur:

- from the gastrointestinal tract (GIT): NSAID gastropathy (abdominal pain, heartburn, diarrhea, flatulence, pain and discomfort in the epigastric region), ulceration of the gastrointestinal mucosa (in some cases complicated by perforation and bleeding) irritation, dry oral mucosa or pain in the mouth, ulceration of the gum mucosa, aphthous stomatitis, pancreatitis, constipation, indigestion, nausea, loss of appetite, vomiting, hepatitis srdlp - from the respiratory system: shortness of breath, bronchospasm, exacerbation of bronchial asthma

- hearing impairment: hearing loss, ringing or tinnitus

- from the central and peripheral nervous system: insomnia, anxiety, nerve fussiness and irritability, psychomotor agitation, depression, confusion, hallucinations, rarely aseptic meningitis (more often in patients with autoimmune diseases), headache, dizziness, drowsiness

- from the cardiovascular system: development or worsening of heart failure, tachycardia, increased blood pressure

- from the urinary system: acute renal failure, allergic nephritis, nephrotic syndrome (edema), polyuria,

cystitis - from hemopoietic organs: hemolytic anemia, aplastic anemia, thrombocytopenia and thrombocytopenia , agranulocytosis, leukopenia, pancytopenia

- on the part of the organs of vision: reversible toxic amblyopia, blurred vision or double vision, dryness and irritation of the eyes, swelling of the conjunctiva and eyelids (allergic genesis). scotoma. color vision disorders

- allergic reactions: skin rash (usually erythematous, urticaria), pruritus, Quincke's edema, anaphylactoid reactions, anaphylactic shock, bronchospasm, fever, erythema multiforme erythema (including Stevens-Johnson syndrome), toxic epidermal necrolysis (Lyell's syndrome), eosinophilia, allergic rhinitis

- others: increased sweating.

The risk of ulceration of the mucous membrane of the gastrointestinal tract, bleeding (gastrointestinal, gingival, uterine, hemorrhoidal), visual impairment (color vision disorders, scotomas, amblyopia) increases with prolonged use in large doses.

If side effects occur, you should stop taking the drug and consult a doctor.

Lab performance:

- bleeding time (may increase)

- serum glucose concentration (may decrease)

- creatinine clearance (may decrease)

- hematocrit or hemoglobin (may decrease)

- serum creatinine concentration (may increase)

- hepatic activity may increase).

Drug interaction

Inductors of microsomal oxidation (phenytoin, ethanol, barbiturates, rifampicin, phenylbutazone, tricyclic antidepressants) increase the production of hydroxylated active metabolites of ibuprofen, increasing the risk of developing severe hepatotoxic reactions.

Microsomal oxidation inhibitors reduce the risk of hepatotoxic effects of ibuprofen.

Ibuprofen reduces the antihypertensive effect of antihypertensive drugs (ACE inhibitors, slow calcium channel blockers, etc.), the natriuretic and diuretic efficacy of furosemide and hydrochlorothiazide reduces the effectiveness of uricosuric drugs, enhances the ulcerogenic effect of glucocorticosteroids, colchogolicin enhances the effect of ethanolin and increases the efficacy of colchogolicin blood digoxin, lithium preparations and methotrexate.

Ibuprofen enhances the undesirable effects of estrogen when used together.

Antacids and colestyramine decrease ibuprofen absorption.

Caffeine enhances the analgesic effect of ibuprofen.

With the simultaneous administration of ibuprofen, it reduces the anti-inflammatory and antiplatelet effect of acetylsalicylic acid (it is possible to increase the incidence of acute coronary insufficiency in patients receiving small doses of acetylsalicylic acid as an antiplatelet agent after starting ibuprofen).

When prescribed with anticoagulant and thrombolytic drugs (alteplase, streptokinase, urokinase), the risk of bleeding increases at the same time.

With the combined use of ibuprofen and cefamandol, cefoperazone, cefotetan. valproic acid increases the incidence of hypoprothrombinemia.

Myelotoxic drugs enhance the hematotoxicity of the drug.

Cyclosporin and gold preparations enhance the effect of ibuprofen on the synthesis of prostaglandins in the kidneys, which is manifested by an increase in nephrotoxicity.

Ibuprofen increases the plasma concentration of cyclosporin and the likelihood of its hepatotoxic effects.

Medicines that block tubular secretion reduce excretion and increase the plasma concentration of ibuprofen.

Ibuprofen may decrease the effectiveness of mifepristone, so ibuprofen should be started no earlier than 8-12 days after taking mifepristone.

With the simultaneous administration of ibuprofen and tacrolimus, an increased risk of nephrotoxicity is possible.

The simultaneous use of ibuprofen and zidovudine may lead to increased hematological toxicity.

There is evidence of an increased risk of hemarthrosis and hematomas in HIV-positive hemophilia patients treated with zidovudine and ibuprofen.

Patients receiving co-treatment with ibuprofen and the quinolone antibiotics may increase the risk of seizures.

Overdose

Symptoms: abdominal pain, nausea, vomiting, lethargy, drowsiness, depression, headache, tinnitus, metabolic acidosis, coma, acute renal failure, lowering blood pressure, bradycardia, tachycardia, fibrillation, prediction.

Treatment: gastric lavage (only within an hour after ingestion), activated carbon, alkaline drink, forced diuresis, symptomatic therapy.

Storage conditions

In the dark place at a temperature of no higher than 25 ° C.

Keep out of the reach of children.

Expiration

2 years.

Do not use after the expiry date stated on the packaging.

Active ingredient

Golden Thyme herb, medicinal root roe, Paracetamol



pharmacy dispensing terms Without a prescription

Form of Treatment

tablets

Appointment

Children over 1 month old, Children by doctor's appointment, Adult doctor pfrorold494561 Appointment emenn m I and II trimester doctor on purpose, for Adults

Indications

From rheumatoid arthritis, From sciatica, From migraine, From osteoarthritis, After trauma and Swelling, From infectious x diseases, From arthrosis and arthritis, Bruises, Dislocations and sprains, Colds, From lumbago

Possible product names

Next Uno Express capsules 200 mg 10 pcs.



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