Nurofen Forte

2024 Author: Rachel Wainwright | [email protected]. Last modified: 2023-12-15 07:39

Nurofen Forte: instructions for use and reviews

1. Form of release and composition
2. Pharmacological properties
3. Indications for use
4. Contraindications
5. Method of application and dosage
6. Side effects
7. Overdose
8. Special instructions
9. Application during pregnancy and lactation
10. Use in childhood
11. In case of impaired renal function
12. For violations of liver function
13. Use in the elderly
14. Drug interactions
15. Analogs
16. Terms and conditions of storage
17. Terms of dispensing from pharmacies
18. Reviews
19. Price in pharmacies

Latin name: Nurofen Forte

ATX code: M01AE01

Active ingredient: Ibuprofen (Ibuprofen)

Manufacturer: Reckitt Benckiser Healthcare International Ltd. (United Kingdom)

Description and photo update: 2018-22-10

Prices in pharmacies: from 79 rubles.

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Nurofen Forte is a drug with analgesic, anti-inflammatory and antipyretic effects.

Form of release and composition

The dosage form of Nurofen Forte is coated tablets: sugar, white, biconvex, round, red overprint “Nurofen 400” on one side (6 or 12 pieces in blisters, 1 or 2 blisters in a cardboard box).

Composition of 1 tablet:

active substance: ibuprofen - 400 mg;
auxiliary components: stearic acid - 4 mg; colloidal silicon dioxide - 2 mg; croscarmellose sodium - 60 mg; sodium lauryl sulfate - 1 mg; sodium citrate - 87 mg;
shell: acacia gum - 1.2 mg; sucrose - 232.2 mg; macrogol 6000 - 0.4 mg; carmellose sodium - 1.4 mg; titanium dioxide - 2.8 mg; talc - 66 mg;
ink: Opakod S-1-15094 red: aqueous ammonia - 1%; butanol - 14%; isopropanol - 7%; simethicone - 0.01%; propylene glycol - 5.5%; shellac - 41.49%; dye iron oxide red (E172) - 31%.

Pharmacological properties

Pharmacodynamics

Nurofen Forte is an NSAID (non-steroidal anti-inflammatory drug). It has a directed fast effect against pain (analgesic), and also has an anti-inflammatory and antipyretic effect.

The mechanism of action of the active substance, ibuprofen (a propionic acid derivative), is due to the inhibition of the synthesis of prostaglandins, which are mediators of pain, hyperthermic reaction and inflammation. Indiscriminately blocks COX-1 and COX-2, which leads to inhibition of prostaglandin synthesis. Ibuprofen also reversibly inhibits platelet aggregation. The analgesic effect of Nurofen Forte lasts up to 8 hours.

Pharmacokinetics

Absorption: has a high absorption, almost completely and quickly absorbed from the gastrointestinal tract. After taking on an empty stomach, the maximum plasma concentration of the substance in the blood is reached after 45 minutes, together with food - from 1 to 2 hours.

Distribution: binding to blood plasma proteins is 90%. It penetrates slowly into the joint cavity, is retained in the synovial fluid, while higher concentrations are created in it than in the blood plasma. Compared to blood plasma, ibuprofen is found in cerebrospinal fluid at lower concentrations.

Limited research has shown that very low concentrations of the substance are found in breast milk.

Metabolism: After absorption, approximately 60% of the pharmacologically inactive R-form is slowly transformed into the active S-form. Metabolism takes place in the liver.

Withdrawal: the half-life is 2 hours. It is excreted by the kidneys (no more than 1% - unchanged), with bile - to a lesser extent.

Indications for use

fever associated with influenza and acute respiratory viral infection;
headache;
toothache;
migraine;
neuralgia;
algodismenorrhea;
myalgia;
back pain;
rheumatic pains.

