Teraflex Advance - Instructions For Use, Price, Reviews, Analogues

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

Teraflex Advance

Teraflex Advance: instructions for use and reviews

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

Latin name: Theraflex Advance

ATX code: M01AE51

Active ingredient: glucosamine + ibuprofen + chondroitin sulfate (glucosamine + ibuprofen + chondroitin sulfate)

Manufacturer: Contract Pharmacal Corporation (USA)

Description and photo update: 2018-22-10

Prices in pharmacies: from 1000 rubles.

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Teraflex Advance is a combined drug that stimulates the regeneration of cartilage tissue, has analgesic and anti-inflammatory effects.

Release form and composition

Teraflex Advance is produced in the form of capsules: size No. 0, gelatinous solid, opaque, cap - blue, body - white, with the inscription THERAFLEX ADVANCE in blue; the contents of the capsules are almost white or white powder with a slight odor (30, 60 or 120 pcs. in a high density polyethylene bottle, 1 bottle in a cardboard box).

1 capsule contains:

• active ingredients: ibuprofen ^* - 100 mg; chondroitin sodium sulfate ^** - 200 mg, glucosamine sulfate (in the form of D-glucosamine sulfate of potassium chloride) - 250 mg;
• additional components: povidone, corn starch (pregelatinized starch), microcrystalline cellulose (MCC), sodium carboxymethyl starch, stearic acid, magnesium stearate, crospovidone, silicon dioxide;
• capsule shell: titanium dioxide, gelatin, brilliant blue dye-based aluminum varnish;
• ink composition: propylene glycol USP, shellac NF, butyl alcohol NF, isopropyl alcohol USP, ethyl alcohol USP, indigo carmine aluminum varnish, ammonia solution NF, titanium dioxide USP.

^* Included in the form of granules obtained by direct compression, 66% (including: ibuprofen - 66%, croscarmellose sodium - 2%, pregelatinized starch - 8%, MCC - 14%, corn starch - 6%, silicon colloidal dioxide - 1%, povidone - 1.5%, stearic acid - 1.5%) - 152 mg.

^** Included in the form of 90% of the substance (taking into account 10% of loss in mass during drying and excess) - 241 mg.

Pharmacological properties

Pharmacodynamics

Teraflex Advance is a tissue repair stimulant with a non-steroidal anti-inflammatory effect. The effect of the drug is due to the properties of the active substances included in its composition:

• ibuprofen, a non-steroidal anti-inflammatory drug (NSAID) derived from propionic acid; demonstrates analgesic, antipyretic and anti-inflammatory effects resulting from the ongoing indiscriminate blockade of cyclooxygenase 1 and 2 (COX-1 and COX-2);
• chondroitin sulfate - plays an important role in the process of building and restoring cartilage tissue, prevents its destruction and helps to improve joint mobility;
• glucosamine sulfate - stimulates the production of proteoglycans, chondroitinsulphuric, hyaluronic acids and other substances contained in cartilage tissue, intra-articular fluid and articular membranes.

Chondroitin sulfate and glucosamine sulfate, which are in the composition of the drug, enhance the analgesic activity of ibuprofen.

Pharmacokinetics

Ibuprofen

The agent is well absorbed from the gastrointestinal tract (GIT). The maximum concentration (C _max) in plasma is observed 1 hour after administration, binding to proteins is about 99%. It is characterized by a slow distribution in the synovial fluid and a slower excretion from it than from plasma. The substance is biotransformed in the liver, mainly through hydroxylation and carboxylation of the isobutyl group with the participation of the CYP2C9 isoenzyme. Approximately 60% of the pharmacologically inactive R-form of ibuprofen is slowly converted to the active S-form after absorption.

Elimination of the substance is characterized by two-phase kinetics. The half-life (T _½) from plasma is from 2 to 3 hours, in the form of metabolites (or their conjugates) in urine, up to 90% of the dose taken is detected. Less than 1% is excreted unchanged in the urine and in small quantities in the bile. The product is completely removed within 24 hours.

