Brufen Abbott oral pain reduces pain and fever in children (60ml)

Patient Heart failure severe.

Patients with severe liver failure.

Caution when using

Caution

Unwanted effects can be minimized by the lowest doses that work in the shortest time needed to control symptoms (see the dose and usage, and the warning and caution parts related to the gastric and cardiovascular stomach below).

Like other NSAID drugs, ibuprofen can hide signs of infection. Ibuprofen should be avoided with NSAIDs, including Cycloxygenase-2 selective inhibitors, due to the risk of copper effect (see the drug interaction).

ibuprofen can temporarily inhibit blood platelet function (platelet collection).

When used for prolonged pain, there may be headaches but not treated by increasing the dose of the drug.

When using the drug with alcohol, the adverse effects are related to the active ingredients of NSAID, especially the effects related to the stomach or central nervous system, which can increase.

Older people

The elderly patients may experience the adverse effects of NSAID with increased frequency, especially perforation and stomach bleeding, which can be fatal.

Heart effects

Be cautious (consult a doctor or pharmacist) before starting treatment for patients with a history of high blood pressure and/or heart failure, due to the phenomenon of water retention and edema that have been reported related to NSAID treatment.

Clinical trials and epidemiological data suggest that the use of ibuprofen, especially at high doses (2400 mg daily) and prolonged can be associated with slight increase in the risk of arterial thrombosis (eg myocardial infarction, stroke). Overall, epidemiological data does not suggest that the use of low -dose ibuprofen (for example Patients with high blood pressure are not controlled, congested heart failure, setting myocardial anemia, peripheral artery disease, and/or brain vessels should only use ibutrofen after careful consideration. It is also necessary to consider carefully before starting to have risk factors for cardiovascular incidents (e.g. high blood pressure, hyperlipidemia, diabetes, and smoking).

Bleeding, ulcers and gastric gastric puncture

Bleeding, ulcers or gastrointestinal perforation, can be fatal, have been reported to all NSAIDs at any time of the treatment, with or without warning signs or a serious stomach problem.

The risk of bleeding, ulcers or gastric perforation is higher when increasing the dose of NSAID for patients with a history of ulcer, especially if the ulcer is bleeding or perforation (see the contraindication), and for the elderly patients. These patients should start treatment at the lowest dose possible.

Combining treatment with protective drugs (for example, peptic ulcer treatment drugs or proton pump inhibitors) should be considered for these patients, as well as for patients who need to treat at the same time, acetylsalicylic acid, or other drugs that are likely to increase the risk of stomach (see the lower part and drug interactions).

Patients with a history of gastric poisoning, especially the elderly patients, should be required to notify any abdominal abnormal symptoms (especially stomach bleeding), especially in the first stage of treatment.

Recommendations should be cautious for patients treated simultaneously with drugs that may increase the risk of ulcers or bleeding, such as oral corticosteroids, anticoagulants such as warfarin, selective Serotonin reabsorption inhibitors, or platelet inhibitors such as acetylsalicylic acid (see drug interactive part).

Should be used with ibuprofen if the patient has bleeding or gastric ulcer intestines.

Be cautious when using NSAIDs for patients with a history of gastrointestinal ulcer or other gastrointestinal disease, for example the colon ulcer and Crohn's disease because these conditions may be more serious (see the unwanted effect).

affect the kidneys

Caution should be cautious for dehydration patients, especially for children, adolescents and the elderly because of the risk of kidney failure. In general, the habit of using painkillers, especially a combination of a few active ingredients, can lead to long -term kidney damage with the risk of kidney failure (kidney disease due to painkillers). This risk may increase when physical stress combined with salt loss and dehydration. Therefore, this habit should be avoided.

Be careful with patients with high blood pressure and/or heart failure, because the kidney function may have decreased (see the contraindications and unwanted effects).

Respiratory disorders

Be careful if you use ibuprofen for patients who are in a state of or have a history of bronchial asthma, due to reporting on NSAID promoting bronchospasm in these patients.

affects skin

Serious skin reactions, some fatal, such as skin peeling dermatitis, Stevens-Johnson syndrome and toxic epidermal necrosis, which has been reported very rarely related to NSAID (see the unwanted effect). The risk of such reactions is the largest at the beginning of treatment, most of the cases occur in the first month. Treatment should be used with ibuprofen as soon as you see skin rash, mucosal damage or other hypersensitive signs.

