Pentalgin or next which is better. Next - instructions for use. Use in children

Next (ibuprofen + paracetamol) is a combined non-narcotic analgesic drug. It also has anti-inflammatory and antipyretic effects. Paracetamol exhibits analgesic and antipyretic effects associated with inactivation of the cyclooxygenase enzyme in the central nervous system and effects on pain and thermoregulatory centers. Ibuprofen is an analgesic, anti-inflammatory and antipyretic agent that indiscriminately inhibits cyclooxygenase and suppresses the formation of prostaglandins. The accentuated synergistic and mutually potentiating effects of the two active substances ensure the rapid achievement of the desired treatment result. Paracetamol is well absorbed in the digestive tract. The half-life is 1-4 hours. It is excreted mainly by the kidneys. Ibuprofen, as well as paracetamol, is well absorbed in the digestive tract. The peak concentration in the blood when taken on an empty stomach is observed after 45 minutes. The half-life is 2-2.5 hours. It is excreted along with urine and bile. Next is indicated for headaches (including migraine) and toothaches, painful menstruation, lesions of peripheral nerves with severe pain, muscle, spinal, joint, traumatic pain, febrile body temperature.

The best time to take it is after a meal. Single dose - 1 tablet. Multiplicity of reception - 3 times a day (adults), 2 times a day (children from 12 years old). The duration of the drug course is no more than three days as an antipyretic and no more than five days as an analgesic. Exceeding the established period of treatment is possible only in agreement with the doctor. Next is contraindicated in persons with individual intolerance to the components, gastric and duodenal ulcers, severe liver and kidney diseases, impaired functions of the blood coagulation and anticoagulation systems, aspirin intolerance, and an abnormally high concentration of potassium in the blood. In pediatrics, the drug is allowed to be used from the age of 12. During pregnancy, Next can be used in the first two trimesters. It is not allowed to take Next at the same time as other drugs containing NSAIDs. During the medication course, you should refrain from drinking alcohol and from activities that require increased concentration and attention, including driving a car and working on potentially dangerous mechanisms.

Pharmacology

The combined drug has analgesic, anti-inflammatory and antipyretic effects.

Paracetamol is a non-narcotic analgesic that has an antipyretic and analgesic effect due to the blockade of cyclooxygenase in the central nervous system and the effect on the centers of pain and thermoregulation.

Ibuprofen is a non-steroidal anti-inflammatory drug that has analgesic, anti-inflammatory and antipyretic effects associated with non-selective suppression of the activity of cyclooxygenase, which regulates the synthesis of prostaglandins.

The components of the drug affect both the central and peripheral mechanisms of pain syndrome formation. The directed, complementary action of the two components has a rapid therapeutic effect and a pronounced analgesic effect.

Pharmacokinetics

Paracetamol

Absorption is high, C max is 5-20 µg/ml, TC max is 0.5-2 h; connection with plasma proteins - 15%. Penetrates through the blood-brain barrier.

Metabolized in the liver, with the formation of both active and inactive metabolites.

T 1 / 2 - 1-4 hours. Mainly excreted by the kidneys in the form of metabolites - glucuronides and sulfates, 3% - unchanged.

ibuprofen

Well absorbed from the gastrointestinal tract. TC max when taken on an empty stomach - 45 minutes, when taken after meals - 1.5-2.5 hours. Communication with plasma proteins - 90%. The concentration of the drug in the synovial fluid exceeds the content in the plasma.

It undergoes presystemic and postsystemic metabolism in the liver.

It has a two-phase excretion kinetics, T 1 / 2 is 2-2.5 hours. It is excreted by the kidneys (unchanged, no more than 1%) and, to a lesser extent, with bile.

Release form

2 pcs. - cellular contour packings (1) - packs of cardboard.
6 pcs. - cellular contour packings (1) - packs of cardboard.
10 pieces. - cellular contour packings (1) - packs of cardboard.
12 pcs. - cellular contour packings (1) - packs of cardboard.
2 pcs. - cellular contour packings (2) - packs of cardboard.
6 pcs. - cellular contour packings (2) - packs of cardboard.
10 pieces. - cellular contour packings (2) - packs of cardboard.
12 pcs. - cellular contour packings (2) - packs of cardboard.