Chondroitin sulfate

More than 70% of the substance is absorbed from the gastrointestinal tract, bioavailability is approximately 13%. After a single oral intake of a therapeutic dose of the substance, C _max is observed in plasma after 3-4 hours, in synovial fluid - after 4-5 hours. Accumulates after absorption in the joint cavity in the synovial fluid, excreted in the urine.

Glucosamine sulfate

When taken orally, it is characterized by the effect of the first passage through the liver, as a result of which the bioavailability of the substance reaches 25%. The highest concentrations of the agent are found in the kidneys, liver and articular cartilage. In muscle and bone tissue approximately 30% of the taken dose persists for a long time. The substance is excreted unchanged, mostly with urine, partly with feces. T _½ is 68 hours.

Indications for use

• osteoarthritis of large joints;
• osteochondrosis of the spine, occurring with moderate pain syndrome.

Contraindications

Absolute:

• incomplete or complete combination of recurrent polyposis rhinosinusitis and bronchial asthma;
• ulcerative colitis, Crohn's disease, stage of exacerbation of gastric ulcer and 12 duodenal ulcer, as well as other erosive and ulcerative defects of the digestive tract;
• intracranial hemorrhage and gastrointestinal bleeding;
• hemorrhagic diathesis, hemophilia, hypocoagulation and other blood clotting disorders;
• diagnosed hyperkalemia;
• severe heart failure, the period after the operation of coronary artery bypass grafting;
• active liver disease, severe liver failure;
• progressive kidney disease, severe renal failure [creatinine clearance (CC) <30 ml / min];
• period of pregnancy and lactation;
• age up to 18 years;
• a history of intolerance to acetylsalicylic acid or other NSAIDs;
• hypersensitivity to any component of the product.

Relative (use Teraflex Advance with extreme caution):

• heart failure, ischemic heart disease (CHD);
• arterial hypertension;
• cerebrovascular lesions;
• liver failure, liver cirrhosis with portal hypertension;
• renal failure mild / moderate (CC ≥ 30 ml / min);
• nephrotic syndrome;
• a history of indication of gastric ulcer and 12 duodenal ulcer;
• colitis, enteritis, gastritis;
• presence of Helicobacter pylori infection;
• hyperbilirubinemia;
• anemia, leukopenia and other blood diseases of unknown etiology;
• diabetes;
• peripheral arterial lesions;
• dyslipidemia / hyperlipidemia;
• tuberculosis;
• bronchial asthma;
• severe somatic diseases;
• smoking and / or alcoholism;
• long-term use of NSAIDs;
• combined use with antiplatelet agents, anticoagulants, glucocorticosteroids (GCS), selective serotonin reuptake inhibitors (SSRIs).

In the presence of intolerance to seafood (shellfish, shrimp) during the period of drug treatment, the threat of side effects in the form of allergic reactions is aggravated.

Instructions for the use of Teraflex Advance: method and dosage

Teraflex Advance is taken orally after meals with a little water.

The drug is prescribed 3 times a day, 2 capsules. Without the agreement of the attending physician, the course of therapy should not exceed 21 days. Longer use of Teraflex Advance is possible only after consulting a specialist.

