Ibuprofen is a NonSteroidal Anit-Inflammatory Drug (known as a NSAID). It is used to relieve mild to moderate pain (such as headaches, menstrual pain, back and muscle pains) as well as reducing fever and also helping with some types of pain associated with Arthritis and Rhematism. It works by reducing the hormones that cause pain and inflammation in the body and has been used for 50 years since its launch in the UK in 1969.

It is important that you read and fully understand the Patient Information Leaflet before purchasing this item.

To see even more information on symptoms and the product please visit the manufacturer’s web-site here

Before you take this medicine

This medicine can be taken by adults and children aged 12 years and over. However, some

people should not take this medicine or should seek the advice of their pharmacist or doctor

first. Please view the section on Ingredients and Precautions.

Usage

Check the foil is not broken before use. If it is, do not take that tablet.

Adults and children of 12 years and over:

Maximum dose of 1200 mg per day in divided doses (200 mg-400 mg, up to three times a day as required. The maintenance dose will be determined on an individual basis (in the range 600 – 1200 mg per day).

Leave at least four hours between doses and do not take more than 1200 mg in any 24 hours.

Older people

To reduce the possibility of side effects if you are older, you should use the minimum dose for the shortest possible duration. Your doctor may monitor you for bleeding in the stomach.

For oral administration and short –term use only.

Adults, the elderly and children over 12 years:

The lowest effective dose should be used for the shortest duration necessary to relieve symptoms. The patient should consult a doctor if symptoms persist or worsen, or if the product is required for more than 10 days.

For immediate release preparations: 200mg -400mg, up to three times a day as required.

For prolonged release preparations: 200 mg – 400mg up to twice a day is required.

Leave at least four hours between doses and do not take more than 1200 mg in any 24 hour period.

Do not give to children under 12 years, unless your doctor tells you to.

Ingredients

The active ingredient is ibuprofen.

The other ingredients are starch, colloidal silicon dioxide, sodium starch glycollate, stearic acid, hydroxypropylmethylcellulose (E464), talc and the dyes erythrosine (E127) and titanium dioxide (E171).

Precautions

Do NOT take Ibuprofen if you:

• are allergic to ibuprofen or any of the other ingredients of this medicine (listed above).
• have or had an allergic reaction to aspirin or any other NSAID (you have ever had asthma, runny nose, itchy skin or swelling of the lips, face or throat after taking these medicines)
• have an increased tendency of bleeding
• are suffering from or have a history of repeated stomach ulcers or other gastric complaint
• are suffering from heart failure, which can cause shortness of breath or ankle swelling
• suffer from kidney or liver problems
• are in last 3 months of your pregnancy.
• have systemic lupus erythematosus (SLE, sometimes known as lupus) or a connective tissue disease (autoimmune diseases affecting connective tissue)

Do not take if you 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.

Talk to your doctor, pharmacist or nurse before taking Ibuprofen. If you:

• are elderly
• are suffering from or have a history of bronchial asthma
• have a history of stomach or bowel problems
• have problems with your kidneys, heart or liver
• suffer from high blood pressure
• have systemic lupus erythematosus (SLE, sometimes known as lupus) or a connective tissue disease (autoimmune diseases affecting connective tissue).
• have a history of gastrointestinal disease
• are severely dehydrated
• have problems conceiving or are in the first 6 months of pregnancy
• are taking any non-steroidal anti-inflammatory medicine, including aspirin as this may result into increased tendency of ulceration or bleeding
• have ulcerated colitis or Crohn’s disease

If you suffer from any of the following at any time during your treatment STOP TAKING the medicine and seek immediate medical help:

• Pass blood in your faeces (stools/ motions)
• Pass black tarry stools
• Vomit any blood or dark particles that look like coffee grounds

STOP TAKING the medicine and tell your doctor if your experience:

• Indigestion or heartburn
• Abdominal pain (pains in your stomach) or other abdominal stomach symptoms
• Anti-inflammatory/pain-killer medicines like ibuprofen may be associated with a small increased risk of heart attack or stroke, particularly when used at high doses. 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 if you have had a heart attack, bypass surgery, peripheral artery disease (poor circulation in the legs of feet due to narrow or blocked arteries), or

any kind of stroke (including ‘mini-stroke’ or transient ischaemic attack “TIA”).

– have high blood pressure, diabetes, high cholesterol, have a family history of heart disease or stroke, or if you are a smoker.

Other medicines and Ibuprofen

Tell your doctor or pharmacist if you are taking, have recently taken or might take any other medicines of the following:

• any other pain-relieving medication, including aspirin
• medicines that are anti-coagulants (i.e. thin blood/prevent clotting e.g. aspirin/acetylsalicylic acid, warfarin, ticlopidine)
• a diuretic (‘water tablet’)
• medicines that reduce high blood pressure (ACE-inhibitors such as captopril, beta-blockers such as atenolol medicines, angiotensin-II receptor antagonists such as losartan)
• medicines for heart problems e.g. digoxin, digitoxin
• lithium, a drug used in the treatment of depression
• methotrexate, a treatment for leukaemia
• medicines known as immunosuppressants such as ciclosporin and tacrolimus (used to dampen down your immune response)
• mifepristone in the last 8 – 12 days, used to end a pregnancy
• corticosteroids, (medicines to treat a variety of conditions such as allergies and hormone imbalances), e.g. aldosterone, hydrocortisone or prednisolone
• quinolone antibiotics, e.g. ciprofloxacin, norfloxacin or levofloxacin
• zidovudine (an anti-viral drug)
• medicines known as selective serotonin reuptake inhibitors (SSRIs), used for the treatment of depression
• any other ibuprofen preparations, such as those you can buy without a prescription
• cholestyramine (a drug used to lower cholesterol)
• medicines known as sulphonylureas such as glibenclamide and glipizide (used to treat diabetes)
• voriconazole or fluconazole (types of anti-fungal drugs)
• Gingko biloba herbal medicine (there is a chance you may bleed more easily if you are taking this with ibuprofen)
• aminoglycosides (a type of antibiotic).

