Strepsils Intensive, honey lemon pills, 24pcs

Composition

1 tablet for resorption contains:

Active ingredients:

flurbiprofen 8.75 mg;

Auxiliary substances:

macrogol 300 of 5.47 mg,

potassium hydroxide of 2.19 mg,

lemon flavor [502904 A) 3.6 mg,

levomenthol 2 mg, honey is 50.4 mg,

sucrose liquid 1407 mg,

dextrose 1069 mg

Pharmacological action

Flurbiprofen is a derivative of propionic acid group of nonsteroidal anti-inflammatory drugs (NSAIDs), and possesses significant analgesic, anti-inflammatory and antipyretic effect by suppressing cyclooxygenase-1 (COX-1) and cyclooxygenase-2 (COX-2), with some selectivity towards COX-1, resulting in reduced production of prostaglandins – mediators of pain, inflammation and hyperthermic reactions.

The drug has a local analgesic and anti-inflammatory effect on the mucous membrane of the mouth and throat: it reduces swelling, difficulty swallowing, pain and irritation in the throat.

The tablet is completely dissolved in the oral cavity within 5-12 minutes. The calming effect starts from the 2nd minute.

A significant reduction in the intensity of sore throat begins at 22 minutes with a maximum effect reaching 70 minutes and lasts up to 4 hours.

Pharmacokinetics

The tablet is completely dissolved in the oral cavity within 5-12 minutes. Absorption is high, flurbiprofen is rapidly and almost completely absorbed, distributed throughout the body and largely binds to plasma proteins. Flurbiprofen is detected in the blood after 5 minutes, the maximum concentration of flurbiprofen in blood plasma (Cmax) is reached 40-45 minutes after resorption.

Flurbiprofen can be absorbed in the oral cavity by passive diffusion. The rate of absorption depends on the dosage form; with resorption, the maximum concentration of flurbiprofen is reached faster than with an oral equivalent dose of flurbiprofen.

The elimination half-life (T 1/2) is 3-6 hours. It is metabolized in the liver by hydroxylation and is excreted by the kidneys and, to a lesser extent, with bile. Flurbiprofen is excreted in breast milk in small amounts ( Approximately 20-25% of the oral dose of flurbiprofen is excreted unchanged.

Indications

Treatment of infectious and inflammatory diseases of the oral cavity and pharynx (sore throat, sore throat).

The drug can be used for people with diabetes mellitus (it does not contain sugar).

Contraindications

• Hypersensitivity to flurbiprofen or any of the components that make up the drug.
• A history of hypersensitivity reactions (asthma, bronchospasm, rhinitis, angioedema, urticaria, recurrent nasal or paranasal polyposis) in response to the use of acetylsalicylic acid or other NSAIDs.
• Erosive and ulcerative diseases of the gastrointestinal tract (including peptic ulcer of the stomach and duodenum, Crohn’s disease, ulcerative colitis) acute or history of ulcerative bleeding (two or more confirmed episodes of peptic ulcer disease or ulcerative bleeding).
• Bleeding or perforation of a history of gastrointestinal ulcers caused by the use of NSAIDs.
• Glucose-6-phosphate dehydrogenase deficiency, hemophilia and other blood clotting disorders (including hypocoagulation), hemorrhagic diathesis.
• Severe liver failure or active liver disease.
• Severe renal insufficiency (creatinine clearance
• Decompensated heart failure; the period after coronary artery bypass grafting.
• Sucrose/isomaltase deficiency, fructose intolerance, glucose-galactose malabsorption.
• Pregnancy (third trimester).
• Children under 12 years of age.

With caution

If you have any of the conditions listed in this section, you should consult your doctor before using the drug.

Concomitant use of other NSAIDs; a history of a single episode of gastric ulcer or ulcerative bleeding of the gastrointestinal tract; a history of gastrointestinal diseases (ulcerative colitis, Crohn’s disease), gastritis, enteritis, colitis, the presence of Helicobacter pylori infection; bronchial asthma or allergic diseases in the acute stage or in the anamnesis-the development of bronchospasm is possible; systemic lupus erythematosus or mixed connective tissue disease (syndrome Sharp) – increased risk of aseptic meningitis (with short – term use of flurbiprofen, the risk is insignificant); renal failure, including dehydration (creatinine clearance less than 30-60 ml/min), nephrotic syndrome; liver failure, cirrhosis of the liver with portal hypertension, hyperbilirubinemia; arterial hypertension and/or heart failure, edema; simultaneous use of medications that may increase the risk of ulcers or bleeding, in particular, oral glucocorticosteroids (including prednisone), anticoagulants (including warfarin), antiplatelet agents (including acetylsalicylic acid, clopidogrel), selective serotonin reuptake inhibitors (including citalopram, fluoxetine, paroxetine, sertraline); pregnancy I-II trimester, breastfeeding; old age; alcohol consumption.

