IBUPROFEN 600 MG TABLETS - patient leaflet, side effects, dosage

1. What Ibuprofen is and what is it used for

Ibuprofen belongs to a group of medicines called anti-inflammatory pain killers. They can be used to relieve pain and inflammation in conditions such as osteoarthritis, rheumatoid arthritis (including juvenile rheumatoid arthritis or Still's disease), arthritis of the spine, ankylosing spondylitis, swollen joints, frozen shoulder, bursitis, tendinitis, tenosynovitis, lower back pain, sprains and strains.

Ibuprofen can also be used to treat other painful conditions such as toothache, pain after operations, period pain and headache, including migraine.

The active ingredient in Ibuprofen Tablets is ibuprofen and each tablet contains either 400 or 600mg.

2. what you need to know before you take ibuprofen

If the answer to any of the following questions is ‚YES‘ please tell your doctor or pharmacist BEFORE taking any Ibuprofen:

Are you pregnant or planning to become pregnant, or are you breast-feeding? Ibuprofen may make it more difficult to become pregnant. You should inform your doctor if you are planning to become pregnant or if you have problems becoming pregnant.

• Are you sensitive (allergic) to any of the ingredients in the tablets? These are listed in Section 6.
• Do you have, or have you previously had, a stomach ulcer or other gastric complaint?

Do not take Ibuprofen if you currently have a peptic ulcer (ulcer in your stomach or duodenum) or bleeding in your stomach, or have had two or more episodes of peptic ulcers, stomach bleeding or perforation in the past.

• Do you have a condition which increases your tendency to bleeding?
• Do you suffer from asthma or have you ever had an allergic reaction or suffered from

wheezing after taking ibuprofen, aspirin or other anti-inflammatory pain killers?

• Do you suffer from swelling and irritation inside the nose?
• Do you suffer from liver or kidney disease?
• Do you suffer from heart disease?

Medicines such as Ibuprofen may be associated with a small increased risk of heart attack (myocardial infarction) or stroke. Any risk is more likely with high doses and prolonged treatment. Do not exceed the recommended dose or duration of treatment. You should discuss your treatment with your doctor or pharmacist before taking Ibuprofen if you:

– have heart problems including heart failure, angina (chest pain) or you have had a heart attack, bypass surgery or peripheral artery disease (poor circulation in the legs or feet due to narrow or blocked arteries).

– have any kind of stroke or think that you might be at risk of these conditions (e.g. if you have a family history of heart disease or stroke, high blood pressure, diabetes, high cholesterol or are a smoker).

• Do you have systemic lupus erythematosus (SLE, sometimes known as lupus) or a

connective tissue disease (autoimmune diseases affecting connective tissue)?

• Do you have chicken pox or shingles?
• Is your child dehydrated? There is a risk of kidney damage in dehydrated children and adolescents.
• Do you have an infection? (please see Infections below).

Warnings and precautions – Take special care with Ibuprofen

Skin reactions

Serious skin reactions have been reported in association with Ibuprofen treatment. You should stop taking Ibuprofen and seek medical attention immediately, if you develop any skin rash, lesions of the mucous membranes, blisters or other signs of allergy since this can be the first signs of a very serious skin reaction. See section 4.

Infections

Ibuprofen, as with other NSAIDs, may hide signs of infections such as fever and pain. It is therefore possible that Ibuprofen may delay appropriate treatment of infection, which may lead to an increased risk of complications. This has been observed in pneumonia caused by bacteria and bacterial skin infections related to chickenpox. If you take this medicine while you have an infection and your symptoms of the infection persist or worsen, consult a doctor without delay.

Can you take Ibuprofen with other medicines?

Some medicines that are anti-coagulants i.e. thin blood/prevent clotting e.g. aspirin/ acetylsalicyclic acid, warfarin, ticlodipine), some medicines that reduce high blood pressure (ACE-inhibitors such as captopril, beta-blockers such as atenolol, or angiotensin-II receptor antagonists such as losartan) and other medicines may affect or be affected by treatment with ibuprofen. You should therefore always seek the advice of your doctor or pharmacist before you use ibuprofen with other medicines.

In particular you should tell your doctor or pharmacist if you are taking any of the following medicines in addition to those mentioned above:

• Diuretics (water tablets)
• Cardiac glycosides, such as digoxin, used to treat heart conditions
• Lithium
• Zidovudine (an anti-viral drug)
• Steroids (used in the treatment of inflammatory conditions)
• Methotrexate (used to treat certain cancers and rheumatoid arthritis)
• Medicines known as immunosuppressants such as ciclosporin and tacrolimus (used to dampen down your immune response)
• Medicines known as selective serotonin reuptake inhibitors (SSRis), used for the treatment of depression
• Antibiotics called quinolones such as ciprofloxacin
• Aminoglycosides (a type of antibiotic)
• Mifepristone
• Any other ibuprofen, such as those you can buy without a prescription
• Any other anti-inflammatory pain killer, including aspirin
• Cholestyramine (a drug used to lower cholesterol)
• Medicines known as sulphonylureas such as glibenclamide (used to treat diabetes)
• Voriconazole or fluconazole (type of anti-fungal drugs)
• Gingko biloba herbal medicine (there is a chance you may bleed more easily if you are taking this with ibuprofen).

