Brustan-N caplets #10

What is Brustan-N?

Brustan-N is a medication containing ibuprofen, a nonsteroidal anti-inflammatory drug (NSAID). It is used for its analgesic (pain-relieving) and anti-inflammatory effects.

What are the indications for Brustan-N?

Rheumatic conditions: rheumatoid arthritis, ankylosing spondylitis, osteoarthritis, other non-rheumatoid arthropathies, periarticular conditions, low back pain Soft tissue injuries: sprains and strains Pain relief: mild to moderate pain, dysmenorrhoea, post-operative pain, headache (including migraine) Symptomatic relief of: dental pain, menorrhagia

What are the contraindications for Brustan-N?

Hypersensitivity: known allergy to ibuprofen or any of the inactive ingredients, previous hypersensitivity reactions to ibuprofen, aspirin, or other NSAIDs. Gastrointestinal Issues: history of gastrointestinal bleeding or perforation related to NSAID use, active or recurrent peptic ulcer or gastrointestinal hemorrhage. Bleeding Tendency: patients with conditions involving an increased tendency to bleed. Severe Organ Failure: severe heart failure, hepatic failure, renal failure. Pregnancy: last trimester of pregnancy.

What are the potential side effects of Brustan-N?

Common: gastrointestinal disorders, fatigue, headache, dizziness. Uncommon: rhinitis, hepatitis, jaundice, abnormal hepatic function, rash, urticaria, pruritus, purpura, angioedema, photosensitivity reaction, hearing impaired, tinnitus, vertigo, dyspnoea, exacerbation of colitis and Crohn's disease, nephropathy, oedema, hypertension. Rare: aseptic meningitis, leukopenia, thrombocytopenia, neutropenia, agranulocytosis, anaemia, haemolytic anaemia, hypersensitivity (anaphylactic reaction), insomnia, anxiety, depression, confusional state, paraesthesia, somnolence, optic neuritis, visual impairment, toxic optic neuropathy, cardiac failure, myocardial infarction. Very Rare: hepatic failure, severe forms of skin reactions.

How is Brustan-N administered and what is the recommended dosage?

Administration: Oral administration Adults and children over 12 years old: 1200-1800 mg daily in divided doses, some patients may be maintained on 600-1200 mg daily, in severe or acute conditions, the dosage can be increased until the acute phase is under control, provided the total daily dose does not exceed 2400 mg in divided doses. Not recommended for children weighing less than 7 kg.

What are the precautions to be taken when administering Brustan-N?

Elderly patients: increased risk of adverse events, use with caution. Patients with frequent headaches: monitor for medication overuse headache (MOH). Alcohol consumption: increased risk of gastrointestinal and central nervous system adverse effects. Gastrointestinal bleeding: risk increases with higher doses, consider protective agents. Patients with gastrointestinal disease: report any unusual abdominal symptoms. Concomitant medications: increased risk of ulceration or bleeding with oral corticosteroids, anticoagulants, SSRIs, and anti-platelet agents. Asthma, rhinitis, or allergic diseases: caution is required as NSAIDs can precipitate bronchospasm, urticaria, or angioedema. Renal impairment: may cause dose-dependent reduction in prostaglandin formation, use lowest effective dose and monitor renal function. Cardiac impairment: use with caution in patients with heart failure or hypertension. Hypertension and heart failure: appropriate monitoring and advice required, avoid high doses. Cardiovascular risk factors: careful consideration required before initiating long-term treatment, avoid high doses. Dehydration: caution should be used when initiating treatment. Long-term administration: may lead to renal papillary necrosis. SLE and mixed connective tissue disease: increased risk of aseptic meningitis. Fertility: may impair female fertility.

What drug interactions are associated with Brustan-N?

Antihypertensives: NSAIDs may reduce the effect of anti-hypertensives. Cardiac glycosides: may exacerbate cardiac failure, increase plasma cardiac glycoside levels. Cholestyramine: may reduce the absorption of ibuprofen. Lithium: decreased elimination of lithium. Methotrexate: may inhibit methotrexate tubular secretion. Ciclosporin: increased risk of nephrotoxicity. Mifepristone: may theoretically decrease the efficacy of mifepristone. Other analgesics and Cox-2 inhibitors: avoid concomitant use. Aspirin: concomitant administration is not generally recommended. Anticoagulants: may enhance the effects of anticoagulants. Quinolone antibiotics: increased risk of convulsions. Sulfonylureas: may potentiate the effects of sulfonylurea medications. Anti-platelet agents and SSRIs: increased risk of gastrointestinal bleeding. Tacrolimus: possible increased risk of nephrotoxicity. Zidovudine: increased risk of haematological toxicity. Aminoglycosides: may decrease aminoglycoside excretion. Herbal extracts: Ginkgo biloba may potentiate the risk of bleeding. CYP2C9 Inhibitors: may increase ibuprofen exposure, consider dose reduction.

What are the signs and symptoms of overdose?

Nausea, vomiting, abdominal pain, lethargy, drowsiness, headache, tinnitus, dizziness, convulsions, loss of consciousness, nystagmus, metabolic acidosis, hypothermia, renal effects, gastrointestinal bleeding, coma, apnoea, diarrhoea, depression of the CNS and respiratory system, disorientation, excitation, fainting, cardiovascular toxicity, renal failure, liver damage.

What therapeutic measures should be taken in case of overdose?

Symptomatic treatment. Consider activated charcoal within one hour of ingestion. Gastric lavage within one hour of ingestion in adults. Ensure good urine output. Closely monitor renal and liver function. Observe patients for at least four hours. Treat seizures with intravenous diazepam. Other measures may be indicated depending on the clinical condition.

What are the storage instructions for Brustan-N?

Store below 30°C. Protect from moisture. Keep all medicines out of reach of children.

What is the supply format for Brustan-N?

Blister pack of 10's, box of 24x10's.

Is there any additional information I should be aware of?

Brustan-N contains lactose monohydrate. Patients with lactose intolerance should not take this medication. Ibuprofen may mask the signs of infection. The diagnosis of medication overuse headache (MOH) should be suspected in patients who have frequent or daily headaches. Avoid concomitant use of ibuprofen with other NSAIDs. Serious skin reactions have been reported with NSAIDs. Discontinue treatment at the first appearance of skin rash. Ibuprofen can interfere with platelet aggregation. Aseptic meningitis has been reported with ibuprofen therapy. The use of ibuprofen may impair female fertility. Please remember that this information is not a substitute for professional medical advice. Consult your doctor or pharmacist for specific guidance on the use of Brustan-N.