Nurofen®

introduction

Nurofen® is a drug that contains the active ingredient ibuprofen. Nurofen® is only available from pharmacies and is available without a prescription and is mainly used to treat pain and inflammation.

Nurofen® is often used for mild to moderate pain (toothache, headache, menstrual cramps), it can also be used to lower fever. For mild to moderate migraine attacks with or without aura, Nurofen® is one of the first-choice remedies (including naproxen, diclofenac, paracetamol).

Mode of action

The active substance Ibuprofen is in the group of so-called non-steroidal antiphlogistics (Anti-inflammatories) respectively Analgesics (Painkillers) counted. This means that Nurofen® can also be used well against inflammation, for example to relieve severe to very severe pain in joint inflammation.
Here Nurofen® is used especially in inflammatory rheumatic diseases ("rheumatism") that cause joint inflammation, such as arthrosis, gout, rheumatoid arthritis and ankylosing spondylitis (Ankylosing spondylitis, inflammatory spinal disease). But even with painful, rheumatic inflammation of muscles and organs, Nurofen® can provide relief with the active ingredient ibuprofen.
Other areas of application are pain from strains and sprains, earache and symptoms associated with colds and flu.
Nurofen® can be used in older infants and children.
The effects of Nurofen® can be explained by the mechanism of action of ibuprofen: Ibuprofen inhibits certain enzymes in the body (cyclooxygenases I and II, COX-1 and COX-2) that are responsible for the formation of tissue hormones (Prostaglandins) are necessary. Since these tissue hormones are responsible for pain, blood clotting, fever and inflammation, the analgesic, anti-inflammatory and antipyretic effects of Nurofen® are explained. However, undesirable effects, such as gastric bleeding, can also be explained by the blood-clotting effect (wound closure) of ibuprofen. However, the risk of this is significantly lower than with acetylsalicylic acid (ASA, Aspirin®).

Dosage and method of administration

Nurofen® can be administered in a number of ways. It can be used orally as a tablet or juice, or rectally as a suppository. The respective dosage of Nurofen® should correspond to the instructions of the doctor and depends on the age and body weight of the person concerned.In small doses (200 to 400 milligrams for adults), Nurofen® mainly relieves pain and reduces fever. For the additional anti-inflammatory effect, higher doses (up to 800 milligrams for adults) are necessary.

When used orally, the maximum single dose should not exceed 800 milligrams Ibuprofen and between 1200 and 2400 milligrams as the maximum daily dose are not exceeded within 24 hours. This applies to adults and young people from the age of fifteen.
It is advisable to take Nurofen® with a meal as it reduces the risk of stomach upset. The dose is adjusted in children and also in patients with severe hepatic impairment.
For children with a body weight between 20 and 40 kilograms, the maximum daily dose is 20 to 30 milligrams of ibuprofen. This dose should not be exceeded and should be divided into individual doses with an interval of six to eight hours.
Nurofen® can be used as a fever or pain juice in children from 6 months of age; the dosage can be found in the package insert or from the doctor or pharmacist and should not be exceeded.

A doctor should be consulted if symptoms persist for more than three to four days despite the use of Nurofen®.

Use in pregnancy and in children

In the first six months of pregnancy, the risk of malformations due to Nurofen® is low; use by pregnant women should only take place after a careful risk-benefit analysis by the doctor.
In the first two thirds of a pregnancy, ibuprofen is part of the pain and fever control Paracetamol one of the drugs of first choice. It is not advisable to take Nurofen in the last trimester of pregnancy, as ibuprofen can harm the unborn child.
Nurofen can be given right before delivery to stop labor and thereby delay delivery.
Since the active ingredient ibuprofen and its breakdown products are only passed into breast milk in very small quantities, there are no known negative consequences for the infant. Therefore, when using Nurofen® for a short time, breastfeeding does not usually have to be interrupted. However, early weaning should be considered if a longer period of use or higher dosages are prescribed.

