Nurofen Express Forte

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

Nurofen Express forte: instructions for use and reviews

1. Release form 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 Express forte

ATX code: M01AE01

Active ingredient: ibuprofen (ibuprofen)

Manufacturer: Pateon Softjels B. V (Netherlands), Banner Pharmacaps Europe B. V. (Netherlands)

Description and photo updated: 20.11.2018

Prices in pharmacies: from 172 rubles.

Buy

Nurofen Express forte is a non-steroidal anti-inflammatory drug (NSAID).

Release form and composition

Dosage form Nurofen Express forte - capsules: oval, with a gelatinous translucent red shell, with a longitudinal inscription NUROFEN on the body; contents - a clear liquid from colorless to light pink (4, 8 and 10 pcs. in blisters, in a cardboard box 1 or 2 blisters with 4, 8 or 10 capsules, or 3 blisters with 10 capsules).

Composition of 1 capsule:

active substance: ibuprofen - 400 mg;
auxiliary components: potassium hydroxide, macrogol 600, water;
shell: sorbitol (partially dehydrated), gelatin, water, crimson dye (Ponso 4R) (E124), white ink Opakod WB NS-78-I801 I [titanium dioxide (E171), propylene glycol, isopropanol, water, hypromellose 3cP].

Pharmacological properties

Pharmacodynamics

Ibuprofen is a propionic acid derivative from the NSAID group. The mechanism of its action is due to the ability to inhibit the synthesis of prostaglandins - mediators of inflammation, pain and hyperthermic reaction. The drug indiscriminately blocks the cyclooxygenases of groups 1 and 2 (COX-1 and COX-2) and, as a result, inhibits the synthesis of prostaglandins.

Ibuprofen has a rapid analgesic, anti-inflammatory and antipyretic effect. In addition, it reversibly inhibits platelet aggregation.

Pharmacokinetics

After oral administration, ibuprofen is rapidly and almost completely absorbed from the gastrointestinal tract. After taking 2 capsules of Nurofen Express forte on an empty stomach, the active substance in the blood plasma is detected after 15 minutes, after 30-40 minutes it reaches its maximum concentration. With simultaneous food intake, the time to reach maximum concentration may increase.

It is characterized by a high bond with plasma proteins - about 90%. The half-life is 2 hours. It slowly penetrates the vascular cavity, retains in the synovial fluid, where it creates higher concentrations than in the blood plasma.

After absorption, about 60% of the pharmacologically inactive R-form is slowly transformed into the active S-form. Metabolized in the liver. It is excreted in the form of metabolites (unchanged only about 1%), mainly by the kidneys and partly with bile.

No significant differences were found in the pharmacokinetic profile of ibuprofen in older people compared with younger people.

In limited studies of the use of ibuprofen during lactation, the drug was found in breast milk, but at very low concentrations.

Indications for use

According to the instructions, Nurofen Express forte is recommended for use in the following cases:

relief of pain: toothache, headache, muscle, rheumatic pain, as well as back pain, during menstruation and neuralgia, migraine;
decrease in fever: feverish conditions with colds and flu.

Contraindications

Absolute:

children under 12 years old;
III trimester of pregnancy;
decompensated heart failure;
period after coronary artery bypass grafting;
hemorrhagic diathesis, hemophilia and other blood clotting disorders (including hypocoagulation);
cerebrovascular or other bleeding;
confirmed hyperkalemia;
severe renal failure (creatinine clearance <30 ml / min);
liver disease in the active phase;
severe liver failure;
erosive and ulcerative diseases of the gastrointestinal tract in the acute stage (including peptic ulcer and 12 duodenal ulcer, ulcerative colitis, Crohn's disease);
peptic ulcer bleeding in the active phase or history (two or more confirmed episodes of peptic ulcer disease or ulcer bleeding);
a history of bleeding or perforation of an ulcer caused by the use of NSAIDs;
complete or incomplete combination of recurrent polyposis of the nose and paranasal sinuses, bronchial asthma and intolerance to acetylsalicylic acid or other NSAIDs (currently or in history);
intolerance to fructose;
individual sensitivity to any component in the composition of the drug.

Relative (Nurofen Express forte should be used with caution and only after consulting a doctor):

concomitant use of other NSAIDs;
concomitant use of drugs that may increase the likelihood of ulceration or bleeding, including oral glucocorticosteroids (eg, prednisolone), anticoagulants (eg, warfarin), selective serotonin reuptake inhibitors (eg, fluoxetine, sertraline, paroxetine, or citalopram), antiplatelet agents (including clopidogrel and acetylsalicylic acid);
elderly age;
I – II trimesters of pregnancy;
lactation period;
hyperbilirubinemia;
liver failure;
cirrhosis of the liver with portal hypertension;
nephrotic syndrome;
renal failure, including with dehydration (creatinine clearance <30-60 ml / min);
allergic diseases (in history or in the acute stage);
bronchial asthma;
the presence of Helicobacter pylori infection, colitis, ulcerative colitis, enteritis, gastritis, a history of a single episode of gastric ulcer or ulcerative bleeding;
peripheral arterial disease;
diabetes;
severe somatic diseases;
blood diseases of unknown etiology (for example, leukopenia or anemia);
cerebrovascular diseases;
phenylketonuria or phenylalanine intolerance;
arterial hypertension and / or heart failure;
systemic lupus erythematosus or mixed connective tissue disease (Sharp's syndrome);
dyslipidemia and hyperlipidemia;
frequent alcohol consumption;
smoking.