Side effects

The risk of side effects can be minimized if you take the drug in a short course at the minimum effective dose necessary to eliminate symptoms.

The following adverse reactions were observed with short-term use of the drug. In the treatment of chronic conditions and with prolonged use, other adverse reactions may occur.

The frequency of adverse reactions is estimated based on the following criteria: very common (≥ 1/10), common (≥ 1/100 to < 1/10), infrequent (≥1/1000 to < 1/100), rare (≥1/10,000 to < 1/1000), very rare (

Blood and lymphatic system disorders

• Frequency unknown: hematopoietic disorders (anemia, thrombocytopenia).

Nervous system disorders

• are common: dizziness, headache, paresthesia.
• Infrequently: drowsiness.

Immune system disorders

• Rare: anaphylactic reactions.

Cardiac disorders

• Frequency unknown: heart failure, edema.

Vascular disorders

• Frequency unknown: increased blood pressure.

Respiratory, thoracic, and mediastinal

• disorders Common: a feeling of irritation in the throat.
• Infrequently: exacerbation of asthma and bronchospasm, shortness of breath, wheezing, blisters in the mouth and pharynx, pharyngeal hypesthesia (decreased sensitivity in the mouth and pharynx).

Gastrointestinal disorders

• Common: diarrhea, ulceration of the oral cavity, nausea, pain in the oral cavity, paresthesia of the oral cavity, pain in the oral cavity and pharynx, discomfort in the oral cavity (feeling of heat, burning or tingling in the mouth).
• Infrequently: bloating, abdominal pain, constipation, dry mouth, dyspepsia, flatulence, glossalgia (burning mouth syndrome), dysgeusia (change in taste perception), oral dysesthesia, vomiting.

Skin and subcutaneous tissue disorders

• Infrequently: skin rash, pruritus.
• Frequency unknown: severe skin reactions such as bullous reactions, including Stevens-Johnson syndrome and toxic epidermal necrolysis (Lyell’s syndrome).

Liver and biliary tract

• disorders Frequency unknown: hepatitis.

Mental disorders

• Infrequently: insomnia.

Other services

• Infrequently: fever, pain.

Interaction

Concomitant use of flurbiprofen with the following medications should be avoided:

• Acetylsalicylic acid: with the exception of low doses of acetylsalicylic acid (no more than 75 mg per day) prescribed by a doctor, since co-use may increase the risk of side effects.
• Other NSAIDs, including ibuprofen and selective cyclooxygenase-2 inhibitors: concomitant use of two or more NSAID drugs should be avoided due to the possible increased risk of side effects.

Use with caution at the same time as the following medications: :