Side effects

• respiratory system: bronchospasm, shortness of breath;
• cardiovascular system: increased risk of arterial thrombosis, development or intensification of manifestations of heart failure, increased blood pressure (BP), tachycardia;
• hepatobiliary system: hepatitis;
• Gastrointestinal tract: ulceration of the gingival mucosa, pain in the mouth, dryness / irritation of the oral mucosa, aphthous stomatitis, NSAIDs-gastropathy (flatulence, decreased appetite, vomiting, diarrhea / constipation, nausea, heartburn, abdominal pain; rarely - ulceration of the gastrointestinal mucosa, in some cases with perforation and bleeding), exacerbation of Crohn's disease and colitis, pancreatitis;
• urinary system: edema (nephrotic syndrome), acute renal failure, cystitis, polyuria, allergic nephritis;
• hematopoietic organs: leukopenia, agranulocytosis, thrombocytopenic purpura and thrombocytopenia, anemia (including aplastic and hemolytic);
• nervous system: dizziness, drowsiness, headache, insomnia, irritability and nervousness, anxiety, psychomotor agitation, hallucinations, confusion, depression; rarely - aseptic meningitis (mainly in the presence of autoimmune diseases);
• allergic reactions: pruritus, skin rash (usually erythematous or urticaria), anaphylactoid reactions, Quincke's edema, anaphylactic shock, toxic epidermal necrolysis, exudative erythema multiforme (including Stevens-Johnson syndrome), fever, rhinitis, eosinophilus
• sensory organs: ringing / tinnitus, hearing loss, blurred vision or double vision, dryness and irritation of the eyes, toxic damage to the optic nerve, swelling of the eyelids and conjunctiva of an allergic nature, scotoma;
• laboratory parameters: possible increase in bleeding time, decrease in CC, serum glucose concentration, hematocrit / hemoglobin level; the activity of hepatic transaminases, the concentration of serum creatinine, the level of urea or bilirubin in the blood may increase;
• others: increased sweating.

Overdose

Symptoms of an ibuprofen-induced overdose may include: tinnitus, drowsiness, headache, lethargy, depression, metabolic acidosis, acute renal failure, coma, vomiting, abdominal pain, nausea, hypokalemia / hyperkalemia, respiratory arrest, atrial fibrillation, decreased, tachycardia, bradycardia.

In case of suspicion of an overdose, gastric lavage is prescribed (the effect is observed only within 1 hour after ingestion), alkaline drinking, the use of activated carbon, forced diuresis, symptomatic treatment aimed at correcting blood pressure and acid-base state.

special instructions

When carrying out long-term therapy, it is necessary to control the activity of the liver and kidneys, the picture of peripheral blood.

If symptoms of gastropathy occur while taking Teraflex Advance, careful monitoring is recommended, including esophagogastroduodenoscopy, blood test with the establishment of hematocrit and hemoglobin levels, and fecal occult blood test.

With the combined use of the drug with analgesics or other NSAIDs, it is required to take into account the presence of ibuprofen in Teraflex Advance. If it is necessary to take additional NSAIDs for a long time, it is recommended to use the drug Teraflex, which does not include ibuprofen.

If a 17-ketosteroid test is prescribed during treatment, the drug should be discontinued 48 hours before the start of this study.

During the period of therapy, you should stop taking ethanol.

Influence on the ability to drive vehicles and complex mechanisms

Persons who drive vehicles or any other potentially dangerous and complex machinery are advised to refrain from this activity during the course of using Theraflex Advance.

Application during pregnancy and lactation

It is not recommended to use Teraflex Advance during pregnancy and lactation.

Pediatric use

According to the instructions, Teraflex Advance is not prescribed to patients under 18 years of age.

With impaired renal function

The use of Teraflex Advance is contraindicated in patients with progressive kidney disease or severe renal failure (CC <30 ml / min).

In the presence of mild / moderate renal failure, the drug is recommended to be taken with caution.

For violations of liver function

Patients with severe liver failure or active liver disease are contraindicated to take Teraflex Advance.

In the presence of a milder degree of liver failure or cirrhosis of the liver with portal hypertension, the drug should be used with caution.

Use in the elderly

Elderly patients are advised to take Teraflex Advance with caution.