In the exception, chickenpox may be the source of soft tissue and serious skin infection. Currently, NSAID's role has not eliminated the role of worshiping these infections. Therefore, avoid using ibuprofen in the case of chickenpox.

SLE and mixed connective tissue disease

Be cautious for patients with systemic lupus erythematosus (SLE) and mixed connective tissue disease. The risk of meningitis may be increased (see below and unwanted effects).

allergic reactions

Serious hypersensitivity reactions (for example, anaphylaxis) have seen but very rare. As soon as you see the first sign of hypersensitivity reaction after taking ibuprofen must stop the drug immediately. The necessary medical measures, depending on the symptoms, must be done by a professional.

Be cautious for patients who have had hypersensitivity reactions or allergies to other substances because the risk of hypersensitivity reactions when using ibuprofen in these patients may increase.

Be cautious for patients with hay, tumors in the nose or chronic respiratory obstruction due to increased risk of allergic reactions. These reactions can manifest such as asthma (also known as asthma due to painkillers), rhymes or urticaria.

Heart thrombosis

Non -steroid anti -inflammatory drugs (NSAIDs), non -aspirin, using systemic sugar can increase the risk of cardiovascular thrombosis, including myocardial infarction and stroke, which can lead to death. This risk may appear early in a few weeks where the drug is used and can increase over time. The risk of cardiovascular thrombosis is recorded mainly at high doses.

Doctors need to periodically evaluate the appearance of cardiovascular events, even if the patient has no previous cardiovascular symptoms.

Patients need to be warned about the symptoms of serious cardiovascular events and need to see a doctor as soon as these symptoms appear.

To minimize the risk of adverse incidents, the lowest daily daily daily dose needs to be used in the shortest possible time.

Information related to excipients

ibuprofen oral fluid 20 mg/ml contains sucrose and sorbitol. Patients with rare genetic problems are intolerant to fructose, absorbent Glucose-Galactose or Sucrose-Isomaltase deficiency should not use this drug. Be cautious with diabetics.

The drug can be harmful to the teeth.

ibuprofen oral oral fluid 20 mg/ml contains methyl parahydroxybenzo and propyl parahydroxybenzoate propyl. Can cause allergic reactions (can be delayed).

ibuprofen oral fluid 20 mg/ml contains yellow color. May cause allergic reactions.

The ability to drive and operate machinery

When using ibuprofen, the patient's reaction time may be affected. Therefore, this impact should be taken into account the activities that require high vigilance, such as driving or operating machinery. This needs to be more concerned when using the drug in combination with alcohol.

Pregnancy

Prostaglandin synthesis inhibitors may have a disadvantage for pregnancy and/or for embryo development. Epidemiological data hypotheses that the use of prostaglandin synthesis inhibitors in the early stages of pregnancy increases the risk of miscarriage, heart defects and abdominal cracks. The risk is thought to increase at dosage and treatment time. In animals, the use of prostaglandin synthesis inhibitors shows increased losses before and after the eggs and increases the risk of fetal embryos death. Moreover, there have been reports in animals using prostaglandin synthetic inhibitors during the formation of the organs (internal organs) that increases the rate of deformities of all kinds including cardiovascular deformities.

In the first three months or three months of pregnancy, Ibuprofen should not be used, unless it is really necessary. If Ibuprofen is used for women who are trying to conceive or in the first three months or the middle three months of pregnancy, the lowest dose should be used as well as the shorter treatment as possible.

During the last three months of pregnancy, the use of ibuprofen may expose the fetus with the following risks:

At the end of pregnancy, the use of Prostaglandin synthetic inhibitors can expose the mother and babies to the following risks:

Do not recommend the use of ibuprofen during birth and labor.

The period of breastfeeding

In limited studies, ibuprofen appears in breast milk with very low content, if possible, should avoid using ibuprofen for nursing mothers.

Drug interaction

should note that when used for patients who are taking the following drugs because there have been interactions reported in some patients:

Diuretics, ACE inhibitors, Beta channel blockers and Angiotensin-II antagonists

NSAID can reduce the effects of these drugs.