• Anticoagulants: NSAIDs may increase the effect of anticoagulants, particularly warfarin.
• Antiplatelet agents and selective serotonin reuptake inhibitors: increased risk of gastrointestinal bleeding.
• Antihypertensive agents (ACE inhibitors and angiotensin II antagonists) and diuretics: NSAIDs may reduce the effectiveness of drugs in these groups and may increase nephrotoxicity due to cyclooxygenase inhibition, especially in patients with impaired renal function (adequate fluid compensation should be provided in such patients).
• Alcohol: there may be an increased risk of adverse reactions, especially bleeding in the gastrointestinal tract.
• Cardiac glycosides: concomitant use of NSAIDs and cardiac glycosides may worsen heart failure, reduce glomerular filtration rate, and increase the concentration of cardiac glycosides in blood plasma.
• Cyclosporine: increased risk of nephrotoxicity with concomitant use of NSAIDs and cyclosporine.
• Glucocorticosteroids: increased risk of gastrointestinal ulcers and gastrointestinal bleeding.
• Lithium preparations: there is evidence of the likelihood of an increase in the concentration of lithium in blood plasma with the use of NSAIDs.
• Methotrexate: There is evidence for the likelihood of an increase in the concentration of methotrexate in blood plasma against the background of NSAID use. NSAIDs should be taken 24 hours before or after taking methotrexate.
• Mifepristone: NSAIDs should be started no earlier than 8-12 days after the end of mifepristone use, as NSAIDs may reduce the effectiveness of mifepristone.
• Quinolone-type antibiotics: patients receiving concomitant treatment with NSAIDs and quinolone antibiotics may have an increased risk of seizures.
• Tacrolimus: concomitant use of NSAIDs and tacrolimus may increase the risk of nephrotoxicity.
• Zidovudine: concomitant use of NSAIDs and zidovudine may lead to increased hematotoxicity.
• Oral hypoglycemic medications: blood glucose levels may change (it is recommended to increase the frequency of blood glucose monitoring).
• Phenytoin: it is possible to increase the serum level of phenytoin (it is recommended to monitor the serum level of phenytoin and, if necessary, adjust the dose).
• Potassium-sparing diuretics: concomitant use of potassium-sparing diuretics and flurbiprofen may lead to hyperkalemia.
• Probenecid and sulfinpyrazone: Medications containing probenecid or sulfinpyrazone may delay the elimination of flurbiprofen.
• Tolbutamide and antacids: To date, studies have found no interactions between flurbiprofen and tolbutamide or antacids.

How to take, course of use and dosage

Please read the instructions carefully before using the product.

For topical application. Only for short-term use.

Adults and children over 12 years of age: slowly dissolve 1 tablet every 3-6 hours.

Maximum daily dose: 5 tablets within 24 hours.

Duration of therapy: no more than 3 days.

If symptoms persist or worsen after taking the drug for 3 days, you should stop treatment and consult a doctor.

Overdose

Symptoms: nausea, vomiting, epigastric pain or, more rarely, diarrhea, tinnitus, headache, and gastrointestinal bleeding. In more severe cases, there are manifestations of the central nervous system: drowsiness, rarely-agitation, convulsions, disorientation, coma. In cases of severe poisoning, metabolic acidosis and increased prothrombin time, acute renal failure, liver tissue damage, decreased blood pressure, respiratory depression and cyanosis can develop. Patients with bronchial asthma may have an exacerbation of this disease.

Treatment: symptomatic, with mandatory provision of airway patency, monitoring of ECG and basic vital signs until the patient’s condition normalizes. Oral use of activated charcoal or gastric lavage within one hour of taking a potentially toxic dose of flurbiprofen is recommended. Frequent or prolonged seizures should be stopped by intravenous use of diazepam or lorazepam. When exacerbating bronchial asthma, the use of bronchodilators is recommended. There is no specific antidote to flurbiprofen.

Special instructions

It is recommended to take the drug in the shortest possible course and in the minimum effective dose necessary to eliminate symptoms.

Patients with diabetes should take into account that each honey-lemon resorption tablet contains about 2.5 g of sugar (0.21 XE) (orange resorption tablets do not contain sugar).

Orange resorption tablets contain liquid maltitol and isomalt (the maximum daily dose of which exceeds 2 g), so they can have a laxative effect.

When symptoms of gastropathy appear, careful monitoring is indicated, including esophagogastroduodenoscopy, 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.

During the treatment period, it is not recommended to take ethanol.

Patients with renal or hepatic insufficiency, as well as elderly patients and patients taking diuretics, should consult a doctor before using the drug, since there is a risk of deterioration of the functional state of the kidneys. With short-term use of the drug, the risk is insignificant.

Patients with a history of hypertension and / or chronic heart failure should consult a doctor before using the drug, as the drug can cause fluid retention, increased blood pressure and edema.

Information for women planning pregnancy: the drug suppresses cyclooxygenase and prostaglandin synthesis and may affect ovulation, disrupting female reproductive function (reversible after discontinuation of treatment).

If you experience irritation in the oral cavity, skin rash, mucosal lesions and other manifestations of an allergic reaction, you should stop using the drug and consult a doctor.

If existing symptoms worsen or new ones appear, including signs of bacterial infection, you should immediately consult a doctor to review therapy.

Form of production

Tablets for resorption

Storage conditions

Store in a dry place at a temperature not exceeding 25° C. Keep out of reach of children!

Shelf

life is 3 years.

Active ingredient

Flurbiprofen

Dosage form

Tablets