Drug interactions

• inhibitors of microsomal oxidation - the risk of a hepatotoxic effect is reduced;
• barbiturates, tricyclic antidepressants, phenylbutazone, phenytoin, rifampicin, ethanol (inducers of microsomal oxidation) - the threat of severe hepatotoxic reactions is aggravated due to an increase in the production of hydroxylated active metabolites of ibuprofen;
• antiplatelet agents, indirect anticoagulants, fibrinolytics - their therapeutic effect increases, which leads to an increased likelihood of hemorrhagic complications;
• oral antidiabetic agents and insulin - their effectiveness increases;
• blockers of slow calcium channels, angiotensin-converting enzyme inhibitors and other vasodilators - the hypotensive effect of these drugs is weakened;
• NSAIDs, GCS, ethanol, estrogens, colchicine - the ulcerogenic effect is enhanced, including with the occurrence of bleeding;
• hydrochlorothiazide, furosemide - the diuretic and natriuretic activity of these drugs is weakened;
• drugs that block tubular secretion - excretion decreases and the plasma level of ibuprofen increases;
• acetylsalicylic acid - its anti-inflammatory and antiplatelet effect is weakened (when acetylsalicylic acid is taken in small doses as an antiplatelet agent, the risk of acute coronary insufficiency may increase at the beginning of the course of treatment with ibuprofen);
• uricosuric drugs, chloramphenicol, semisynthetic penicillins, doxorubicin, etoposide, teniposide, hypoglycemic agents, mifepristone - the effect of these drugs may decrease;
• valproic acid, cefotetan, cefamandol, plikamycin, cefoperazone - the likelihood of developing hypoprothrombinemia increases;
• methotrexate, digoxin, lithium preparations - their concentration in the blood increases;
• anticoagulant and thrombolytic drugs (urokinase, alteplase, streptokinase), warfarin, drugs containing glucosamine - the risk of bleeding is aggravated (monitoring of blood coagulation indicators is required);
• cyclosporine - its plasma concentration increases under the influence of ibuprofen and the threat of hepatotoxic effects increases;
• cholestyramine, antacids - absorption of ibuprofen decreases;
• gold preparations, cyclosporine - the nephrotoxicity of ibuprofen increases;
• myelotoxic drugs - the manifestations of hematotoxicity are aggravated;
• antibiotics of the tetracycline group - their absorption increases;
• potassium-sparing diuretics - the threat of hyperkalemia increases;
• tacrolimus - may increase nephrotoxicity;
• quinolones - the risk of seizures is aggravated;
• zidovudine - an increase in the hematological toxicity of NSAIDs is possible;
• caffeine - increases the analgesic effect.

Analogs

The drug has no absolute analogues (for three active components). For the two active substances included in the composition (glucosamine, chondroitin), Teraflex Advance analogs are: Artra, Teraflex, Protecon, Movex ACTIVE, KONDRONova.

Terms and conditions of storage

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

Shelf life is 2 years.

Terms of dispensing from pharmacies

Available without a prescription.

Reviews about Teraflex Advance

Reviews about Teraflex Advance are overwhelmingly positive. Users who have taken the drug speak of it as an effective tool that helps to quickly stop pain syndrome and significantly improve the condition during exacerbations of osteoarthritis and osteochondrosis.

However, some users express dissatisfaction with the short-term or insufficiently effective action of the drug. The disadvantages of Teraflex Advance also include the development of side reactions (mainly from the digestive tract) and a large number of contraindications.

Price for Teraflex Advance in pharmacies

The approximate price for Teraflex Advance can be:

• 30 capsules - 740-810 rubles;
• 60 capsules - 1410-1780 rubles;
• 120 capsules - 2080-2490 rubles.

Teraflex Advance: prices in online pharmacies

Drug name Price Pharmacy

Teraflex Advance 250 mg + 100 mg + 200 mg capsules 60 pcs. RUB 1000 Buy

Teraflex Advance capsules 60 pcs. 1498 RUB Buy

Teraflex Advance 250 mg + 100 mg + 200 mg capsules 120 pcs. 1600 RUB Buy

Teraflex Advance capsules 120 pcs. 2282 RUB Buy

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!