Contraindications

Absolute:

erosive and ulcerative diseases of the gastrointestinal tract (including peptic ulcer and duodenal ulcer, ulcerative colitis, Crohn's disease), ulcerative bleeding in the active phase, or the presence of a burdened history (from two confirmed episodes of peptic ulcer or ulcer bleeding);
a combination (complete / partial) of bronchial asthma, recurrent polyposis of the paranasal sinuses / nose and intolerance to acetylsalicylic acid or other NSAIDs (including a burdened history);
active phase of liver disease, severe liver failure;
period after coronary artery bypass grafting;
burdened history of bleeding / perforation of gastrointestinal ulcers associated with the use of NSAIDs;
hemorrhagic diathesis;
diagnosed hyperkalemia;
severe renal failure (with creatinine clearance <30 ml / min);
decompensated heart failure;
hemophilia and other blood clotting disorders (including hypocoagulation);
cerebrovascular or other bleeding;
glucose-galactose malabsorption, fructose intolerance, sucrase-isomaltase deficiency;
age up to 12 years;
III trimester of pregnancy;
individual intolerance to the components of the drug.

Relative (diseases / conditions in the presence of which the appointment of Nurofen Forte requires caution):

arterial hypertension / heart failure, cerebrovascular diseases;
the presence of a burdened history of a single episode of gastric ulcer or ulcerative bleeding of the gastrointestinal tract;
presence of Helicobacter pylori infection, gastritis, colitis, enteritis, ulcerative colitis;
peripheral arterial disease;
bronchial asthma or allergic diseases in an exacerbation stage or a burdened history (due to the likelihood of bronchospasm);
combined use with other NSAIDs;
blood diseases of unknown origin (anemia and leukopenia);
dyslipidemia / hyperlipidemia;
severe somatic diseases;
diabetes;
renal failure, including with dehydration (with creatinine clearance less than 30-60 ml / min), nephrotic syndrome;
systemic lupus erythematosus or mixed connective tissue diseases (Sharp's syndrome) (due to an increased risk of developing aseptic meningitis);
liver failure, liver cirrhosis with portal hypertension, hyperbilirubinemia;
frequent alcohol consumption;
smoking;
combined use with drugs that may increase the likelihood of ulceration or bleeding, including oral glucocorticosteroids, anticoagulants, selective serotonin reuptake inhibitors or antiplatelet agents;
I – II trimesters of pregnancy, lactation period;
elderly age.

Instructions for the use of Nurofen Forte: method and dosage

Nurofen Forte is taken orally with water. In the presence of hypersensitivity of the stomach, it is recommended to take the drug with meals.

A single dose - 1 tablet, the frequency of administration - 3 times a day (at intervals of at least 6 hours).

The maximum daily dose for children 12-18 years old is 2 tablets, for adults - 3 tablets.

Nurofen Forte should only be taken for a short time. If symptoms persist / intensify for 2-3 days of therapy, the drug should be discontinued and a specialist should be consulted.

Side effects

If the recommended regimen for the use of Nurofen Forte is observed, the likelihood of developing adverse reactions is minimal.

In elderly patients, the incidence of disorders is higher, especially manifested in the form of perforations and gastrointestinal bleeding (sometimes fatal).

Side effects are predominantly dose-dependent.

Possible side reactions with a short-term course in a daily dose of Nurofen Forte up to 3 tablets (> 10% - very often;> 1% and 0.1% and 0.01% and <0.1% - rarely; <0.01% - rarely):

hematopoietic system: very rarely - hematopoietic disorders in the form of leukopenia, anemia, hemolytic / aplastic anemia, pancytopenia, thrombocytopenia, agranulocytosis (the first symptoms appear as severe weakness, flu-like symptoms, fever, sore throat, superficial ulcers in the oral cavity, subcutaneous hemorrhage bleeding from the nose, bruising / bleeding of unknown origin);
immune system: infrequently - hypersensitivity reactions, respiratory tract reactions [including bronchial asthma (including its exacerbation), shortness of breath, bronchospasm, dyspnea], skin reactions (in the form of itching, urticaria, purpura, angioedema, exfoliative / bullous dermatoses, including toxic epidermal necrolysis, Stevens-Johnson syndrome, erythema multiforme), eosinophilia, allergic rhinitis; very rarely - hypersensitivity reactions in severe course (including edema of the face, larynx and tongue), tachycardia, shortness of breath, arterial hypotension;
digestive system: infrequently - abdominal pain, nausea, dyspepsia (including bloating, heartburn); rarely - diarrhea, constipation, flatulence, vomiting; very rarely - melena, peptic ulcer, gastrointestinal bleeding or perforation, bloody vomiting (in some cases fatal, especially in elderly patients), gastritis, ulcerative stomatitis; with an unknown frequency - exacerbation of Crohn's disease and colitis;
liver / biliary tract: very rarely - violations of hepatic function, increased activity of hepatic transaminases, jaundice, hepatitis;
urinary system: very rarely - decompensated / compensated acute renal failure (especially with a long course, in combination with an increase in the plasma concentration of urea in the blood and the appearance of edema, proteinuria and hematuria), nephrotic / nephritic syndrome, interstitial nephritis, papillary necrosis, cystitis;
nervous system: infrequently - headache; very rarely - aseptic meningitis;
cardiovascular system: with an unknown frequency - heart failure, peripheral edema; with prolonged use, the likelihood of thrombotic complications increases, an increase in blood pressure;
respiratory system: with an unknown frequency - shortness of breath, bronchospasm, bronchial asthma;
laboratory parameters: decrease in hematocrit / hemoglobin, plasma glucose concentration in the blood, creatinine clearance; an increase in bleeding time, plasma creatinine concentration, hepatic transaminase activity.