Dosage

Inside, after eating.

Adults: 1 tablet 3 times / day. The maximum daily dose is 3 tablets.

Children over 12 years old (body weight over 40 kg): 1 tablet 2 times / day.

The duration of treatment is not more than 3 days as an antipyretic and not more than 5 days as an anesthetic. Continuation of treatment with the drug is possible only after consulting a doctor.

Overdose

Symptoms: abdominal pain, nausea, vomiting, agitation or lethargy, drowsiness, confusion, tachycardia, arrhythmia, acute renal failure, metabolic acidosis, frequent urination, pyrexia, headache, tremor or muscle twitching; increased activity of "liver" transaminases, an increase in prothrombin time. If you suspect an overdose, you should immediately seek medical help.

Treatment: gastric lavage, followed by the appointment of activated charcoal; alkaline drink, forced diuresis, symptomatic therapy.

Interaction

Inducers of microsomal oxidation in the liver (phenytoin, ethanol, barbiturates, flumecinol, rifampicin, phenylbutazone, tricyclic antidepressants) increase the production of hydroxylated active metabolites, which makes it possible to develop severe intoxication in case of overdose.

Microsomal oxidation inhibitors (including cimetidine) reduce the risk of hepatotoxicity.

Myelotoxic drugs increase the manifestations of hematotoxicity of the drug.

The combination of ibuprofen with ethanol, glucocorticosteroids increases the risk of erosive and ulcerative lesions of the gastrointestinal tract.

The simultaneous use of paracetamol with ethanol increases the risk of acute pancreatitis.

Paracetamol and ibuprofen increase the effect of indirect anticoagulants and reduce the effectiveness of uricosuric drugs.

Prolonged use of barbiturates reduces the effectiveness of paracetamol. Diflunisal increases the plasma concentration of paracetamol by 50%, which increases the risk of hepatotoxicity.

Ibuprofen reduces the hypotensive activity of vasodilators, natriuretic and diuretic - furosemide and hydrochlorothiazide.

Antacids and cholestyramine reduce the absorption of ibuprofen.

Ibuprofen enhances the effect of oral hypoglycemic agents and insulin.

Ibuprofen increases the blood concentration of digoxin, lithium preparations and methotrexate.

When administered simultaneously with acetylsalicylic acid, ibuprofen reduces its anti-inflammatory and antiplatelet effect.

Cefamandol, cefoperazone, cefotetan, valproic acid, plicamycin increase the incidence of hypoprothrombinemia.

Side effects

From the nervous system: headache, dizziness, sleep disturbances, anxiety, depression.

From the side of the cardiovascular system: tachycardia, increased blood pressure, heart failure.

From the respiratory system: shortness of breath, bronchospasm.

From the gastrointestinal tract: abdominal pain, nausea, vomiting, heartburn, loss of appetite, diarrhea or constipation, flatulence, ulceration of the gum mucosa, aphthous stomatitis, pancreatitis.

Sense organs: hearing impairment, ringing or noise in the ears, visual disturbances, blurred vision or diplopia, dry and irritated eyes.

From the urinary system: acute renal failure, nephrotic syndrome, polyuria, cystitis.

Allergic reactions: skin rash, pruritus, allergic rhinitis, angioedema, erythema multiforme exudative (including Stevens-Johnson syndrome), toxic epidermal necrolysis (Lyell's syndrome).

On the part of the hematopoietic organs: anemia, thrombocytopenia, thrombocytopenic purpura, agranulocytosis, leukopenia, eosinophilia.

With prolonged use in high doses - hepatotoxic and nephrotoxic (hepatitis, interstitial nephritis and papillary necrosis) action; hemolytic anemia, aplastic anemia, methemoglobinemia, pancytopenia.

Indications

headache (including migraine);
toothache;
algomenorrhea (painful menstruation);
neuralgia;
myalgia;
back pain;
joint pain, pain syndrome in inflammatory and degenerative diseases of the musculoskeletal system;
pain with bruises, sprains, dislocations, fractures;
post-traumatic and postoperative pain syndrome;
febrile conditions (including flu and colds).

