Best antihypertensive drug in bronchial asthma. Algoflex Forte

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It is especially important not to use ibuprofen during the last 3 months of pregnancy unless definitely directed to do so by a doctor because it may cause problems in the unborn child or complications during delivery.

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Keep out of reach of children. The use of Brufen with concomitant NSAIDs, including cyclooxygenase-2 selective inhibitors, should be avoided due to the increased risk of ulceration or bleeding.

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Elderly The elderly have an increased frequency of adverse reactions to NSAIDs, especially gastrointestinal bleeding and perforation, which may be fatal. Paediatric population There is a risk of renal impairment in dehydrated children and adolescents.

Gastrointestinal bleeding, ulceration and perforation GI bleeding, ulceration or perforation, which can be fatal, has been reported with all NSAIDs at anytime during treatment, with or without warning symptoms or a previous history of serious GI events.

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The risk of GI bleeding, ulceration or perforation is higher with increasing NSAID doses, in patients with a history of ulcer, particularly if complicated with haemorrhage or perforationand in the elderly. Patients with a history of gastrointestinal disease, particularly when elderly, should report any unusual abdominal symptoms especially gastrointestinal bleeding particularly in the initial stages of treatment.

Caution should be advised in patients receiving concomitant medications which could increase the risk of ulceration or bleeding, such as oral corticosteroids, anticoagulants such as warfarin, selective serotonin-reuptake inhibitors or anti-platelet agents such as aspirin.

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When GI bleeding or ulceration occurs in patients receiving Brufen, the treatment should be withdrawn. NSAIDs should be given with care to patients with a history of ulcerative colitis or Crohn's disease as these conditions may be exacerbated. Respiratory disorders and hypersensitivity reactions Caution is required if Brufen is administered to patients suffering from, or with a previous history of, bronchial asthma, chronic rhinitis or allergic diseases since NSAIDs have been reported to precipitate bronchospasm, urticaria or angioedema in such patients.

Cardiac, renal and hepatic impairment The administration of an NSAID may cause a dose dependent reduction in prostaglandin formation and precipitate renal failure. Brufen should be given reggeli vércukorszint care to patients with a history of heart failure or hypertension since oedema has been reported in association with ibuprofen administration. Overall, epidemiological studies do not suggest that low dose ibuprofen e.

Careful consideration should also be exercised before initiating long-term treatment of patients with risk factors for cardiovascular events e. Renal effects Caution should be used when initiating treatment with ibuprofen in patients with considerable dehydration.

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As with other NSAIDs, long-term administration of ibuprofen has resulted in renal papillary necrosis and other renal pathologic changes. Renal toxicity has also been seen in patients in whom renal prostaglandins have a compensatory role in the maintenance of renal perfusion.

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In these patients, administration of an NSAID may cause a dose-dependant reduction in prostaglandin formation and, secondarily, in renal blood flow, which may cause renal failure. Patients at greatest risk of this reaction are those with impaired renal function, heart failure, liver dysfunction, those taking diuretics and ACE inhibitors and the elderly. SLE and mixed connective tissue disease. Dermatological effects Serious skin reactions, some of them fatal, including exfoliative dermatitis, Stevens-Johnson syndrome, and toxic epidermal necrolysis, have been reported very rarely in association with the use of NSAIDs.

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Patients appear to be at highest risk of these reactions early in the course of therapy, the onset of the reaction occurring within the first month of treatment in the majority of cases. Brufen should be discontinued at the first appearance of skin rash, mucosal lesions, or any other sign of hypersensitivity.

Haematological effects Ibuprofen, like other NSAIDs, can interfere with platelet aggregation and prolong bleeding time in normal subjects.

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Aseptic meningitis Aseptic meningitis has been observed on rare occasions in patients on ibuprofen therapy. Although it is probably more likely to occur in patients with systemic lupus erythematosus and related connective tissue diseases, it has been reported in patients who do not have an underlying chronic disease. Impaired female fertility The use of Brufen may impair female fertility and is not recommended in women attempting to conceive. In women who have difficulties conceiving or who are undergoing investigation of infertility, withdrawal of Brufen should be considered.

However, patients with known CV disease or risk factors had a higher absolute incidence of excess serious CV thrombotic events, due to their increased baseline rate. Some observational studies found that this increased risk of serious CV thrombotic events began as early as the first weeks of treatment.

The increase in CV thrombotic risk has been observed most consistently at higher doses. To minimize the potential risk for an adverse CV event in NSAID-treated patients, use the lowest effective dose for the shortest duration possible. Physicians and patients should remain alert for the development of such events, throughout the entire treatment course, even in the absence of previous CV symptoms.

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Patients should be informed about the symptoms of serious CV events and the steps to take if they occur. There is no consistent evidence that concurrent use of aspirin mitigates the increased risk of serious CV thrombotic events associated with NSAID use.

Although the absolute rate of death declined somewhat after the first year post-MI, the increased relative risk of death in NSAID users persisted over at least the next four years best antihypertensive drug in bronchial asthma follow-up.

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Avoid the use of Algoflex Forte in patients with a recent MI unless the benefits are expected to outweigh the risk of recurrent CV thrombotic events.