Pregnancy and breast-feeding : The use of Ibuprofen whilst pregnant or breast feeding should be avoided. Ibuprofen should not be used in late (the last three months of) pregnancy and should only be taken in the first six months of pregnancy on the advice of your doctor.

Driving and Using Machines : Ibuprofen may make you feel dizzy or drowsy. If the tablets affect you in this way do not drive, operate machinery or do anything that requires you to be alert.

Ibuprofen tablets contain lactose monohydrate

If you have been told by your doctor that you have an intolerance to some sugars, contact your doctor before taking this medicinal product.

3. how to take ibuprofen

ALWAYS take Ibuprofen exactly as your doctor has told you. If you are not sure refer to the label on the carton or check with your doctor or pharmacist.

The lowest effective dose should be used for the shortest duration necessary to relieve symptoms. If you have an infection, consult a doctor without delay if symptoms (such as fever and pain) persist or worsen (see section 2).

Take your Ibuprofen with or after food, with a glass of water.

Ibuprofen should be swallowed whole and not chewed, broken, crushed or sucked to help prevent discomfort in the mouth or irritation in the throat.

DOSAGE :

Adults and children over 12 years – The usual dosage is 600 to 1800mg spread throughout the day. Your doctor may choose to increase this depending on what you are being treated for; but no more than 2400mg should be taken in one day.

Children -The usual daily dose is 20mg per kg of bodyweight each day, given in divided doses. Ibuprofen should NOT be taken by children weighing less than 7kg. The 600mg tablets should not be given to children under the age of 12 years.

In cases of severe juvenile arthritis your doctor my increase the dosage up to 40mg/kg in divided doses.

You should avoid excessive use of painkillers. If you usually take painkillers, especially combinations of different painkillers, you may damage your kidneys, tell your doctor if you are already taking another painkiller before taking this medicine and your doctor will decide whether you should take this medicine. This risk may be increased if you are dehydrated. IF YOU TAKE MORE IBUPROFEN THAN PRESCRIBED (AN OVERDOSE) or if children have taken this medicine by accident you should contact a doctor or go to the nearest hospital casualty department IMMEDIATELY taking your tablets with you. The symptoms can include nausea, stomach pain, vomiting (may be blood streaked), headache, ringing in the ears, confusion and shaky eye movement. At high doses, drowsiness, chest pain, palpitations, loss of consciousness, convulsions (mainly in children), weakness and dizziness, blood in urine, cold body feeling, and breathing problems have been reported.

IF YOU FORGET TO TAKE YOUR IBUPROFEN take them as soon as you remember, unless it is almost time for your next dose. Ifit is, do not take the missed dose at all. Never double up on a dose to make up for the one you have missed.

4. possible side effects

As with all medicines, Ibuprofen may cause side effects, although they are usually mild and not everyone will suffer from them. If any side effects become serious or if you notice any side effects that are not listed in this leaflet, please tell your doctor or pharmacist. You can minimise the risk of side effects by taking the least amount of tablets for the shortest amount of time necessary to control your symptoms.

STOP TAKING Ibuprofen and seek immediate medical help if you experience:

• Signs of aseptic meningitis such as severe headache, high temperature, stiffness of the neck or intolerance to bright light.
• Signs of intestinal bleeding such as

o Passing blood in your faeces (stools/motions)

o Passing black tarry stools

o Vomiting any blood or dark particles that look like coffee grounds

TELL YOUR DOCTOR AND STOP TAKING IBUPROFEN IF YOU EXPERIENCE:

• Unexplained stomach pain (abdominal pain) or other abnormal stomach symptoms, indigestion, heartburn, feeling sick and/or vomiting.
• Unexplained wheezing, shortness of breath, skin rash, itching or bruising (these may be symptoms of an allergic reaction).
• Yellowing of the eyes and/or skin (jaundice).
• Severe sore throat with high fever (these may be symptoms of a condition known as agranulocytosis).
• Blurred or disturbed vision (visual impairment) or seeing/hearing strange things (hallucinations).
• Fluid retention e.g. swollen ankles (this may be a sign of kidney problems).
• Severe spreading skin rash (Stevens-Johnson Syndrome and erythema multiforme, symptoms include severe skin rash, blistering of skin, including inside mouth, nose, and genitals, as well as skin peeling which may be accompanied with symptoms such as aching, headaches, and feverishness).