Contraindications

hypersensitivity to the components of the drug;
erosive and ulcerative diseases of the gastrointestinal tract (in the acute phase), gastrointestinal bleeding;
severe hepatic and / or renal failure;
blood clotting disorders (hemophilia, prolongation of bleeding time, bleeding tendency, hemorrhagic diathesis);
complete or incomplete combination of bronchial asthma, recurrent polyposis of the nose and paranasal sinuses and intolerance to acetylsalicylic acid or other non-steroidal anti-inflammatory drugs, incl. in history;
condition after coronary artery bypass grafting;
confirmed hyperkalemia;
deficiency of glucose-6-phosphate dehydrogenase;
pregnancy (III trimester);
children's age up to 12 years.

With caution: chronic heart failure; viral hepatitis, alcoholic liver damage, hepatic and / or renal failure of moderate and mild severity, benign hyperbilirubinemia (Gilbert, Dubin-Johnson and Rotor syndrome), cirrhosis of the liver with portal hypertension, nephrotic syndrome; diabetes mellitus, peripheral arterial disease, peptic ulcer of the stomach and duodenum (history); gastritis, enteritis, colitis; bronchial asthma, bronchospasm; elderly age; pregnancy (I and II trimesters - use is possible only as directed by a doctor in cases where the potential benefit outweighs the possible risk), lactation (if necessary, the use of the drug during breastfeeding should stop breastfeeding).

Application features

Use during pregnancy and lactation

The use of the drug in the III trimester of pregnancy is contraindicated.

If it is necessary to use the drug in the I and II trimester of pregnancy, care should be taken - the use is possible only as directed by a doctor in cases where the potential benefit outweighs the possible risk. During breastfeeding, if necessary, the use of the drug should stop breastfeeding.

Application for violations of liver function

With caution: viral hepatitis, alcoholic liver damage, liver failure of moderate and mild severity, benign hyperbilirubinemia (Gilbert, Dubin-Johnson and Rotor syndrome), cirrhosis of the liver with portal hypertension.

Application for violations of kidney function

With caution: renal failure of moderate and mild severity, nephrotic syndrome.

Use in children

Contraindicated in children under 12 years of age.

special instructions

Simultaneous use of the drug with other drugs containing paracetamol and / or non-steroidal anti-inflammatory drugs should be avoided.

When using the drug for more than 5-7 days, peripheral blood parameters and the functional state of the liver should be monitored.

Paracetamol distorts the results of laboratory studies of glucose and uric acid in blood plasma.

When symptoms of NSAID gastropathy appear, careful monitoring is indicated, including esophagogastroduodenoscopy, a blood test to determine hemoglobin and hematocrit, and a fecal occult blood test.

If it is necessary to determine 17-ketosteroids, the drug should be discontinued 48 hours before the study.

While taking the drug, patients should refrain from all activities that require increased attention, rapid mental and motor reactions.

The sensation of pain is associated with significant discomfort and a decrease in the standard of living of a person. Therefore, Next pain pills and other analgesics are very popular among the population. Reviews about this drug are positive, due to its rapid action and low risk of side effects.

Composition and dosage form

Painkillers Next are available in the form of tablets, which greatly facilitates their use at home, non-stationary conditions. Next for headache is a combined drug consisting of two active substances: ibuprofen and paracetamol at a dosage of 400 and 200 mg, respectively. These tablets have a special shell that is soluble only in the intestine, which reduces the damaging effect of the drug on the stomach and reduces the risk of mucosal ulcers.

In addition to active ingredients, the drug also contains auxiliary components that stabilize the composition and give the tablets a certain shape. The composition of Next tablets is carefully selected and perfectly suited for its effects.

The use of the drug Next

According to the instructions for the drug Next, this drug can be used for these symptoms:

various conditions, including migraine and migraine-like attacks;
rise in body temperature above 38.5 ° C;
spastic conditions in the internal organs, accompanied by pain;
inflammatory diseases of muscle fibers;
joint pains of various etiologies;
toothache;
traumatic injuries with pain syndrome.