If Algoflex Forte is used in patients with a recent MI, monitor patients for signs of cardiac ischemia. Gastrointestinal Bleeding, Ulceration, And Perforation NSAIDs, including ibuprofen, cause serious gastrointestinal GI adverse events including inflammation, bleeding, ulceration, and perforation of the esophagus, stomach, small best antihypertensive drug in bronchial asthma, or large intestine, which can be fatal.

These serious adverse events can occur at any time, with or without warning symptoms, in patients treated with NSAIDs. However, even short-term therapy is not without risk. Other factors that increase the risk of GI bleeding in patients treated with NSAIDs include longer duration of NSAID therapy; concomitant use of oral corticosteroids, aspirin, anticoagulants, or selective serotonin reuptake inhibitors SSRIs ; smoking; use of alcohol; older age; and poor general health status.

Most postmarketing reports of fatal GI events occurred in elderly or debilitated patients. Avoid use in patients at higher risk unless benefits are expected to outweigh the increased risk of bleeding. If a serious GI adverse event is suspected, promptly initiate evaluation and treatment, and discontinue Algoflex Forte until a serious GI adverse event is ruled out.

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In the setting of concomitant use of low-dose aspirin for cardiac prophylaxis, monitor cukorbetegség kezelésére kecske more closely for evidence of GI bleeding.

In addition, rare, sometimes fatal, cases of severe hepatic injury, including fulminant hepatitis, liver necrosis, and hepatic failure have been reported.

Inform patients of the warning signs and symptoms of hepatotoxicity e. If clinical signs and symptoms consistent with liver disease develop, or if systemic manifestations occur e. Hypertension NSAIDs, including Algoflex Forte, can lead to new onset of hypertension or worsening of pre - existing hypertension, either of which may contribute to the increased incidence of CV events. Patients taking angiotensin converting enzyme ACE inhibitors, thiazide diuretics, or loop diuretics may have impaired response to these therapies when taking NSAIDs.

Use of ibuprofen may blunt the CV effects of several therapeutic agents used to treat these medical conditions e. Avoid the use of Algoflex Forte in patients with severe heart failure unless the benefits are a cukorbetegségtől való láb lábak száma to outweigh the risk of worsening heart failure.

If Algoflex Forte is used in patients with severe heart failure, monitor patients for signs of worsening heart failure. In these patients, administration of an NSAID may cause a dose dependent reduction in prostaglandin formation and, secondarily, in renal blood flow, which may precipitate overt renal decompensation.

Patients at greatest risk of this reaction are those with impaired renal function, dehydration, hypovolemia, heart failure, liver dysfunction, those taking diuretics and ACE inhibitors or ARBs, diabétesz kezelésében kanada the elderly.

No information is available from controlled clinical studies regarding the use of Algoflex Forte in patients with advanced renal disease. The renal effects of Algoflex Forte may hasten the progression of renal dysfunction best antihypertensive drug in bronchial asthma patients with preexisting renal disease. Correct volume status in dehydrated or hypovolemic patients prior to initiating Algoflex Forte.

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Monitor renal function in patients with renal or hepatic impairment, heart failure, dehydration, or hypovolemia during use of Algoflex Forte. Avoid the use of Algoflex Forte in patients with advanced renal disease unless the benefits are expected to outweigh the risk of worsening renal function.

If Algoflex Forte is used in patients with advanced renal disease, monitor patients for signs of worsening renal function.

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Hyperkalemia Best antihypertensive drug in bronchial asthma in serum potassium concentration, including hyperkalemia, have been reported with use of NSAIDs, even in some patients without renal impairment. In patients with normal renal function, these effects have been attributed to a hyporeninemic­hypoaldosteronism state.

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Anaphylactic Reactions Ibuprofen has been associated with anaphylactic reactions in patients with and without known hypersensitivity to ibuprofen and in patients with aspirin-sensitive asthma. Seek emergency help if anaphylactic reaction occurs. Because cross-reactivity between aspirin and other NSAIDs has been reported in such aspirin-sensitive patients, Algoflex Forte is contraindicated in patients with this form of aspirin sensitivity.

When Algoflex Forte is used in patients with preexisting asthma without known aspirin sensitivitymonitor patients for changes in the signs and symptoms of asthma. These serious events may occur without warning. Inform patients about the signs and symptoms of serious skin reactions, and to discontinue the use of Algoflex Forte at the first appearance of skin rash or any other sign of hypersensitivity.

This may be due to occult or gross GI blood loss, fluid retention, or an incompletely described effect on erythropoiesis.

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If a patient treated with Algoflex Forte has any signs or symptoms of anemia, monitor hemoglobin or hematocrit. Co-morbid conditions such as coagulation disorder, concomitant use of warfarin, other anticoagulants, antiplatelet agents e. Monitor these patients for signs of bleeding.

Algoflex Forte must be diluted prior to use.

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Infusion of the drug product without dilution can cause hemolysis. Masking Of Inflammation And Fever The pharmacological activity of Algoflex Forte in reducing inflammation, and possibly fever, may diminish the utility of diagnostic signs in detecting infections. Laboratory Monitoring Because serious GI bleeding, hepatotoxicity, and renal injury can occur without warning symptoms or signs, consider monitoring patients on long-term NSAID treatment with a CBC and a chemistry profile periodically.

Ophthalmological Effects Blurred or diminished vision, scotomata, and changes in color vision have been reported with oral ibuprofen. Discontinue ibuprofen if a patient develops such complaints, and refer the patient for an ophthalmologic examination that includes central visual fields and color vision testing.

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