Buy Strepsils Intensive spray 875mg/dose fl. 15 ml

Strepsils® [Flurbiprofen]

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Available since: 2019-09-19

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Clinical Pharmacology

Nonsteroidal anti-inflammatory drug

Indications

As a symptomatic remedy to relieve sore throat in infectious and inflammatory diseases of the upper respiratory tract

Composition

1 dose (3 sprays) contains flurbiprofen 8.75 mg

Excipients: Betadex 22.83 mg; sodium hydrogen phosphate dodecahydrate 17,19 mg; citric acid monohydrate 0.63 mg, methyl parahydroxybenzoate 1.18 mg; propyl parahydroxybenzoate 0.24 mg; sodium hydroxide 1.30 mg; mint flavor (PHL 175628) 1.08 mg; cherry flavoring (PHL 175629) 1.35 mg; N-2,3-trimethyl-2-isopropylbutanamide 0.54 mg; sodium saccharin 0.27 mg; hydroxypropylbetadex 12.09 mg; water 492.55 mg.

Flurbiprofen is marketed under different brands and generic names, and comes in different dosage forms:

Brand name	Manufacturer	Country	Dosage form
Strepsils Intensive			spray
			lozenges
Strepsils	Reckitt Benckiser	UK	pills

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Dosage and Administration

Read the instructions carefully before using the drug.
For local use. For short term use only.
Adults and children over 12 years of age: 1 dose of the drug (3 presses on the dispenser) should be sprayed on the back of the oropharynx every 3-6 hours, not more than 5 doses within 24 hours.
Duration of therapy: no more than 3 days.
Do not inhale when spraying.
Before the first use of the drug, it is necessary to make at least four presses on the dispenser in the opposite direction until a uniform spraying appears.
Before each subsequent application, it is necessary to make at least one click on the dispenser in the opposite direction until a uniform spraying appears.

Adverse reactions

The risk of side effects can be minimized if you take the drug in a short course at the minimum effective dose necessary to eliminate the symptoms.

The following adverse reactions were observed with short-term use of the drug. In the treatment of chronic conditions and long-term use may cause other adverse reactions.

The frequency of adverse reactions was estimated based on the following criteria: very often (≥1 / 10), often (≥1 / 100 to

From the side of blood and lymphatic system: the frequency is unknown - impaired blood formation (anemia, thrombocytopenia).

From the nervous system: often - dizziness, headache, paresthesia; infrequently - drowsiness.

Mental Disorders: Infrequently - insomnia.

On the part of the immune system: rarely - anaphylactic reactions.

Since the cardiovascular system: the frequency is unknown - heart failure, edema, increased blood pressure.

On the part of the respiratory system: often - a feeling of irritation in the throat; infrequently - exacerbation of asthma and bronchospasm, shortness of breath, wheezing, blisters in the mouth and pharynx, hypoesthesia in the mouth and pharynx.

On the part of the digestive system: often - diarrhea, ulceration of the oral cavity, nausea, paresthesia of the oral cavity, pain in the mouth and pharynx, discomfort in the mouth (sensation of heat, burning sensation or tingling in the mouth); infrequently - abdominal distension, abdominal pain, constipation, dry mouth, dyspepsia, flatulence, glossalgia, dysgeusia, oral dysesthesia, vomiting; frequency unknown - hepatitis.

On the part of the skin and subcutaneous tissues: infrequently - skin rash, itching; frequency unknown - severe skin reactions such as bullous reactions, including Stevens-Johnson syndrome and toxic epidermal necrolysis (Lyell's syndrome).

Other: infrequently - fever, pain.