With a long course / treatment of chronic conditions, the development of other disorders may be observed.

Overdose

Overdose symptoms in children may appear after taking Nurofen Forte at a dose above 400 mg / kg. The dose-dependent effect of overdose in adults is less pronounced. In case of an overdose, the half-life of the drug varies from 1.5 to 3 hours.

The main symptoms are vomiting, nausea, epigastric pain, and in more rare cases, tinnitus, diarrhea, gastrointestinal bleeding and headache. In more severe cases, disturbances from the central nervous system are possible, manifested in the form of drowsiness, less often - excitement, convulsions, disorientation, coma. In severe poisoning, metabolic acidosis and an increase in prothrombin time, renal failure, liver tissue damage, lowering blood pressure, respiratory depression and cyanosis are possible. With bronchial asthma, its aggravation is possible.

Therapy is symptomatic, including the mandatory provision of airway patency, ECG monitoring and vital signs (until the condition normalizes). Within 1 hour after taking a potentially toxic dose of Nurofen Forte, it is recommended to ingest activated charcoal or gastric lavage. If the drug has already been absorbed, an alkaline drink is prescribed (for the excretion of the acidic ibuprofen derivative by the kidneys), forced diuresis. Prolonged / frequent seizures should be treated with diazepam or lorazepam (intravenous). In cases of aggravation of bronchial asthma, bronchodilators are usually prescribed.

special instructions

With systemic lupus erythematosus or mixed connective tissue diseases, the likelihood of aseptic meningitis increases.

If it is necessary to take Nurofen Forte for more than 10 days, a medical consultation is required.

Taking the drug for bronchial asthma or allergic diseases in the acute stage, as well as with a burdened history of bronchial asthma / allergic diseases, can provoke bronchospasm.

During a long course, monitoring of the functional state of the kidneys / liver and the picture of peripheral blood is required.

In cases of the onset of symptoms of gastropathy, careful monitoring of the condition is required, including esophagogastroduodenoscopy, general blood test (determination of hemoglobin), and fecal occult blood test.

If it is necessary to determine 17-ketosteroids 48 hours before the study, Nurofen Forte should be canceled.

Taking ethanol during therapy is not recommended.

Due to the fact that Nurofen Forte against the background of arterial hypertension, including a history of, and / or chronic heart failure can lead to fluid retention, increased blood pressure and edema, you should consult your doctor before starting therapy.

When planning pregnancy, women should take into account that Nurofen Forte affects ovulation, inhibits COX and prostaglandin synthesis, leading to impaired female reproductive function (is reversible).

Influence on the ability to drive vehicles and complex mechanisms

If during the period of therapy the development of dizziness, drowsiness, lethargy or visual impairment is observed, you should refuse to drive vehicles.

Application during pregnancy and lactation

I – II trimesters of pregnancy - before prescribing the drug, you must consult a doctor;
III trimester - Nurofen Forte is contraindicated.

With a short use of the drug, there is no need to refuse breastfeeding (there is no negative effect on the child's health). In cases of a long course, a medical consultation is required.

Pediatric use

According to the instructions, Nurofen Forte is not prescribed for children under 12 years old.