In premature babies (before the 34th week of pregnancy) ibuprofen can be used to open an open Ductus arteriosus Botalli (Connection between the main artery and pulmonary artery in the prenatal blood circulation).

Nurofen® and the active ingredient ibuprofen are not suitable for children under six months.
For older children, the age restriction is based on the respectively approved doses of Nurofen®, as they can be found in the package insert or as prescribed by the pediatrician.
As a rule, 7 to 10 milligrams of ibuprofen per kilogram of body weight are given as a single dose; the maximum daily dose is 30 milligrams per kilogram of body weight.
If the child has ever had an allergic reaction to an active ingredient from the group of non-steroidal anti-inflammatory drugs (e.g. Acetylsalicylic acid) Nurofen® should not be administered. It is especially important that a child never takes more Nurofen® than the recommended dose.
In inherited metabolic disease Cystic fibrosis (cystic fibrosis) treatment with ibuprofen in very high doses significantly improves symptoms in children with mild cystic fibrosis. In this area, however, ibuprofen is not widely used due to the potential side effects.

Side effects

The most common side effects of Nurofen® are gastrointestinal complaints (abdominal pain, heartburn, constipation, nausea and vomiting, diarrhea, flatulence) and slight bleeding in the gastrointestinal tract.
The development of a gastrointestinal ulcer is also one of the undesirable side effects of Nurofen®. This complication depends on the dose and duration of use and is more common in the elderly.
Further side effects of Nurofen® are inflammatory mouth ulcers, relapse triggering of chronic inflammatory bowel diseases (Ulcerative colitis, Crohn's disease), Dizziness, irritability, or tiredness.
Occasionally, water retention in the tissue may occur under Nurofen® (Edema), especially in patients with impaired kidney function or high blood pressure. Rashes, itchy skin, asthma attacks, and kidney dysfunction are also occasionally seen. Long-term use of Nurofen® can cause headaches (so-called analgesic-induced headache), which must not be treated with even higher doses of the drug.

The influence of Nurofen® on blood clotting is weaker than that of Acetylsalicylic acid, however, the risk of bleeding after surgery can increase if you take Nurofen®.
Very rarely there is a bleeding disorder (Agranulocytosis), which manifests itself as fever, sore throat, flu-like symptoms, skin and nose bleeding. If such symptoms occur, a doctor should be consulted immediately.

When should Nurofen® not be used?

Nurofen® must not be used in case of blood formation disorders, gastrointestinal ulcers, bleeding in the brain or other parts of the body, in severe heart failure and in severe liver or kidney dysfunction. It is therefore not advisable to take drugs that are also kidney damaging, such as ACE inhibitors, ciclospoprin A or tacrolimus at the same time.
Using Nurofen® at the same time as drugs that also affect blood clotting (anticoagulants) can increase the risk of bleeding. Nurofen® can reduce the anticoagulant effect of acetylsalicylic acid (because the mechanisms of action are different).

Lithium-containing drugs should not be combined with Nurofen®, as lithium poisoning (intoxication) can occur.
If severe hypersensitivity reactions occur when taking Nurofen® (or with similar active ingredients, e.g. acetylsalicylic acid) such as swelling of the face or tongue, shortness of breath, rapid heartbeat, drop in blood pressure, itching and reddening of the eyes, narrowing of the airways (asthma) or, in rare cases, allergic Shock with loss of consciousness, a doctor should be consulted immediately and the drug should then no longer be used.
When taking anti-diabetic drugs, the blood sugar level should be checked particularly carefully and the dosage of the anti-diabetic drug adjusted if necessary, as Nurofen® also affects the blood sugar level.
Taking Nurofen® can impair your ability to react to such an extent that driving or using machines can be dangerous. This is especially true in conjunction with alcohol.
People who suffer from nasal polyps, hay fever, chronically pathological narrowing of the airways or have a tendency to allergies may only use Nurofen® under certain precautionary measures and under direct medical supervision.