Instructions for use Nurofen Express forte: method and dosage

Nurofen Express Forte is indicated for oral administration. Capsules should be swallowed whole, without opening or biting, and washed down with plenty of water.

The recommended single dose is 1 capsule. The interval between doses is at least 4 hours. Number of receptions per day: for adults - up to 3 times, for adolescents 12-17 years old - no more than 2 times.

Nurofen Express forte is intended for short-term use. If, after 2-3 days of treatment, symptoms persist or worsen, a doctor's consultation is required.

Side effects

Side effects are dose-dependent, therefore the risk of their development is minimized when taking Nurofen Express Forte in the minimum effective dose for the shortest possible course.

The frequency of side effects was assessed according to the following criteria: very often - ≥ 1/10, often - from ≥ 1/100 to <1/10, infrequently - from ≥ 1/1000 to <1/100, rarely - from ≥ 1/10 000 up to <1/1000, very rarely - <1/10 000, the frequency is unknown - there are not enough data to estimate the frequency.

from the immune system: infrequently - hypersensitivity reactions, such as nonspecific allergic or anaphylactic reactions, eosinophilia; allergic rhinitis, skin reactions (purpura, urticaria, pruritus, angioedema, exfoliative and bullous dermatoses, including Stevens-Johnson syndrome, toxic epidermal necrolysis, erythema multiforme), reactions from the respiratory tract (shortness of breath, bronchospasm, exacerbation development of bronchial asthma); very rarely - severe hypersensitivity reactions (including shortness of breath, swelling of the tongue, larynx and face, arterial hypotension, tachycardia);
from the side of the blood and lymphatic system: very rarely - hematopoiesis disorders, such as anemia (including hemolytic and aplastic), thrombocytopenia, agranulocytosis, leukopenia, pancytopenia. The first symptoms of these disorders may be sore throat, fever, flu-like symptoms, superficial oral ulcers, nosebleeds, subcutaneous hemorrhages, bruising and bleeding of unknown etiology, severe weakness;
from the nervous system: infrequently - headache; very rarely - aseptic meningitis (isolated cases of such symptoms of aseptic meningitis as fever, headache, stiff neck, loss of orientation, nausea and vomiting, were observed in patients with autoimmune diseases - systemic lupus erythematosus or mixed connective tissue disease);
from the digestive system: infrequently - abdominal pain, dyspeptic disorders (including heartburn and bloating), nausea; rarely - diarrhea / constipation, flatulence, vomiting; very rarely - ulcerative stomatitis, melena, gastritis, perforation, peptic ulcer, gastrointestinal bleeding, bloody vomiting, in some cases fatal, especially in elderly patients; frequency unknown - exacerbation of colitis and Crohn's disease;
on the part of the kidneys and urinary system: very rarely - cystitis, interstitial nephritis, nephrotic syndrome, nephritic syndrome, hematuria, proteinuria, papillary necrosis, acute renal failure;
from the liver and biliary tract: very rarely - liver dysfunction (especially with prolonged use), jaundice, hepatitis;
from the respiratory system: the frequency is unknown - shortness of breath, bronchospasm, bronchial asthma;
on the part of the cardiovascular system: the frequency is unknown - increased blood pressure, peripheral edema, heart failure; with long-term treatment - thrombotic complications (for example, stroke or myocardial infarction);
laboratory parameters: increased activity of hepatic transaminases, plasma creatinine concentration, bleeding time, decreased creatinine clearance, plasma glucose concentration, hemoglobin, hematocrit.

The above adverse reactions have been reported with short-term intake of Nurofen Express Forte in daily doses up to 1200 mg. It should be borne in mind that with prolonged use of the drug and in the treatment of chronic diseases, other side effects may appear.

Overdose

In children, signs of overdose are possible after taking a dose of more than 400 mg / kg. In adult patients, the dose-dependent effect of overdose is less pronounced. The half-life of ibuprofen in case of an overdose is 1.5-3 hours.

Symptoms: epigastric pain, nausea and vomiting; less often - headache, tinnitus, diarrhea, gastrointestinal bleeding. In more severe cases, reactions from the central nervous system are possible: drowsiness, increased agitation, disorientation, convulsions, coma. In severe poisoning, there is a risk of an increase in prothrombin time, damage to liver tissue, a decrease in blood pressure, the development of acidosis, cyanosis and acute renal failure, and respiratory depression. In patients with bronchial asthma, the disease may worsen.

Treatment is symptomatic. It is imperative to ensure airway patency, monitor the electrocardiogram and vital signs until the patient's condition returns to normal. If after taking a potentially toxic dose of Nurofen Express Forte no more than an hour has passed, it is recommended to perform a gastric lavage and / or take activated charcoal. If more than one hour has passed, the ibuprofen has already been absorbed, so alkaline drinking and forced diuresis may be prescribed to remove it. Frequent or prolonged seizures are treated with diazepam or intravenous lorazepam. Patients with bronchial asthma, if it worsens, are prescribed bronchodilators.

special instructions

Nurofen Express forte must be taken in the minimum dose sufficient to eliminate symptoms, in the shortest possible course.