Important to remember! The occurrence of any pain is an alarming signal of the body about internal damage.

Therefore, if the pain occurs for the first time or persists for a long time, it is necessary to contact your doctor for diagnostic measures and timely treatment of the underlying pathology.

Contraindications

Instructions for tablets for pain Next also highlights a number of contraindications to the use of this medication:

The most important contraindication is individual allergic sensitivity to the active ingredients of Nexta or to its other components.
The age of the patient is up to 12 years, since the drug has not been studied for this age group.
Third period of pregnancy and breastfeeding.

In addition to these absolute contraindications, there are also relative ones that are associated with an increased risk of side effects:

The instructions for the Next tablets especially single out various lesions of the gastric mucosa (erosions, ulcers and other inflammatory processes) in this group;
decompensated states of renal, hepatic and heart failure;
bronchial asthma and other diseases with an allergic component;
kidney damage with nephrotic syndrome;
glucose metabolism disorders, including diabetes mellitus.

The use of anesthetic Next

It is very important not to prescribe Next with other drugs from the group of non-steroidal anti-inflammatory drugs. This situation may lead to an increased risk of side effects.

The drug Next for pain is recommended to be used after meals. The maximum daily dosage for adults is no more than three tablets, and for children from 12 to 18 years old - no more than two tablets. Apply the drug one tablet at a time in the presence of appropriate symptoms (pain syndrome of any localization).

Possible side effects

All side effects of the anesthetic Next can be divided into several groups depending on the organs in which they occur:

damage to the cardiovascular system, characterized by the occurrence of various arrhythmias, heart failure and slightly;
when the mucous membranes of the gastrointestinal tract are damaged, pain occurs in the upper abdomen, dyspeptic symptoms and erosive lesions;
depressive or anxiety states, persistent headaches,;
bronchospastic conditions, accompanied by respiratory failure;
allergic manifestations in the form of urticaria, edema, etc.

In case of occurrence of these side effects, it is necessary to stop the drug and consult your doctor.

Additional Information

The drug Next is very effective for relieving pain. Reviews for the medicine Next are positive, which is associated with a good analgesic effect and a low risk of side effects. The average price of Next medicine for pain ranges from 100 to 150 rubles, depending on the region and the specific pharmacy.

Before using the drug, it is recommended to consult your doctor with pain syndrome to find out its cause. Learn more about the use of non-steroidal anti-inflammatory drugs in the video.

Attention!

Any pain causes discomfort to a person and significantly reduces his standard of living. Next is a modern combined broad-spectrum analgesic, which can be purchased at a pharmacy without a prescription. The drug helps to relieve pain and relieve the patient's condition in a short time, and also has anti-inflammatory and antipyretic effects.

The composition of Next is Ibuprofen and Paracetamol, which affect the central and peripheral mechanism of pain syndrome formation. There are many indications for the use of the drug, but in some cases, treatment with it is contraindicated.

The main form of release of the drug are tablets, which are film-coated. Next is an anesthetic and its release in tablet form makes it much easier to take at home.

The components of the drug are such active substances as Ibuprofen and Paracetamol. The tablets are coated with a special soluble coating that dissolves only in the gastrointestinal tract. This makes it possible to minimize the damaging effect of the drug on the stomach and avoid ulcerative mucosal formations.

In addition to the active substances, the composition of the drug also includes auxiliary components. They stabilize the composition of Next and give the tablets the desired shape.

The active ingredients have a complex effect on all mechanisms of the formation of pain in humans.

It is possible to achieve an analgesic and rapid therapeutic effect due to the complementary action of all the substances that make up the drug.

Paracetamol is a component of the drug, which belongs to the analgesics of the non-narcotic group. It quickly anesthetizes and eliminates fever caused by the blockade of the central nervous system, as well as the effect on pain centers and the process of thermoregulation.

Ibuprofen is a non-steroidal anti-inflammatory substance with antipyretic and analgesic effect. It helps to suppress the activity of cyclooxygenase, which controls the synthesis of prostaglandins.

