Index of drugs

Pains of various origins, including: headaches, migraine, menstrual pain, toothache, muscle pain, bone and joint pain, low back pain, post-traumatic pain, neuralgia. Fever.

1 tabl contains 200 mg of Ibuprofen and 325 mg of paracetamol.

A drug with combined action of ingredients with various analgesic mechanisms. Combines peripheral analgesic, antipyretic and anti-inflammatory effects of ibuprofen with the central analgesic and antipyretic effects of paracetamol. The mechanism of action of ibuprofen is the inhibition of cyclooxygenase COX-1 and COX-2 isoenzymes, which leads to the inhibition of the synthesis of prostanoids: prostaglandins and thromboxane. Over 80% is absorbed from the gastrointestinal tract, reaching the maximum concentration in the blood after 1-2 h. It slowly penetrates into joint cavities, the maximum concentration in the synovial fluid occurs after 5-6 h after administration. It is more than 90% bound to plasma proteins. T_0,5 is 1.5-2 h. It is metabolized in the liver. 50-60% of the administered dose is excreted in the urine as metabolites and the products of their conjugation with glucuronic acid. It does not tend to accumulate in the body, it is completely excreted within 24 hours of the last dose. The mechanism of action of Paracetamol consists mainly in inhibiting the synthesis of prostaglandins in o.u.n, thus reducing the sensitivity of pain receptors to the action of mediators such as kinins and serotonin, which causes an increase in the pain threshold. About 90% is absorbed from the gastrointestinal tract. The maximum concentration in the blood is reached after 0.5-1.5 hours after administration. In 15-20%, it binds to plasma proteins. T_0,5 paracetamol is 1-2.5 h. It is metabolised mainly in the liver. Paracetamol is coupled with glucuronic acid (approximately 60% of the dose) and sulphate ions (approximately 30% of the dose). Only 3-4% of the dose is oxidized with the participation of cytochrome P-450 to the toxic intermediate metabolite N-acetylbenzoquinamine. This metabolite is rapidly coupled to glutathione in urine in the form of non-toxic mercapturate. This mechanism is easily saturated when very high doses of paracetamol are taken, which can lead to liver cell damage, necrosis and acute hepatic failure. Paracetamol is 100% excreted in the urine, of which about 5% in unchanged form.

Hypersensitivity to Paracetamol, Ibuprofen, other NSAIDs or any of the excipients. Past hypersensitivity reactions, such as bronchial asthma, rhinitis or urticaria caused by the administration of salicylates (including acetylsalicylic acid) or other NSAIDs. Peptic ulcer of the stomach and / or duodenum, active or in history, perforation or bleeding, also those occurring after the use of NSAIDs. Concomitant use of other NSAIDs, including COX-2 inhibitors. Hemorrhagic diathesis, taking anticoagulants. Severe renal failure. Severe hepatic failure. Severe hypertension. Severe heart failure. Severe cardiovascular disease, tachycardia, angina. Urinary retention. Alcoholic disease. Congenital G-6-PD deficiency. Children <12 years. Pregnancy. Breastfeeding period.

Caution should be used in patients with: hepatic and / or renal dysfunction and circulatory system disorders; bronchial asthma or allergy (risk of bronchial spasm); systemic lupus erythematosus and mixed connective tissue disease (increased risk of developing aseptic meningitis); digestive tract history (ulcerative colitis, Leśniowski-Crohn's disease); cardiac arrhythmia, hypertension, myocardial infarction or history of cardiac failure (risk of fluid retention) and in patients over 65 years of age. Caution should be exercised when using the product in patients who are taking other medicines at the same time, who may increase the risk of gastrointestinal disorders or may increase the risk of bleeding, such as corticosteroids or anticoagulants, antiplatelet agents.Patients with uncontrolled hypertension, congestive heart failure, ischemic heart disease, peripheral arterial disease or cerebrovascular disease should be treated with ibuprofen very prudently. In the event of a gastrointestinal haemorrhage or ulcer or the first signs of a hypersensitivity reaction, such as a skin rash or mucosal damage, the drug should be discontinued. While using the drug should not drink alcohol because of the risk of liver damage. The medicine may mask the symptoms of an existing infection.

The drug is contraindicated during pregnancy and breastfeeding. Due to the content of ibuprofen, the drug may cause fertility disorders in women by affecting ovulation; this effect is transient and disappears after completion of therapy. For women who have difficulty conceiving or who are being tested for infertility, the end of ibuprofen should be considered.

ibuprofen. Uncommon: indigestion, abdominal pain, nausea, headache, urticaria, pruritus. Rare: diarrhea, bloating, constipation, vomiting, gastritis, dizziness, insomnia, agitation, irritability and fatigue. Very rare: haematological abnormalities - anemia, leukopenia, thrombocytopenia, pancytopenia, agranulocytosis (the first symptoms are: fever, sore throat, superficial ulceration of the oral mucosa, flu-like symptoms, fatigue, bleeding, eg bruises, ecchymosis, purpura, nosebleed) ), liver problems (especially during long-term use), erythema multiforme, Stevens-Johnson syndrome, toxic epidermal necrolysis, tarry stools, bloody vomiting, ulcerative stomatitis, exacerbation of colitis and Crohn's disease, peptic ulcer disease and (or) duodenum, gastrointestinal bleeding and perforation (sometimes life-threatening, especially in the elderly), painful urination, decreased urine output, kidney failure, renal papillary necrosis, increased urea in the blood, increased sodium in the blood, severe hypersensitivity reactions (e.g. swelling of the face, tongue and larynx, dyspnea, tachycardia, hypotension, shock), exacerbation of asthma, bronchospasm, edema, hypertension, heart failure associated with the use of NSAIDs in high doses. Isolated cases: depression, psychotic reactions, tinnitus, aseptic meningitis (mainly in patients with autoimmune disease, e.g. systemic lupus erythematosus and related connective tissue diseases). Clinical studies and epidemiological data suggest that intake of ibuprofen, especially at high doses (2,400 mg / day) over a long period of time, may be associated with a small increase in the risk of arterial thrombosis (e.g., myocardial infarction or stroke).paracetamol. Uncommon: vomiting, diarrhea. Rare: hives, erythema, dermatitis. Very rare: hepatomegaly, thrombocytopenia, leukopenia, agranulocytosis.

Orally. Adults: 1-2 tabls at one time; if necessary, the dose can be repeated up to 3 times a day; do not use more than 6 tables. per day. Youth> 12 years: one sheet at a time; if necessary, the dose can be repeated up to 3 times a day; do not use more than 3 tables per day.Way of giving. Take it after a meal.