Some other medicines may also affect or be affected by the treatment of Ibuprofen. You should therefore always seek the advice of your doctor or pharmacist before you take Ibuprofen with other medicines.

Pregnancy, breast-feeding and fertility

The use of Ibuprofen whilst pregnant or breast feeding should be avoided. Ibuprofen should not be used in the last 3 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. Please do not drive or operate machinery if you experience this effect.

If you take more Ibuprofen than you should

If you (or someone else) swallow a lot of the tablets all together or if you think a child has swallowed any of the tablets, contact your nearest hospital casualty department or your doctor immediately. An overdose is likely to cause stomach pain, feeling sick, being sick, diarrhoea, ringing in the ears, headache, bleeding in the stomach or intestines. Please take this leaflet, any remaining tablets and the container with you to the hospital or doctor so that they know which tablets were consumed.

If you forget to take Ibuprofen

If you forget to take a tablet, take one as soon as you remember, unless it is nearly time to take the next one. Do not take a double dose to make up for a forgotten dose. Take the remaining doses at the correct time.

If you stop taking Ibuprofen

Do not stop taking your medicine without talking to your doctor first even if you feel better. If you have any further questions on the use of this medicine, ask your doctor, pharmacist or nurse.

Possible side effects

Like all medicines, Ibuprofen can cause side effects, although not everybody gets them. If any of the following happen, stop taking the tablets and tell your doctor immediately or go to the casualty department at your nearest hospital:

• an allergic reaction swelling of the lips, face or neck leading to severe difficulty in breathing; skin rash or hives)
• Stevens-Johnson syndrome (severe blisters and bleeding in the mucous membranes of the lips, eyes, mouth, nasal passage, and genitals) or severe headache, high temperature, stiffness of the neck, a skin reaction causing blistering and flaking of the skin, intolerance to light
• you pass blood in your faeces (stools/motions)
• you pass black tarry stools
• you vomit any blood or dark particles that look like coffee grounds.
• blood disorders such as low numbers of red or white blood cells, reduction in blood platelets (which may increase the risk of bleeding and bruising), neutropenia (which may cause fever or chills, sore throat, ulcers in your mouth or throat)
• heart problems causing symptoms such as shortness of breath when exercising or lying flat, wheezing and a cough, weight gain

These are very serious but rare side effects. You may need urgent medical attention or hospitalisation.

The following side effects have been reported at the approximate frequencies shown:

Rare: may affect up to 1 in 1,000 people – stop taking the medicine and tell your doctor if you experience:

• abdominal pain (pains in your stomach) or other abnormal stomach symptoms, indigestion, heartburn, feeling sick and/or being sick
• unexplained wheezing, shortness of breath, skin rash, itching or bruising
• yellowing of the eyes and/or skin
• severe sore throat with high fever
• blurred or disturbed vision, or seeing/hearing strange things
• fluid retention (e.g. swollen ankles)

Very rare: may affect up to 1 in 10,000 people

Very rarely Ibuprofen Tablets may cause aseptic meningitis (inflammation of the protective membrane surrounding the brain) especially in patients with an auto-immune disease e.g. Systemic Lupus Erythematosus (SLE) or mixed connective tissue disease; symptoms may include stiff neck, headache, nausea, vomiting, fever, disorientation.

Other side effects (Frequency unknown) and other side effects that have been reported while taking Ibuprofen:

• peptic ulcer (ulcer in your stomach or duodenum) or bleeding in your stomach
• pancreatitis (inflammation of the pancreas)
• diarrhoea
• constipation
• flatulence (wind)
• inflammation or ulceration of the mouth e.g. mouth ulcers and cold sores (ulcerative stomatitis)
• high blood pressure
• heart problems causing symptoms such as shortness of breath when exercising or lying flat,
• kidney problems such as inflammation of the kidneys, kidney damage or kidney failure
• liver problems such as abnormal liver function test results, inflammation of the liver (hepatitis)
• breathlessness and wheezing in patients suffering from or with a previous history of asthma or allergic disease e.g. allergy to house dust mites, cats or dogs
• runny nose
• problems with the senses such as vision problems, inflammation of the optic nerve, pins-and-needles or numbness, ringing in the ears or impaired hearing
• headaches, hallucinations, depression, confusion, dizziness and vertigo (a feeling of dizziness or “spinning”), drowsiness and a general feeling of being unwell, lethargy
• difficulty in sleeping, anxiety

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

Medicines such as ibuprofen may be associated with a small increased risk of heart attack (“myocardial infarction”) or stroke.

If any of the side effects get serious, or if you notice any side effects not listed in this leaflet, please tell your doctor or pharmacist. You can minimize the risk of side effects by taking the least amount of tablets for the shortest amount of time necessary to control your symptoms.

Reporting of side effects

If you get any side effects, talk to your doctor, pharmacist or nurse. This includes any possible side

effects not listed here You can also report side effects directly via the Yellow Card Scheme at:

www.mhra.gov.uk/yellowcard

By reporting side effects you can help provide more information on the safety of this product.

 Other Information

If you need more advice consult your doctor or pharmacist.

Keep all medicines out of the sight and reach of children.