Indications for the use of the drug

The instruction attached to the drug indicates that a drug such as Next is allowed to be used for the following indications:

headache of various origins, including migraine and migraine-like attacks
spastic condition of the internal organs, which are accompanied by severe pain
discomfort in the joints of various origins and pathology of the musculoskeletal system
toothache
fever and fever
injuries, bruises, sprains and fractures of varying complexity, which are complemented by severe pain
too painful menstruation in women

It should be remembered that pain of a different nature is considered a dangerous manifestation and may indicate internal damage. It is for this reason that with a pronounced pain syndrome that persists for a long time, it is necessary to seek the advice of a doctor.

Contraindications to treatment

There are the following main contraindications to drug treatment:

last weeks of pregnancy and lactation
children under 12
individual intolerance to individual constituent substances of the drug
condition after coronary artery bypass grafting
revealed hyperkalemia
complicated renal and hepatic insufficiency

An absolute contraindication to the appointment of Nekst are problems with, including such pathological conditions of the body as hemophilia, hemorrhagic diathesis and the likelihood of bleeding.

In addition, the use of the drug should be abandoned in case of bronchial asthma, recurrent polyposis of the paranasal sinuses, increased sensitivity of the body to acetylsalicylic acid and other non-steroids.

An absolute contraindication to the appointment of Nekst are gastrointestinal bleeding, as well as erosive and ulcerative formations in the organs of the digestive system.

Specialists identify relative contraindications, that is, those conditions and diseases in the presence of which increased caution is required in the treatment of the drug.

You can learn more about how to choose the right painkillers from the video:

These include:

viral hepatitis
first and second trimester of pregnancy
old age
pathology of peripheral arteries
chronic heart failure
a history of ulcerative lesions of the stomach and duodenum
alcoholic liver damage
slight disturbance in the work of the kidneys and liver
colitis, gastritis and enteritis
nephrotic syndrome

If it is necessary to use Neksta in the first and second trimester of pregnancy, it is important to exercise increased caution. It is allowed to take medication only under the supervision of a doctor and only in those situations where the benefit of treatment is much higher than the possible risk. In the third trimester, treatment with such a drug is strictly prohibited. When treating with Next during lactation, breastfeeding should be stopped for a while.

Overdose and side effects

When taking Next, side effects may occur, which can be divided into several groups depending on the location of the organ:

lesions of the heart and vascular system, which are characterized by the appearance of various, and a slight rise
bronchospastic conditions in which breathing problems occur
anxiety and depression, insomnia and severe headaches
trauma of the mucous membranes of the gastrointestinal tract, the appearance of pain in the upper abdomen, erosive lesions and dyspepsia

In the event that these side effects occur while taking the drug, you should stop taking it and visit your doctor.

In case of an overdose, the following symptoms may develop:

pain in the abdomen
nausea and vomiting
increased drowsiness
kidney dysfunction
lethargy or agitation
frequent urination
headache
increased thrombin time
confusion

If these symptoms appear, you should immediately seek medical help. Usually, in such a situation, treatment is prescribed in the form of gastric lavage, followed by the intake of activated charcoal. To restore the normal functioning of the body, abundant drinking, symptomatic therapy and forced diuresis are indicated.

Instructions for use

Next in the form of tablets should be taken orally after a meal at a dosage selected by a doctor. Adult patients are prescribed 1 capsule three times a day, and the maximum dosage is 3 tablets. Patients over 12 years of age are shown taking 1 capsule twice a day.

The duration of drug therapy is determined by the doctor and can be:

as an antipyretic drug can be taken no more than 3 days
to relieve pain, Next is usually prescribed for 5 days

Next is considered a completely safe drug and even long-term use does not cause addiction to the body. However, the maximum duration of taking the drug is 5 days, and the decision on the need to continue it is made only by the doctor.

In the event that the duration of treatment is more than a week, then it is necessary to monitor the functional state of the liver and peripheral blood.

Paracetamol can significantly distort the results of studies of the concentration of glucose and uric acid in plasma.