Contraindications

history of hypersensitivity reactions (bronchial asthma, bronchospasm, rhinitis, angioedema, urticaria, recurrent polyposis of the nose or paranasal sinuses) in response to the use of acetylsalicylic acid or other NSAIDs;

Erosive and ulcerative diseases of the gastrointestinal tract (including gastric ulcer and duodenal ulcer), ulcer bleeding in phase or in history (2 or more confirmed episodes of peptic ulcer or ulcerative bleeding):
bleeding or perforation of the gastrointestinal ulcer, ulcerative colitis, hemorrhagic and hematopoietic disorders in the anamnase, provoked by the use of NSAIDs;
pregnancy (III trimester);
breastfeeding period;
children up to 12 years;

severe liver failure or liver disease in the active phase;
severe renal failure (CC)
decompensated heart failure;
the period after coronary artery bypass surgery;
confirmed hyperkalemia;
deficiency of glucose-6-phosphate dehydrogenase;
hemophilia and other bleeding disorders (including hypocoagulation), hemorrhagic diathesis.

With caution and only after consulting a doctor should take the drug in the presence of a single episode of a history of gastric ulcer or ulcerative bleeding of the gastrointestinal tract; a history of gastrointestinal diseases (ulcerative colitis, Crohn's disease), gastritis, enteritis, colitis, Helicobacter pylori infection; bronchial asthma or allergic diseases in the acute stage or in the anamnesis (the development of bronchospasm is possible); systemic lupus erythematosus or mixed connective tissue disease (Sharpe syndrome), because increased risk of aseptic meningitis (with short-term use of flurbiprofen, the risk is insignificant); renal failure, incl. with dehydration (CC less than 30-60 ml / min), nephrotic syndrome; liver failure; liver cirrhosis with portal hypertension; hyperbilirubinemia; hypertension and / or heart failure, edema; simultaneous use of other NSAIDs; simultaneous use of drugs that can increase the risk of ulcers or bleeding, in particular, GCS for oral administration (including prednisolone), anticoagulants (including warfarin), antiplatelet agents (including acetylsalicylic acid, clopidogrel ), selective serotonin reuptake inhibitors (including citalopram, fluoxetine, paroxetine, sertraline); in the I and II trimesters of pregnancy, during the breastfeeding period; elderly patients; when drinking alcohol.

Drug interactions

Combinations to be avoided

Acetylsalicylic acid: with the exception of low doses of acetylsalicylic acid (not more than 75 mg / day) prescribed by a doctor, because the combined use may increase the risk of side effects.

Other NSAIDs, including ibuprofen and selective COX-2 inhibitors: the simultaneous use of two or more drugs from the group of NSAIDs should be avoided due to the possible increase in the risk of side effects.

Combinations that should be used with caution

Anticoagulants: NSAIDs can enhance the effect of anticoagulants, in particular, warfarin.

Antiplatelet and selective serotonin reuptake inhibitors: an increased risk of gastrointestinal bleeding.

Antihypertensive drugs (ACE inhibitors and angiotensin II receptor antagonists) and diuretics: NSAIDs can reduce the effectiveness of drugs in these groups and can increase nephrotoxicity due to inhibition of COX, especially in patients with impaired renal function (these patients should be adequately replaced with fluid).

Ethanol: possible increase in the risk of adverse reactions, especially bleeding from the gastrointestinal tract.

Cardiac glycosides: the simultaneous use of NSAIDs and cardiac glycosides can lead to aggravation of heart failure, a decrease in the glomerular filtration rate and an increase in the concentration of cardiac glycosides in the blood plasma.

Cyclosporine: increased risk of nephrotoxicity with simultaneous use of NSAIDs and cyclosporine.

GCS: increased risk of gastrointestinal ulcers and gastrointestinal bleeding.

Lithium preparations: there is evidence of the likelihood of increasing the concentration of lithium in the blood plasma during the use of NSAIDs.

Methotrexate: there is evidence of the likelihood of increasing the concentration of methotrexate in the blood plasma during the use of NSAIDs. NSAIDs should be taken 24 hours before or after taking methotrexate.

Mifepristone: the use of NSAIDs should be started no earlier than 8-12 days after the end of the use of mifepristone, since NSAIDs can reduce the effectiveness of mifepristone.