With prolonged therapy, the peripheral blood picture, the functional state of the kidneys and liver should be monitored. Patients with symptoms of gastropathy require careful monitoring of the condition, including a fecal occult blood test, a complete blood count (determination of Hb), and esophagogastroduodenoscopy.

Nurofen Express forte should be canceled 48 hours before the analysis for the determination of 17-ketosteroids.

It is recommended to refrain from drinking alcohol during treatment.

Women planning a pregnancy should be aware that ibuprofen can interfere with ovulation, thereby impairing fertility. After discontinuation of treatment, this effect is reversible.

Influence on the ability to drive vehicles and complex mechanisms

In case of visual impairment, the development of dizziness, drowsiness, lethargy during treatment with ibuprofen, it is recommended to refrain from performing potentially hazardous activities, including working with complex mechanisms and driving vehicles.

Application during pregnancy and lactation

Nurofen Express forte is contraindicated in the third trimester of pregnancy. In the I and II trimesters of pregnancy, the use of the drug is recommended to be avoided, if necessary, you should consult your doctor.

Ibuprofen passes into breast milk, but in small amounts that do not have a negative effect on the baby, so there is no need to stop breastfeeding if treatment with the drug is short-term. However, if long-term therapy is required, you should consult your doctor about the advisability of continuing or stopping breastfeeding while taking Nurofen Express forte.

Pediatric use

Nurofen Express forte is contraindicated in children under 12 years of age. The maximum daily dose for children 12-17 years old is 800 mg.

With impaired renal function

Contraindicated: severe renal failure (creatinine clearance <30 ml / min).

Caution is required: the presence of concomitant kidney disease.

For violations of liver function

Contraindicated: active liver disease, severe liver failure.

Caution is required: liver failure, cirrhosis of the liver with portal hypertension.

Use in the elderly

Nurofen Express forte should be used by elderly patients on the recommendation of a doctor.

Drug interactions

Nurofen Express forte should be used with caution in combination with the following agents, since there is a possibility of their interaction:

glucocorticosteroids: the risk of ulceration and bleeding from the gastrointestinal tract increases;
anticoagulants (including warfarin) and thrombolytic drugs: their effect may increase;
lithium preparations, methotrexate: their concentration in blood plasma increases;
mifepristone: its effectiveness decreases (you can start taking ibuprofen no earlier than 8–12 days after discontinuation of mifepristone);
cardiac glycosides: an increase in their concentration in blood plasma, aggravation of heart failure, a decrease in the glomerular filtration rate is possible;
quinolone antibiotics: seizures may occur;
antiplatelet agents and selective serotonin reuptake inhibitors: gastrointestinal bleeding may occur;
cyclosporine, tacrolimus: the risk of nephrotoxicity increases;
zidovudine: increased hematotoxicity. There is an increased risk of hematomas and hemarthrosis in HIV-positive patients with concomitant hemophilia;
diuretics, antihypertensive drugs (ACE inhibitors and ARA II): their effectiveness may decrease, and the nephrotoxicity of ibuprofen may increase with the use of diuretics.

Nurofen Express forte is not recommended to be used simultaneously with the following drugs due to the risk of unwanted interactions:

other NSAIDs, in particular selective COX-2 inhibitors: the risk of side effects increases;
acetylsalicylic acid (ASA): the risk of side effects increases; When ASA is taken in low doses as an antiplatelet agent, its anti-inflammatory and antiplatelet effect decreases, which may increase the incidence of acute coronary insufficiency.

Analogs

According to the active substance, the analogues of Nurofen Express forte are: Brufen SR, Deep Relief, Brudol for children, Bonifen, Deblok, Nurofen, Ibuprofen Sandoz, Advil Maximum, Ibuprofen, Dolgit, Ibuprofen-Hemofarm, Advil, Ibuprofen-Akrikhin, Advil, Ibuprofen-Akrikhin children, MIG for children, Ibuprofen for children, Nurofen for children, Ibufen, Nebolin caps, MIG for babies, Nurofen Express Neo, MIG 400, Next Uno Express, Ibuprofen-Verte, Maxikold for children, Nurofen forte, Sedalgin SPRINT, Nurofen Rapid forte, Pedea, Faspik, Solpaflex.

Terms and conditions of storage

Store for no more than 3 years out of the reach of children at temperatures up to 25 ° C.

Terms of dispensing from pharmacies

Available without a prescription.

Reviews about Nurofen Express Fort

Reviews of Nurofen Express Forte are mostly positive: the drug quickly relieves pain, reduces fever, and is sold in almost all pharmacies.

The disadvantages of the drug include a relatively high price, a large list of contraindications and possible side effects.

Price for Nurofen Express forte in pharmacies

The price for Nurofen Express Forte for 10 capsules is about 190-210 rubles, for 20 capsules - 375-425 rubles.