Diuretics may also increase the risk of NSAID's kidney poisoning.

In some patients with impaired renal function (for example, patients with dehydration or elderly patients with impaired renal function), simultaneous use with ACE inhibitors, beta blockers, Angiotensin-II antagonists and cyclooxygenase inhibitors can ruin kidney function, including acute renal impairment, usually recover. Therefore, the use of drugs should be conducted carefully, especially in the elderly. Patients should be fully rehydrated and should consider monitoring kidney function after initiating the treatment at the same time, and periodically later.

glycosides cardiac

NSAID can worsen heart failure, reduce glomerular filtration rate and increase plasma concentrations of glycoside support (e.g. digoxin).

lithium

Concomitance ibuprofen use with lithium preparations can increase the serum concentration of these drugs.

methotrexate

NSAID can inhibit methotrexate excretion in the renal tubules and reduce methotrexate clearance.

ciclosporin

Increased risk of kidney poisoning with NSAID.

Mifepristone

Theoretically, the effectiveness of the drug is reduced due to the Prostaglandin resistance of NSAID, including acetylsalicylic acid. The evidence is very limited, showing that the combination of use with NSAIDs on the same day with prostaglandin does not affect the effects of Mifepristone or Prostaglandin on the softness of the cervix or uterine contractions and does not reduce the clinical effect of medical intervention to stop pregnancy.

corticosteroid

ibuprofen should be used carefully when combined with corticosteroids because this combination may increase the risk of adverse effects, especially for stomach tubes (ulcers or stomach bleeding).

anticoagulants

NSAID can increase the effects of anticoagulants, for example Warfarin (see the warning and caution).

Acetylsalicylic acid

As with other drugs containing NSAIDs, simultaneously taking ibuprofen with acetylsalicylic/ aspirin acid is generally not recommended due to the ability to increase adverse effects.

Experimental figures suggest that ibuprofen can inhibit the anti -platelet cohesion effect at the low doses of salicylic acid when used simultaneously.

However, the limitations of data and uncertainty of extrapolation from clinical data on clinical situations suggest that it is impossible to make a certain conclusion about the regular use of ibuprofen, and there is no significant clinical effect that can be considered to occur when using ibuprofen (see the pharmacological properties).

sulfonylurea

NSAID substances can increase the effects of sulfonylurea drugs. There are very few reports showing that the phenomenon of hypoglycemia in patients being treated with sulfonylurea uses ibuprofen.

zidovudine

Used with NSAIDs increases the risk of blood toxicity. There is evidence that increases the risk of joint hematoma and hematoma in HIV patients with positive blood with difficulty clotting, after being treated simultaneously zidovudine and ibuprofen.

Other NSAIDs, including salicylate and selective inhibitors Cycloxygenase-2

Simultaneous use of a few NSAIDs can increase the risk of ulcer and stomach bleeding due to the synergistic effect. Ibuprofen should be avoided simultaneously with other NSAIDs.

aminoglycosides

NSAID can reduce the elimination of aminoglycoside.

cholestyramine

The use of ibuprofen and cholestyramine combination is capable of reducing ibuprofen's absorption in the digestive tract. However, the clinical impact is not known.

tacrolimus

Simultaneous use of two drugs may increase the risk of kidney toxicity.

Anti -platelet anti -capacitors and selective Serotonin re -inhibitors

Increased risk of stomach bleeding (see the warning and caution).

Plants and plants

Ginkgo Biloba may increase the risk of bleeding with NSAID.

Quinolone antibiotics

The data obtained on animals shows that NSAIDs may increase the risk of convulsions associated with Quinolone antibiotics. Patients using NSAID and Quinolone antibiotics may increase the risk of convulsions.

CYP2C9 inhibitors

The use of ibuprofen combinations with CYP2C9 inhibitors can increase exposure with ibuprofen (substrate of CYP2C9). In a study with voriconazole and fluconazole (CYP2C9 inhibitors) showed that the level of exposure to S (+)-ibuprofen increased from 80 to 100%. Ibuprofen dose reduction should be considered when indicated to combine CYP2C9 inhibitors, especially when high -dose ibuprofen is used in combination with voriconazole or fluconazole.