Quinol antibiotics: in patients receiving joint treatment of NSAIDs and quinolone antibiotics, the risk of seizures may increase.

Tacrolimus: with the simultaneous use of NSAIDs and tacrolimus may increase the risk of nephrotoxicity.

Zidovudine: simultaneous use of NSAIDs and zidovudine can lead to increased hematotoxicity.

Hypoglycemic drugs for oral administration: possible changes in the concentration of glucose in the blood (it is recommended to increase the frequency of glucose control in the blood).

Phenytoin: possible increase in the concentration of phenytoin in the serum (it is recommended to control the serum concentration of phenytoin and, if necessary, dose adjustment).

Potassium-sparing diuretics: The combined use of potassium-sparing diuretics and flurbiprofen can lead to hyperkalemia.

Probenecid and sulfinpirazon: drugs containing probenecid or sulfinpirazon can delay the excretion of flurbiprofen.

Tolbutamide and antacids: to date, studies have not revealed interaction between flurbiprofen and tolbutamide or antacids.

Pregnancy and Lactation

Use of the drug in the III trimester of pregnancy is contraindicated. The use of flurbiprofen in the I and II trimesters of pregnancy should be avoided; if necessary, use of the drug should be consulted with the doctor.

There is evidence that flurbiprofen in small quantities can penetrate into breast milk without any negative consequences for the health of the infant, but due to the possible side effects of NSAIDs, the use of the drug during breastfeeding is not recommended.

Special instructions

It is recommended to take the drug in the shortest possible course and in the minimum effective dose necessary to eliminate the symptoms.

Patients with diabetes should take into account that each tablet contains about 2.5 g of sugar (0.21 XE).

When symptoms of gastropathy appear, careful monitoring is shown, including esophagogastroduodenoscopy, complete blood count (hemoglobin test), fecal occult blood test.

If necessary, determine the 17-ketosteroids drug should be canceled 48 hours before the study.

During the treatment period, ethanol is not recommended.

Patients with renal or hepatic insufficiency, as well as elderly patients and patients taking diuretics, should consult with a physician before using the drug, because there is a risk of deterioration of the functional state of the kidneys. With short-term use of the drug, the risk is insignificant.

For patients with arterial hypertension, incl. history, and / or chronic heart failure, you should consult with your doctor before using the drug, because the drug can cause fluid retention, increased blood pressure and edema.

If irritation occurs in the oral cavity, skin rash, mucosal lesions and other manifestations of an allergic reaction, the patient should stop using the drug and consult a doctor.

In case of worsening of existing symptoms or the appearance of new ones, incl. When signs of a bacterial infection appear, the patient should immediately consult a doctor to review the therapy.

Influence on ability to drive motor transport and control mechanisms

Patients who notice dizziness, drowsiness, lethargy or visual impairment while taking flurbiprofen, should avoid driving vehicles or driving mechanisms.

Overdosage

Symptoms: nausea, vomiting, epigastric pain or, less commonly, diarrhea, tinnitus, headache, and gastrointestinal bleeding. In more severe cases, there are manifestations of the central nervous system: drowsiness, rarely - excitement, convulsions, disorientation, coma. In cases of severe poisoning, metabolic acidosis and an increase in prothrombin time, acute renal failure, liver tissue damage, decreased blood pressure, respiratory depression and cyanosis can develop.Patients with bronchial asthma may worsen this disease.

Treatment: symptomatic, with the mandatory provision of airway patency, monitoring of ECG and major vital signs until the patient's condition is normalized. Oral administration of activated charcoal or gastric lavage for 1 hour after administration of a potentially toxic dose of flurbiprofen is recommended. Frequent or prolonged seizures should be stopped in / in the introduction of diazepam or lorazepam. With the aggravation of asthma, the use of bronchodilators is recommended. There is no specific antidote to flurbiprofen.