Nurofen, express gel for joint pain 5%, 100g

Composition

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of 1 g of gel for external use 5% contains:

Active ingredients: ibuprofen 50 mg.

Auxiliary substances:

hydroxyethylcellulose,

sodium hydroxide,

benzyl alcohol,

isopropyl alcohol,

water.

Pharmacological action

Nurofen Express (ibuprofen) gel 5% is quickly absorbed, acts directly on the source of pain and has a double effect-analgesic and anti-inflammatory drug Nurofen Express dosage form gel for external use is easy to apply and quickly absorbed into the skin. Pharmacodynamics : The drug belongs to the group of nonsteroidal anti-inflammatory drugs (NSAIDs). It has a double effect: analgesic and anti-inflammatory. Ibuprofen, being a propionic acid derivative, selectively blocks cyclooxygenase 1 (COX-1) and cyclooxygenase 2 (COX-2), as a result of which it inhibits the synthesis of prostaglandins – mediators of pain, inflammation and hyperthermic reaction. When applied to the skin, the gel has an additional cooling effect due to the rapid evaporation of the benzyl alcohol contained in the composition. Pharmacokinetics: After application to the skin, ibuprofen is detected in the epidermis and dermis after 24 hours. The maximum plasma concentration of ibuprofen when applied topically is 5% of the maximum concentration when using oral forms of ibuprofen. Clinically significant systemic absorption practically does not occur. It is metabolized in the liver. It is excreted by the kidneys (no more than 1% unchanged) and, to a lesser extent, with bile.

Indications

As a topical analgesic and anti-inflammatory agent for conditions such as muscle pain, back pain, arthritis, pain from ligament injuries and sprains, sports injuries, and neuralgia.

Contraindications

-Hypersensitivity to ibuprofen or other components of the drug. – A history of hypersensitivity reactions (bronchial asthma, rhinitis, angioedema, urticaria) in response to the use of acetylsalicylic acid or other NSAIDs. – Violations of the integrity of the skin at the site of application of the drug (including infected abrasions and wounds, wet dermatitis, eczema). – Children under 14 years of age. – Pregnancy of the third trimester. With caution, if you have any of the conditions listed in this section, you should consult a doctor before using the drug. Bronchial asthma or allergic diseases in the acute stage or in the anamnesis-possible development of bronchospasm, renal failure, liver failure, stomach ulcer, including in the anamnesis, enteritis, colitis, hemorrhagic diathesis, pregnancy I-II trimester, breastfeeding.

Side effects

The frequency of adverse reactions is estimated based on the following criteria: very frequent (≥ 1/10), frequent (≥1/100 to < 1/10), infrequent (≥1/1000 to < 1/100), rare (≥1/10000 to < 1/1000), very rare (> 1/10000), frequency unknown (frequency cannot be determined based on available data).

The following adverse reactions were observed with short-term use of ibuprofen at a dose not exceeding 500 mg / day. In the treatment of chronic conditions and with prolonged use, other adverse reactions may occur.

– Violations of the immune system

Frequency not known: hypersensitivity reactions are non – specific allergic reactions and anaphylactic reactions, reactions of the respiratory tract (bronchial asthma, including its exacerbation, bronchospasm, dyspnea, dyspnea), skin reactions (pruritus, urticaria, purpura, angioedema, bullous and exfoliative dermatitis including toxic epidermal necrolysis (Lyell’s syndrome), and Stevens-Johnson syndrome, erythema multiforme).

– Disorders of the gastrointestinal tract

Frequency unknown: abdominal pain, dyspepsia.

– Renal and urinary tract

disorders Frequency unknown: impaired renal function.

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

Interaction

Concomitant use of Nurofen tablets with acetylsalicylic acid (ASA) and other NSAIDs is not recommended.

When administered concomitantly, ibuprofen reduces the anti-inflammatory and antiplatelet effects of acetylsalicylic acid (ASA) (it is possible to increase the incidence of acute coronary insufficiency in patients receiving small doses of acetylsalicylic acid (ASA) as an antiplatelet agent after starting ibuprofen).

When prescribed with anticoagulant and thrombolytic drugs (alteplase, streptokinase, urokipase) at the same time, the risk of bleeding increases. Cefamandol, cefaperazone, cefotetan, valproic acid, plicamycin, increase the purity of hypoprothrombinemia development. Cyclosporine and gold preparations enhance the effect of ibuprofen on the synthesis of prostoglapdines in the kidneys, which is manifested by an increase in nephrotoxicity.

