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Indications for use

The use of Imet is indicated for the symptomatic treatment of pain of mild to moderate intensity:

• Diseases of the musculoskeletal system: osteoarthritis, rheumatoid arthritis, ankylosing spondylitis and other inflammatory and degenerative pathologies; psoriatic arthritis, articular syndrome with exacerbation of gout;
• Bursitis, tendovaginitis;
• Post-traumatic pain in joints and muscles;
• Toothache and headache;
• Acute respiratory viral infections (as part of complex therapy);
• Algodismenorrhea, adnexitis;
• Feverish conditions of various origins.

Contraindications

• Severe renal and/or liver dysfunction;
• Severe form of cardiovascular failure;
• Peptic ulcers, hemorrhage, including a history;
• Functional disorders of the hematopoietic system associated with a tendency to active bleeding, including gastrointestinal and cerebrovascular bleeding;
• Aspirin triad (history);
• Concomitant use of selective cyclooxygenase-2 inhibitors or other non-steroidal anti-inflammatory drugs;
• Age up to 12 years;
• III trimester of pregnancy;
• Hypersensitivity to the components of the drug and other non-steroidal anti-inflammatory drugs.

It is recommended to prescribe Imet with caution to: elderly patients due to the increased risk of bleeding, including death; with systemic lupus erythematosus, arterial hypertension, mixed collagenosis, cardiovascular failure, impaired renal and liver function; in the first and second trimesters of pregnancy, during breastfeeding; immediately after surgery.

Special instructions for the use of the drug Imet

Particular caution is required in patients with a congenital disorder of porphyrin metabolism (for example, acute intermittent porphyria); systemic lupus erythematosus or mixed collagenosis; complaints from the gastrointestinal tract or chronic intestinal diseases (ulcerative colitis, Crohn's disease); hypertension (arterial hypertension) and/or heart failure; impaired renal function; allergies (for example, skin reactions to other drugs, asthma, hay fever) and/or with hay fever or chronic inflammation of the airways, accompanied by their narrowing; with simultaneous administration of methotrexate (dose 15 mg). In order to reduce the severity of side effects, it is necessary to take the minimum effective dose of the drug for the shortest period. If long-term use of the drug Imet is necessary, regular monitoring of liver function indicators, kidney function, and hemogram is necessary. In the case of long-term use of painkillers in high doses, headaches may occur, which cannot be treated by increasing the dose of the drug. In general, addiction to painkillers, especially combinations of several active ingredients with analgesic effects, can lead to further kidney damage with the risk of renal failure (“analginic” nephropathy). Pregnancy and lactation period: Imet should not be used in the first and second trimester of pregnancy, since the effect of inhibition of prostaglandin synthesis on pregnancy has not been clarified. Ibuprofen and its metabolites pass into breast milk in small quantities. In the case of short-term use of the drug in therapeutic doses for pain and fever, there is no need to interrupt breastfeeding, since harmful consequences for the child have not been established. It is advisable to stop breastfeeding if long-term treatment or higher doses (1200 mg ibuprofen per day) are necessary. Effect on the ability to drive vehicles and operate complex mechanisms When taking the drug for a short time, there is no need for preventive measures.

Directions for use and dosage

The tablets are taken orally, without chewing, during or immediately after meals, with a sufficient amount of water.

The dose and duration of use are prescribed by the doctor individually, taking into account the clinical indications and the patient’s condition.

Recommended daily dosage:

• Pain syndrome of weak and moderate intensity: 200-400 mg 2-3 times a day with an interval between doses of at least 4 hours;
• Feverish conditions of various origins: 200-400 mg 1 time per day, if necessary, repeated administration is allowed after 4 hours.

The maximum daily dose for patients over 15 years of age is 1200 mg, for children over 12 years of age – 1000 mg.

For elderly patients, no dose adjustment is required.

Side effects

• From the gastrointestinal tract: nausea, epigastric pain, vomiting, dry mouth, heartburn, flatulence, indigestion, diarrhea or constipation; possible - ulcerative lesions of the stomach and duodenum (including with perforation and bleeding), gastrointestinal bleeding, ulcerative stomatitis, exacerbation of colitis and Crohn's disease, esophagitis, gastritis, pancreatitis; in isolated cases – duodenitis;
• From the cardiovascular system: heart failure, arrhythmia, arterial hypertension; possible – development of myocardial infarction (when taking high doses);
• From the nervous system: dizziness, headache, sleep disturbances, irritability, increased fatigue; possibly depression, emotional lability, feelings of causeless anxiety and other psychotic reactions; in isolated cases – convulsions, psychomotor agitation;
• From the hematopoietic system: thrombocytopenia, anemia, pancytopenia, agranulocytosis, leukopenia; in patients with impaired function of the hematopoietic system - erosive lesions of the oral mucosa, sore throat and/or muscle pain, increased body temperature, depression; possible - hematomas, skin hemorrhages, nosebleeds and other bleeding of unknown etiology;
• From the hepatobiliary system: functional liver disorders, toxic liver damage, hepatitis, acute liver failure, hepatorenal syndrome;
• From the senses: blurred vision (with long-term use), including dryness of the mucous membrane and color perception of the eye, decreased clarity of vision; possible – hearing impairment, tinnitus;
• From the genitourinary system: edema (mainly in patients with arterial hypertension and/or renal failure), necrosis of the renal papillae, interstitial nephritis, hyperuricemia, nephrotic syndrome, polyuria, cystitis, oliguria; in isolated cases - hematuria, glomerulonephritis;
• Allergic reactions: itching, skin rash, rhinitis, erythema multiforme, urticaria, anaphylactoid reactions, including swelling of the tongue and larynx, arterial hypotension, anaphylactic shock; possible – development of bronchospasm and bronchial asthma in patients with increased individual sensitivity;
• From the skin: dry skin, Stevens-Johnson syndrome, alopecia, Lyell's syndrome, photosensitivity;
• Other: arterial thromboembolism, stroke (with long-term use in high doses).