With impaired renal function

severe renal failure (with creatinine clearance <30 ml / min) - therapy is contraindicated;
renal failure, including dehydration (with creatinine clearance <30-60 ml / min), nephrotic syndrome - the appointment of Nurofen Forte requires caution.

For violations of liver function

severe liver failure or liver disease in the active phase - therapy is contraindicated;
liver failure, liver cirrhosis with portal hypertension, hyperbilirubinemia - the appointment of Nurofen Forte requires caution.

Use in the elderly

In old age, the use of Nurofen Forte requires caution.

Drug interactions

Contraindicated combinations:

acetylsalicylic acid (except for low doses - up to 75 mg per day): a decrease in its anti-inflammatory / antiplatelet effect; an increase in the likelihood of adverse reactions (there may be an increase in the incidence of acute coronary insufficiency in patients who receive small doses of acetylsalicylic acid as an antiplatelet agent after starting ibuprofen);
selective inhibitors of COX-2 and other NSAIDs: an increase in the likelihood of side effects.

Combinations requiring caution:

diuretics and antihypertensive drugs (angiotensin-converting enzyme inhibitors and angiotensin II receptor antagonists): decrease in their effectiveness, possibly worsening renal function;
thrombolytic drugs, anticoagulants: enhancing their effect;
selective serotonin reuptake inhibitors and antiplatelet agents: increasing the likelihood of gastrointestinal bleeding;
lithium preparations: an increase in the plasma concentration of lithium in the blood;
glucocorticosteroids: an increase in the likelihood of gastrointestinal ulceration and gastrointestinal bleeding;
cardiac glycosides: worsening of heart failure, a decrease in the glomerular filtration rate and an increase in their plasma concentration in the blood;
methotrexate: an increase in its plasma concentration in the blood;
tacrolimus: increased risk of nephrotoxicity;
tricyclic antidepressants, rifampicin, ethanol, phenytoin, barbiturates, phenylbutazone and other inducers of microsomal oxidation: an increase in the production of hydroxylated active metabolites, an increase in the likelihood of severe intoxication;
cyclosporine: increased likelihood of nephrotoxicity;
mifepristone: a decrease in its effects; Nurofen Forte can be taken 8–12 days after its withdrawal;
zidovudine: increased hematotoxicity;
drugs that block tubular secretion: an increase in plasma concentration and a decrease in the excretion of ibuprofen;
cholestyramine, antacids: decreased absorption;
insulin, oral hypoglycemic drugs, sulfonylurea derivatives: increased drug action;
ethanol, estrogens: an increase in the likelihood of adverse reactions;
uricosuric drugs: decrease in their effectiveness;
antibacterial drugs of the quinolone series: an increase in the likelihood of seizures;
plikamycin, cefoperazone, cefamandol, valproic acid, cefotetan: an increase in the incidence of hypoprothrombinemia;
caffeine: increased analgesic effect;
myelotoxic drugs: increased hematotoxicity;
inhibitors of microsomal oxidation: reducing the likelihood of hepatotoxic effects.

Analogs

The analogues of Nurofen Forte are: MIG 400, Solpaflex, Pedea, Nebolin, Ibufen, Ibuprofen, Deblok, Advil, Bonifen, Dolgit, Faspik and others.

Terms and conditions of storage

Store at temperatures up to 25 ° C. Keep out of the reach of children.

The shelf life is 3 years.

Terms of dispensing from pharmacies

Available without a prescription.

Reviews about Nurofen Forte

According to reviews, Nurofen Forte has a quick analgesic effect for pain of various origins. In some cases, the development of side effects is noted.

Price for Nurofen Forte in pharmacies

The approximate price for Nurofen Forte (12 tablets per pack) is 95–105 rubles.

Nurofen Forte: prices in online pharmacies

Drug name

Price

Pharmacy

Nurofen forte 400 mg film-coated tablets 12 pcs.

79 RUB

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Nurofen Forte tablets p.o. 400mg 12 pcs.

92 RUB

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Maria Kulkes Medical journalist About the author

Education: First Moscow State Medical University named after I. M. Sechenov, specialty "General Medicine".

Information about the drug is generalized, provided for informational purposes only and does not replace the official instructions. Self-medication is hazardous to health!