Apsifen-F
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Read all of this leaflet carefully before you start taking this medicine because it contains important information for you.
• Keep this leaflet. You may need to read it again.
• If you have any further questions, ask your doctor, pharmacist or nurse.
• This medicine has been prescribed for you only. Do not pass it on to others. It may harm them, even if their signs of illness are the same as yours.
• If you get any of the side effects, talk to your doctor, pharmacist or nurse. This includes any side effects not listed in this leaflet. See section 4.
What is in this leaflet:
1. What Aspifen-F Tablets are and what they are used for
2. What you need to know before you take Aspifen-F Tablets
3. How to take Aspifen-F Tablets
4. Possible side effects
5. How to store Aspifen-F Tablets
6. Contents of the pack and other information
1. What Aspifen-f Tablets are and what they are used for
Apsifen-F tablets contain 400 mg of the active ingredient ibuprofen BP. Ibuprofen belongs to a group of medicines called Non Steroidal Anti-Inflammatory Drugs (known as NSAIDs), which relieve pain and reduce inflammation in joints and soft tissues such as muscles and ligaments.
Ibuprofen tablets are used to:
• relieve mild to moderate pain e.g.:- post-operative pain, toothache, period pain and soft tissue injury (muscles and ligaments)
• relieve stiffness and pain in the back and other muscles
• reduce inflammation in different types of arthritis.
2. What you need to know before you take Aspifen-F Tablets Do NOT take Ibuprofen if you:
• are allergic to ibuprofen or any of the other ingredients of this medicine (listed in section 6).
• 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.
Warnings and precautions
Talk to your doctor, pharmacist or nurse before you start 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
Medicines such as Ibuprofen may be associated with a small increased risk of heart attack (“myocardial infarction”) or stroke. Any risk is more likely with high doses and prolonged treatment. Do not exceed the recommended dose or duration of treatment.
If you have heart problems, previous stroke or think that you might be at risk of these conditions (for example if you have high blood pressure, diabetes, or high cholesterol or are a smoker) you should discuss your treatment with your doctor or pharmacist.
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
• an anticoagulant, e.g. warfarin to reduce the clotting of the blood
• a diuretic ('water tablet')
• medicines to treat high blood pressure , e.g. losartan, atenolol, captopril
• 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).
Tell your doctor or pharmacist if you are taking, have recently taken or might take any other medicines, including medicines obtained without a prescription.
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.
3. How to take Aspifen-F Tablets
Always take Ibuprofen exactly as your doctor or pharmacist has told you. Check with your doctor or pharmacist if you are not sure.
If you suffer from heart, liver or kidney problems your doctor may lower your dose and carry out regular tests. If you see another doctor or go into hospital, let the doctor or the staff knows what medicines you are taking.
Ibuprofen with food and drink
The tablets should be swallowed preferably with a drink of water. Take with or after food.
The recommended dose is:
Adults
Initially 1200 mg per day in divided doses. Larger doses up to 1800 mg per day may be taken if necessary. The maintenance dose will be determined on an individual basis (in the range 600 - 1200 mg per day).
Do not take more than 2400 mg in any 24 hours.
Use in children and adolescents
The exact dosage will depend on body weight. The usual dosage is 20 mg/kg of body weight, which should be given in divided doses throughout the day. Do not give to children weighing less than 20 kg. Do not give more than 2 x 200 mg tablets in 24 hours to children weighing less than 30 kg.
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.
Your doctor has decided the dose which is suited to you. Always follow your doctor's instructions and those which are on the pharmacy label. If you do not understand these instructions, or you are in any doubt, ask your doctor or pharmacist.
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.
4. 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)
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
• 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 in this leaflet. 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 medicine.
5. How to store Aspifen-F Tablets
Keep this medicine out of the sight and reach of children.
These tablets should be stored in a dry place, at or below 25° C, protected from light in the package or container supplied. Do not transfer them to another container.
Do not use Ibuprofen after the expiry date that is stated on the outer packaging. The expiry date refers to the last day of that month.
Do not throw away any medicines via wastewater or household waste. Ask your pharmacist how to throw away medicines you no longer use. These measures will help to protect the environment.
6. Contents of the pack and other information
What Aspifen-F Tablets contain:
• The active ingredient is ibuprofen.
• The other ingredients are maize starch, colloidal silicon dioxide, sodium starch glycollate and stearic acid. The tablet film coating contains hydroxypropylmethylcellulose (E464), talc and the colours erythrosine (E127) and titanium dioxide (E171)
What Ibuprofen tablets look like and contents of the pack:
• The Aspifen-F 400 mg tablets are Pink, biconvex film-coated tablets with APS on one side, plain on reverse
• The tablets are available in pack sizes of 7, 10, 14, 21, 28, 30, 56, 60, 84, 90, 100, 110, 112, 120, 150, 160, 168 and 250 tablets.
Not all pack sizes may be marketed.
Marketing Authorisation Holder and Manufacturer
The Marketing Authorisation holder and company responsible for manufacture is TEVA UK Limited, Eastbourne, BN22 9AG England.
This leaflet was last revised: September 2014
PL 00289/0063
POM