In addition, undesirable effects of using Imet can be an exacerbation or development of infectious diseases: necrotizing fasciitis, aseptic meningitis (symptoms - stiff neck, hyperthermia, nausea, headache, vomiting, impaired consciousness).

Side effects of the drug Imet

The assessment of side effects is based on these frequencies: very often (1/10); often (1/100); sometimes (1/1000); rare (1/10,000); very rare ≤1/10,000, including isolated cases). Digestive tract Sometimes: complaints from the digestive tract, such as heartburn, abdominal pain, nausea. Rarely: diarrhea, bloating, constipation, vomiting. Very rare: stomach and/or intestinal ulcers (in certain circumstances, with bleeding and/or perforation). Nervous system Sometimes: headache. Kidneys Very rare: decreased diuresis and edema; damage to renal tissue (necrosis of the renal papillae) with long-term use; increased concentration of uric acid in blood serum. Liver Very rare: damage to liver tissue with prolonged use. Blood system Very rare: hematopoietic disorders (anemia, leukopenia, thrombocytopenia, pancytopenia, agranulocytosis). Skin Very rare: severe skin reactions such as skin rashes with redness and blistering (eg Erythema exsudativum multiforme). Immune system Very rare: symptoms of aseptic meningitis, accompanied by severe headache, nausea, fever, stiff neck or confusion. The risk of developing this condition is higher in patients with systemic lupus erythematosus or mixed collagenosis. Hypersensitivity reactions Sometimes: skin rashes and itching, asthma attacks (possibly with a decrease in blood pressure). Very rare: severe hypersensitivity reactions with manifestations of swelling of the face, tongue and larynx with signs of obstruction, shortness of breath, tachycardia, decreased blood pressure up to the development of shock.

special instructions

Elderly patients should be prescribed a minimum single dose at the beginning of treatment; if necessary and normal tolerability of the drug, it can be gradually increased.

If allergic reactions develop, the patient should stop taking it and immediately consult a doctor for advice.

With long-term use of Imet, regular monitoring of hemograms and renal function is recommended.

If gastrointestinal bleeding develops, the signs of which are severe pain in the epigastric region, vomit the color of coffee grounds, black stools, you must stop taking the drug and consult a doctor.

If an infectious pathology worsens or a new infection develops while using ibuprofen, the patient should consult a doctor to prescribe antibacterial therapy.

During the period of use of Imeta, patients are advised to refrain from performing potentially hazardous types of work, including driving vehicles and machinery.

Drug interactions Imet

Ibuprofen, like other NSAIDs, should be taken with caution in combination with drugs such as acetylsalicylic acid or other NSAIDs and corticosteroids (increased risk of stomach and intestinal ulcers, gastrointestinal bleeding), excluding their local use; antihypertensive drugs and diuretics (ibuprofen may weaken their effect); with agents that inhibit blood clotting (control of the blood coagulation system); with lithium (control of lithium levels in the blood); methotrexate (increased side effects); cidovudine (increased risk of hemarthrosis and hematomas in HIV-infected patients).

Drug interactions

When taken simultaneously, Imet reduces the antihypertensive effect of amlodipine, captopril, angiotensin-converting enzyme (ACE) inhibitors and beta-blockers; pharmacological effect of furosemide, hypothiazide, hydrochlorothiazide and other diuretics.

The drug enhances the effect of anticoagulants, increasing the risk of gastrointestinal bleeding.

Ibuprofen in combination with lithium preparations, phenytoin, digoxin helps to increase the level of their concentration in the blood plasma.

When taken simultaneously, the drug displaces indirect anticoagulants, sulfonylurea derivatives, oral hypoglycemic agents and hydantoin derivatives from their bonds with blood plasma proteins; increases the toxic effect of methotrexate and baclofen.

With simultaneous use of Imeta:

• Cholestyramine – helps reduce the absorption of ibuprofen in the gastrointestinal tract;
• Warfarin – promotes the development of microhematuria and hematomas, increasing the period of bleeding;
• Acetylsalicylic acid - reduces the plasma concentration of ibuprofen;
• Magnesium hydroxide – increases the initial absorption of ibuprofen in the gastrointestinal tract;
• Glucocorticosteroids - increase the likelihood of developing side effects from the digestive system.

Pharmacological properties of the drug Imet

Ibuprofen is an NSAID whose action is associated with inhibition of prostaglandin synthesis. It reduces pain, swelling and fever caused by inflammation. In addition, ibuprofen inhibits platelet aggregation caused by ADP and collagen. When administered orally, ibuprofen is partially absorbed in the stomach and completely absorbed in the small intestine. Undergoing biotransformation in the liver (hydroxylation, carboxylation), pharmacologically inactive metabolites are completely excreted, mainly by the kidneys (90%), and are also excreted through the hepatobiliary system. The half-life in healthy people and in patients with liver and/or kidney diseases is 1.8–3.5 hours. Plasma protein binding after oral administration is 99%. Peak serum concentrations after oral administration are achieved within 1–2 hours.