Medicines such as Ibuprofen have been associated with a small increased risk of heart attack (myocardial infarction) or stroke.

Medicines such as Ibuprofen have in exceptional cases been associated with severe skin problems for patients with chicken pox or shingles.

Blood disorders, kidney problems, liver problems or severe skin reactions may occur rarely with ibuprofen.

Very rarely Ibuprofen may cause aseptic meningitis (inflammation of the protective membrane surrounding the brain).

Ibuprofen has also been shown to sometimes worsen the symptoms of Crohn's disease or colitis.

Other side effects

Common (affects up to 1 in 10 people):

• Rash
• Feeling dizzy or tired
• Stomach pain, indigestion, diarrhoea, feeling sick, being sick, wind, constipation
• Headache- if this happens while you are taking this medicine it is important not to take any other medicines for pain to help with this.
• Passing black tarry stools
• Passing blood in your fasces (stools/motions)
• Vomiting any blood

Uncommon (affects up to 1 in a 100 people):

• Feeling drowsy
• Feeling anxious
• Feeling a tingling sensation or ‚pins and needles‘
• Difficulty sleeping
• Hives, itching
• Skin becomes sensitive to light
• Visual disturbances, hearing problems
• Hepatitis, yellowing of your skin or eyes, reduced liver function
• Reduced kidney function, inflammation of the kidneys, kidney failure
• Sneezing, blocked, itchy or runny nose (rhinitis)
• Stomach or gut ulcer, hole in the wall of the digestive tract
• Inflammation of your stomach lining
• Small bruises on your skin or inside your mouth, nose or ears
• Difficulty breathing, wheezing or coughing, asthma or worsening of asthma
• Ringing in ears (tinnitus)
• Sensation of feeling dizzy or spinning (vertigo)
• Mouth ulcers
• Serious allergic reaction which causes swelling of the face or throat

Rare (affects up to 1 in a 1000 people):

• Feeling depressed or confused
• Fluid retention (oedema)
• A brain infection called ‚non-bacterial meningitis‘
• Loss of vision
• Changes in blood count – the first signs are: high temperature, sore throat, mouth ulcers, flulike symptoms, feeling very tired, bleeding from the nose and the skin
• Reduction in blood cells (anaemia)
• Serious allergic reaction which causes difficulty in breathing or dizziness
• Severe sore throat with high fever (agranulocytosis)

Very rare (affects up to 1 in 10,000 people):

• Liver failure
• Heart failure
• Heart attack
• Inflammation of the pancreas
• Skin problems (which can also affect inside your mouth, nose or ears) such as ‚Stevens-Johnson syndrome‘, ‚toxic epidermal necrolysis‘ or ‚erythema multiforme‘.
• High blood pressure

Not known (frequency cannot be estimated from available data):

• Worsening of ulcerative colitis or Crohn's Disease inflammation of the colon)
• A severe skin reaction known as DRESS syndrome can occur. Symptoms of DRESS include: skin rash, fever, swelling of lymph nodes and an increase of eosinophils (a type of white blood cells).
• A red, scaly widespread rash with bumps under the skin and blisters mainly localized on the skin folds, trunk, and upper extremities accompanied by fever at the initiation of treatment (acute generalised exanthematous pustulosis). Stop using Ibuprofen if you develop these symptoms and seek medical attention immediately. See also section 2.
• Skin becomes sensitive to light.

5. how to store ibuprofen

Your tablets should not be stored above 25° C. They should be kept in a safe place out of the reach and sight of children as your medicine could harm them.

They should be kept in the original packaging. Do NOT take Ibuprofen after the ‚use by‘ date shown on the carton. If your doctor decides to stop your treatment, return any leftover tablets to your pharmacist.

Only keep the tablets if your doctor tells you to.

Do not throw away any medicines via wastewater. Ask your pharmacist how to throw away medicines you no longer use. These measures will help protect the environment.

6. contents of the pack and other information

The active substance in Ibuprofen Tablets is Ibuprofen Ph.Eur. available as 400 or 600mg tablets. The tablets are white, pillow shaped and film-coated.

They are supplied in blister packs containing 60 tablets.

Ibuprofen Tablets inactive ingredients: microcrystalline cellulose, croscarmellose sodium, lactose monohydrate, colloidal anhydrous, silica, sodium laurilsulfate, magnesium stearate, Opaspray white M-1–7111 B (comprising hypromellose 2910 and titanium dioxide), dry colour dispersion, white 06A28611 (or a combination of Opaspray white M-1–7111 B, hypromellose and talc).

Marketing Authorisation Holder:

Abbott Laboratories Limited

Abbott House

Vanwall Business Park

Vanwall Road

Maidenhead

Berkshire

SL6 4XE

UK

Manufacturer:

7 Anthousas Ave, 153 44 Anthousa Attiki, Greece

This leaflet was last revised in 10/2020

This information is confidential