Ibuprofen increases the plasma concentration of cyclosporine and the likelihood of developing its hepatotoxic effects. Drugs that block tubular secretion reduce excretion and increase the plasma concentration of ibuprofen. Inducers of microsomal oxidation (phenytoin, ethanol, barbiturates, rifampicin, fepylbutazone, tricyclic anti-depressants) increase the production of hydroxylated active metabolites, increasing the risk of severe hepatotoxic reactions. Microsomal oxidation inhibitors-reduce the risk of hepatotoxic effects.

Reduces the hypotensive activity of vasodilators, natriuretic in furosemide and hydrochlorothiazide.

Reduces the effectiveness of uricosuric drugs, enhances the effect of indirect anti-coagulants, aptiaggregants, fibrinolytics. Increases the side effects of mineralocorticosteroids, glucocorticosteroids, estrogens, and ethanol. Enhances the effect of oral hypoglycemic drugs, derivatives of sulfonylureas and insulin.

Antacids and colestyramine reduce absorption. Increases the concentration of digoxin, lithium preparations, and methotrexate in the blood. Caffeine enhances the analgesic effect.

The drug interaction of Nurofen gel has not yet been described. However, even with external use, ibuprofen can have a systemic effect, therefore, theoretically, simultaneous use of the gel with other NSAIDs can lead to increased side effects.

How to take, course of use and dosage

For external use only.

Please read the instructions carefully before using the product.

Nurofen® Express gel is prescribed for adults and children over 14 years of age.

When using the tube for the first time: after opening the lid, check that the safety foil on the tube neck is not damaged. Open the foil by pressing down on it with the outside of the lid.

Squeeze 4-10 cm of the drug (equivalent to approximately 50 – 125 mg of ibuprofen) from the tube onto your hand and gently rub the gel into the skin until it is completely absorbed.

Wash your hands immediately after using the drug.

Re-use the drug should not be earlier than in 4 hours. Do not apply the gel more than four times within 24 hours. The maximum daily dose is 500 mg.

If symptoms persist or worsen within 2 weeks of using the drug, you should stop treatment and consult a doctor.

Do not exceed the indicated dose.

Overdose

The probability of accidental overdose of the drug in the form of a gel is minimal.

In children, overdose symptoms may occur after ingestion of a dose exceeding 400 mg / kg of body weight. In adults, the dose-dependent effect of overdose is less pronounced. The half-life of the drug in case of overdose is 1.5-3 hours.

If the drug was accidentally taken by mouth, the following symptoms may occur: headache, vomiting, low blood pressure.

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

Special instructions

During long-term treatment, it is necessary to monitor the picture of peripheral blood and the functional state of the liver and kidneys.

When symptoms of gastropathy appear, careful monitoring is indicated, including esophagogastroduodeposcopy, a general blood test (determination of hemoglobin), and a fecal occult blood test.

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

Patients should refrain from all activities that require increased attention, rapid mental and motor reactions. During the treatment period, you should refrain from drinking alcoholic beverages.

The possibility of using the drug Nurofen® for children is decided individually by the doctor in the following cases: :

• if your child is taking other painkillers;
• if there is indication of a history of peptic ulcer disease, gastritis, ulcerative colitis, bleeding from the gastrointestinal tract;
• in diseases of the liver or kidneys;
• in identifying Helicobacter pylori;
• during therapy with indirect anticoagulants, drugs to lower blood pressure, GCS, antiplatelet agents, diuretics, lithium drugs, methotrexate;
• in children with bronchial asthma, urticaria.

Gel

After using the drug, wash your hands thoroughly.

Avoid getting the gel in your eyes and on your lips. Do not apply the gel on damaged areas of the skin, as well as on the area around the eyes and lips.

If the gel accidentally gets inside, it is possible to develop gastrointestinal disorders, in this situation you should rinse your mouth and consult a doctor.

Form of production

Gel

Storage conditions

At a temperature not exceeding + 25°C, out of the reach of children.

Shelf

life is 3 years.

Active ingredient

Ibuprofen

Dosage form

gel for external use

Purpose

For adults

Indications

Osteoarthritis, Periarthritis, Osteoarthritis, Arthritis, Lumbago, Swelling after injuries and operations, Rheumatoid arthritis