When taking a drug such as Next, you should avoid those activities that need close attention, as well as a quick mental and motor reaction. During the entire treatment, you should stop drinking drinks that contain alcohol.

Drug analogues

The following analogues of the drug are considered the most effective:

Ibuprofen is a non-steroidal anti-inflammatory drug that contains the active ingredient ibuprofen. The drug is prescribed for degenerative and inflammatory pathologies of the musculoskeletal system and pain syndrome of various etiologies.
MIG 400 is another anti-inflammatory drug based on ibuprofen. According to indications for use and contraindications, there are no differences with Next.
Ketonal is available in tablet form and contains such an active ingredient as ketoprofen. The drug is used for the symptomatic treatment of pathologies of the musculoskeletal system and pain of various origins.

Structural analogue of Next in terms of the active substance is:

Brustan
Khairumat
Ibuklin Junior

Next is an effective drug that helps to quickly relieve pain and alleviate the patient's condition. Basically, reviews about the use of such a drug are mostly positive, due to a good analgesic effect and a low risk of side effects. In case of severe pain syndrome, it is necessary to seek the advice of a specialist who will determine the treatment.

ibuprofen 400 mg, paracetamol 200 mg.

Red, oval, biconvex, film-coated tablets with a score; on a cross section, the core is white or almost white.

combined analgesic
(NSAID + non-narcotic analgesic)
ATC Code: M01AE51

Pharmacodynamics

The combined drug has analgesic, anti-inflammatory and antipyretic effects.

Paracetamol - non-narcotic analgesic, has an antipyretic and analgesic effect due to the blockade of cyclooxygenase in the central nervous system and the effect on the centers of pain and thermoregulation.

Ibuprofen - non-steroidal anti-inflammatory agent, has analgesic, anti-inflammatory and antipyretic effects associated with non-selective suppression of the activity of cyclooxygenase, which regulates the synthesis of prostaglandins.

Components of the drug affect both the central and peripheral mechanisms of pain syndrome formation. The directed, complementary action of the two components has a rapid therapeutic effect and a pronounced analgesic effect.

Pharmacokinetics

Paracetamol

Absorption is high, the maximum concentration (C max) is 5-20 μg / ml, the time to reach the maximum concentration (T cmax) is 0.5-2 hours; connection with plasma proteins - 15%. Penetrates through the blood-brain barrier.

Metabolized in the liver, with the formation of both active and inactive metabolites.

The half-life (T 1/2) is 1-4 hours. Primarily excreted by the kidneys as

metabolites - glucuronides and sulfates, 3% - unchanged.

ibuprofen

Well absorbed from the gastrointestinal tract. The time to reach the maximum concentration (T max) when taken on an empty stomach is 45 minutes, when taken after a meal - 1.5-2.5 hours. Communication with plasma proteins is 90%. The concentration of the drug in the synovial fluid exceeds the content in the plasma.

It undergoes presystemic and postsystemic metabolism in the liver. It has a two-phase excretion kinetics, T1 / 2 is 2-2.5 hours. It is excreted by the kidneys (unchanged, no more than 1%) and, to a lesser extent, with bile.

Headache (including migraine);

Toothache;

Algodysmenorrhea (painful menstruation);

Neuralgia;

myalgia;

Back pain;

Articular pain, pain syndrome in inflammatory and degenerative diseases of the musculoskeletal system;

Pain with bruises, sprains, dislocations, fractures;

Post-traumatic and postoperative pain syndrome;

Feverish conditions (including flu and colds).

Hypersensitivity to the components of the drug, including other non-steroidal anti-inflammatory drugs (NSAIDs);

Erosive and ulcerative diseases of the gastrointestinal tract (in the acute phase), gastrointestinal bleeding;

progressive kidney disease;

Severe renal failure (creatine clearance (CC) less than 30 ml / min.);

severe liver failure or active liver disease;

Blood clotting disorders (hemophilia, prolongation of bleeding time, bleeding tendency, hemorrhagic diathesis);

Cerebrovascular or other bleeding;

Complete or incomplete combination of bronchial asthma, recurrent polyposis of the nose and paranasal sinuses and intolerance to acetylsalicylic acid or other non-steroidal anti-inflammatory drugs, incl. in history;

Chronic heart failure (functional class III-IV according to the NYHA classification);

Condition after coronary artery bypass grafting;

Confirmed hyperkalemia;

Deficiency of glucose-6-phosphate dehydrogenase;

Pregnancy (III trimester);

The period of breastfeeding;

Children's age up to 18 years.

