Drug reference
Osteoarthritis ▶BY MOUTH ▶Adult: 600–900 mg daily in up to 3 divided doses; increased if necessary up to 1200 mg daily (max. per dose 400 mg) Dysmenorrhoea ▶BY MOUTH ▶Adult: 600–900 mg daily in up to 3 divided doses (max. per dose 400 mg) Mild-to-moderate pain ▶BY MOUTH ▶Adult: 600 mg daily in up to 3 divided doses; increased if necessary up to 1200 mg daily (max. per dose 400 mg), higher dose for short-term use for acute pain
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Active gastro-intestinal bleeding. active gastro-intestinal ulceration. cerebrovascular bleeding. history of gastro-intestinal bleeding related to previous NSAID therapy. history of gastro-intestinal perforation related to previous NSAID therapy. history of recurrent gastro-intestinal haemorrhage (two or more distinct episodes). history of recurrent gastro-intestinal ulceration (two or more distinct episodes). severe heart failure
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Allergic disorders. cardiac impairment (NSAIDs may impair renal function). cerebrovascular disease. coagulation defects. congestive heart failure. connective- tissue disorders. Crohn’s disease (may be exacerbated). elderly (risk of serious side-effects and fatalities). ischaemic heart disease. peripheral arterial disease. risk factors for cardiovascular events. ulcerative colitis (may be exacerbated). uncontrolled hypertension CAUTIONS, FURTHER INFORMATION ▶High-dose dexibuprofen A small increase in cardiovascular risk, similar to the risk associated with cyclo-oxygenase-2 inhibitors and diclofenac, has been reported with high- dose dexibuprofen ( 1.2 g daily); use should be avoided in patients with established ischaemic heart disease, peripheral arterial disease, cerebrovascular disease, congestive heart failure (New York Heart Association classification II-III), and uncontrolled hypertension.
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Contra-indicated in patients with a history of hypersensitivity to aspirin or any other NSAID—which includes those in whom attacks of asthma, angioedema, urticaria or rhinitis have been precipitated by aspirin or any other NSAID.
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→Appendix 1: NSAIDs
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▶Common or very common Diarrhoea. dizziness. drowsiness . fatigue. gastrointestinal discomfort. headache. nausea. skin reactions. vertigo. vomiting ▶Uncommon Angioedema. anxiety. gastrointestinal disorders. haemorrhage. increased risk of infection. insomnia. oral disorders. respiratory disorders. tinnitus. vasculitis. vision disorders ▶Rare or very rare Agranulocytosis. alopecia. asthma. blood disorder. bone marrow disorders. confusion. constipation. depression. fever. granulocytopenia. haemolytic anaemia. hearing impairment. hepatic disorders. hypersensitivity. hypotension. inflammatory bowel disease. irritability. leucopenia. meningitis aseptic (patients with connective-tissue disorders such as systemic lupus erythematosus may be especially susceptible). nephritis tubulointerstitial. nephrotic syndrome. photosensitivity reaction. psychotic disorder. renal failure (more common in patients with pre-existing renal impairment). severe cutaneous adverse reactions (SCARs). shock. tachycardia. thrombocytopenia ▶Frequency not known Fluid retention. generalised oedema . glomerulonephritis. increased risk of arterial thromboembolism. renal impairment. renal papillary necrosis SIDE-EFFECTS, FURTHER INFORMATION For information about cardiovascular and gastrointestinal side-effects, and a possible exacerbation of symptoms in asthma, see Non- steroidal anti-inflammatory drugs. p. 1193
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Caution—long-term use of some NSAIDs is associated with reduced female fertility, which is reversible on stopping treatment.
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Avoid unless the potential benefit outweighs the risk. Avoid during the third trimester (risk of closure of fetal ductus arteriosus in utero and possibly persistent pulmonary hypertension of the newborn); onset of labour may be delayed and duration may be increased.
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Use with caution during breast-feeding. Present in milk—but risk to infant minimal.
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Manufacturer advises caution in mild to moderate impairment; avoid in severe impairment. Dose adjustments Manufacturer advises initial dose reduction in mild to moderate impairment.
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Avoid if possible or use with caution. Avoid if eGFR less than 30 mL/minute/1.73 m2. Dose adjustments Reduce initial dose. The lowest effective dose should be used for the shortest possible duration. Monitoring Monitor renal function; sodium and water retention may occur and renal function may deteriorate, possibly leading to renal failure.
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There can be variation in the licensing of different medicines containing the same drug. Tablet CAUTIONARY AND ADVISORY LABELS 21 ▶Seractil (Gebro Pharma GmbH) Dexibuprofen 300 mg Seractil 300mg tablets | 60 tablet P £9.47 DT = £9.47
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600–900 mg daily in up to 3 divided doses;
First-line fragment. Read the complete Indications and Dose section above.
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600–900 mg daily in up to 3 divided doses (max.
First-line fragment. Read the complete Indications and Dose section above.
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600 mg daily in up to 3 divided doses; increased
First-line fragment. Read the complete Indications and Dose section above.
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