Drug title

Motrin (Ibuprofen)

Pharmacological action

NSAID. It has anti-inflammatory, analgesic and antipyretic effect due to non-selective inhibition of COX-1 and COX-2 activity, which regulates synthesis of prostaglandins.

Pharmacokinetics

Absorption and distribution

Absorption from the gastrointestinal tract is fast and complete, bioavailability is 95% (eating has almost no effect on either the completeness or the rate of absorption). Time to reach Cmax is 2 hours.

Binding to plasma proteins is 99%. Css of the drug in plasma is reached after 2-3 days.

Metabolism and excretion

Metabolized in the liver to dimethylnaproxen with the participation of the CYP2C9 enzyme system. Clearance is 0.13 ml/min/kg.

T1/2 is 12-15 hours. 98% is excreted with the urine, 10% of it is excreted unchanged; 0.5-2.5% is excreted with the bile.

Pharmacokinetics in special clinical cases

Cumulation of metabolites is possible in chronic renal failure.

Contraindications to use

• Hypersensitivity to naproxen or naproxen sodium;
• complete or incomplete combination of bronchial asthma, recurrent nasal and paranasal sinus polyposis and intolerance to acetylsalicylic acid or other NSAIDs (including history);
• the period of aortocoronary bypass surgery;
• erosive-ulcerative lesions of the stomach and duodenum in the acute phase (ulcerative colitis, Crohn's disease);
• cerebrovascular bleeding or other bleeding and hemostasis disorders;
• Severe renal insufficiency (CKR less than 30 ml/min), including confirmed hyperkalemia, advanced renal disease;
• Inhibition of medullary hematopoiesis;
• pregnancy;
• Lactation period (breast-feeding);
• Children under 12 years of age.

Caution should be exercised if the drug is prescribed in CHD, cerebrovascular disease, congestive heart failure, dyslipidemia/hyperlipidemia, diabetes mellitus, peripheral artery disease, IQ 30-60 ml/min, anamnestic data on the development of gastrointestinal ulcers, Helicobacter pylori infection, long-term use of NSAIDs, severe somatic diseases, concomitant therapy with anticoagulants (e.g., warfarin), antiplatelet agents (acetylsalicylic acid, clopidogrel), oral GCS (e.g., prednisolone), selective serotonin reuptake inhibitors (citalopram, fluoxetine, paroxetine, sertraline), smoking, frequent alcohol consumption, elderly patients, children and adolescents under 16 years old.

To reduce the risk of gastrointestinal adverse events, the lowest effective dose with the lowest possible course should be used.

Administration during pregnancy and lactation

The drug is contraindicated when pregnant and during lactation (breast-feeding).

Administration if liver function abnormalities

Caution should be exercised when prescribing the drug in patients with liver disease.

Administration in patients with kidney dysfunction

It is contraindicated in patients with severe renal insufficiency (CKG less than 30 ml/min), including confirmed hyperkalemia and in advanced renal disease.

The drug should be used with caution in case of CKD 30-60 ml/min.

Administration in children

It is contraindicated for children under 12 years of age.

Caution should be exercised when prescribing in children and adolescents under 16 years of age.

Administration in elderly patients

Caution should be exercised when prescribing the drug in elderly patients.

Indications of Motrin

Pain syndrome of mild to moderate severity:

• neuralgia;
• osalgia;
• myalgia;
• lumbo ischialgia;
• Post-traumatic pain syndrome (sprains and contusions) accompanied by inflammation;
• Postoperative pain (in traumatology, orthopedics, gynecology, maxillofacial surgery);
• headache;
• migraine;
• algodysmenorrhea;
• adnexitis;
• toothache.

Symptomatic therapy of pain syndrome in diseases of the musculoskeletal system, including:

• bursitis;
• tendovaginitis.

As part of the complex therapy of infectious and inflammatory diseases of the ear, throat, nose with a pronounced pain syndrome, including:

• pharyngitis;
• tonsillitis;
• otitis.
• Feverish states of the flu and colds.

The drug is used for symptomatic therapy (to reduce pain, inflammation and fever) and has no effect on the progression of the underlying disease.

Dosage regimen

The drug is taken orally. The tablets should be taken whole with plenty of fluid, and may be taken with food.

In adults and children over 12 years of age, the initial dose for pain relief is 500 mg, then, if necessary, 500 mg every 12 hours or 250 mg every 8 hours. The daily dose used for pain relief is 500-1000 mg.

For migraine pain relief, a dose of 500 mg 2 times a day is recommended. However, treatment should be discontinued if the frequency, intensity and duration of migraine attacks do not decrease within 4-6 weeks.

For relief of menstrual pain, pain after IUD insertion and other gynecological pain (adnexitis), the initial dose is 500 mg, then, if necessary, 250 mg every 6-8 hours for 3-4 days.

For symptomatic treatment of pain syndrome in musculoskeletal system disorders (bursitis, tendovaginitis), the usual daily dose of the drug is 500-1000 mg, one or two tablets twice a day in the morning and in the evening.

When using the drug as an antipyretic agent the initial dose is 500 mg and then, if necessary, 250 mg every 8 hours.

It is not recommended to use the drug as an analgesic for more than 5 days without consulting a doctor. If symptoms persist, the patient should consult a physician.