Chronic heart failure; viral hepatitis, alcoholic liver damage, hepatic and / or renal failure of moderate and mild severity, benign hyperbilirubinemia (Gilbert, Dubin-Johnson and Rotor syndrome), cirrhosis of the liver with portal hypertension, nephrotic syndrome; diabetes mellitus, peripheral arterial disease, peptic ulcer of the stomach and duodenum (history); gastritis, enteritis, colitis; bronchial asthma, bronchospasm; elderly age; pregnancy (I and II trimesters - use is possible only as directed by a doctor in cases where the potential benefit outweighs the possible risk), lactation (if necessary, the use of the drug during breastfeeding should stop breastfeeding).

Use during pregnancy and lactation

If it is necessary to use the drug in the I and II trimester of pregnancy, care should be taken - the use is possible only as directed by a doctor in cases where the potential benefit outweighs the possible risk. The use of the drug in the III trimester of pregnancy is contraindicated.

During breastfeeding, if necessary, the use of the drug should stop breastfeeding.

Inside, after eating.

1 tablet 3 times a day. The maximum daily dose is 3 tablets.

The duration of treatment is not more than 3 days as an antipyretic and not more than 5 days as an anesthetic. Continuation of treatment with the drug is possible only after consulting a doctor.

From the nervous system: headache, dizziness, sleep disturbances, anxiety, depression.

From the side of the cardiovascular system: tachycardia, increased blood pressure, heart failure.

From the respiratory system: shortness of breath, bronchospasm.

From the gastrointestinal tract: abdominal pain, nausea, vomiting, heartburn, decreased appetite, diarrhea or constipation, flatulence, ulceration of the gum mucosa, aphthous stomatitis, pancreatitis.

Sense organs: hearing impairment, ringing or noise in the ears, visual disturbances, blurred vision or diplopia, dry and irritated eyes.

From the urinary system: acute renal failure, nephrotic syndrome, polyuria, cystitis.

Allergic reactions: skin rash, pruritus, allergic rhinitis, angioedema, erythema multiforme exudative (including Stevens-Johnson syndrome), toxic epidermal necrolysis (Lyell's syndrome).

From the side of the hematopoietic organs: anemia, thrombocytopenia, thrombocytopenic purpura, agranulocytosis, leukopenia, eosinophilia.

With prolonged use in high doses - hepatotoxic and nephrotoxic (hepatitis, interstitial nephritis and papillary necrosis) action; hemolytic anemia, aplastic anemia, methemoglobinemia, pancytopenia.

Symptoms: abdominal pain, nausea, vomiting, agitation or lethargy, drowsiness, confusion, tachycardia, arrhythmia, acute renal failure, metabolic acidosis, frequent urination, pyrexia, headache, tremor or muscle twitching; increased activity of "liver" transaminases, an increase in prothrombin time. If you suspect an overdose, you should immediately seek medical help.

Treatment: gastric lavage, followed by the appointment of activated charcoal; alkaline drink, forced diuresis, symptomatic therapy.

Microsomal oxidation inhibitors (including cimetidine) reduce the risk of hepatotoxicity.

Myelotoxic drugs increase the manifestations of hematotoxicity of the drug.

The combination of ibuprofen with ethanol, glucocorticosteroids increases the risk of erosive and ulcerative lesions of the gastrointestinal tract.

The simultaneous use of paracetamol with ethanol increases the risk of acute pancreatitis.

Paracetamol and ibuprofen increase the effect of indirect anticoagulants and reduce the effectiveness of uricosuric drugs.

Prolonged use of barbiturates reduces the effectiveness of paracetamol.

Diflunisal increases the plasma concentration of paracetamol by 50%, which increases the risk of hepatotoxicity.