Health Centres - Nurofen plus
How does it work?
Nurofen plus tablets contain two active ingredients, ibuprofen and codeine phosphate. Both are pain-relieving medicines.
Ibuprofen is a type of medicine called a non-steroidal anti-inflammatory drug (NSAID). It relieves pain and inflammation. Ibuprofen works by blocking the action of a substance in the body called cyclo-oxygenase. Cyclo-oxygenase is an enzyme involved in the production of various chemicals in the body. Some of these natural chemicals are known as prostaglandins, and are produced by cyclo-oxygenase in response to injury or certain diseases and conditions. Prostaglandins cause pain, swelling and inflammation. By blocking the action of cyclo-oxygenase, ibuprofen stops the production of these inflammatory prostaglandins, and therefore reduces inflammation and pain.
Codeine phosphate is a type of painkiller called an opioid. It is related to morphine but is not as strong. Opioid painkillers work by mimicking the action of naturally occurring pain-reducing chemicals called endorphins. Endorphins are found in the brain and spinal cord and reduce pain by combining with opioid receptors.
Codeine phosphate mimicks the action of natural endorphins by combining with the opioid receptors in the brain and spinal cord. This blocks the transmission of pain signals sent by the nerves to the brain. Therefore, even though the cause of the pain may remain, less pain is actually felt.
This combination of painkillers can be used to relieve mild to moderate pain and inflammation associated with various conditions. These include rheumatic, arthritic and muscular aches and pains, sprains and strains, period pains, headache and migraine, backache, dental pain and neuralgia.
What is it used for?
- Mild to moderate pain including non-serious arthritic and rheumatic pain, soft tissue injuries such as sprains and strains, tendonitis, backache, nerve pain (neuralgia), migraine, headache, toothache, period pain.
Warning!
- Do not exceed the recommended dose of this medicine, which will be stated in the product packaging or information leaflet supplied with the medicine.
- If symptoms persist despite treatment, seek medical advice from your doctor or pharmacist. Do not take this medicine for longer than three days without consulting your doctor.
- Taking a painkiller for headaches too often or for too long can make them worse.
- Regular use of codeine for long periods of time can lead to addiction and may result in symptoms such as restlessness and irritability when you stop taking the medicine. If you find you need to use this product all the time, see your doctor straight away.
- Ibuprofen is generally well-tolerated and most people do not experience any side effects. The most common side effects are related to stomach irritation and include abdominal pain, indigestion and nausea. These can mainly be avoided by taking the ibuprofen with food. Rarely, serious side effects such as ulceration or bleeding of the stomach or intestines may occur. These are more likely with high doses and in elderly people. If you experience any sign of bleeding from the stomach or bowels, such as vomiting blood and/or passing black/tarry/bloodstained stools, you should consult your doctor.
- Very rarely, NSAIDS may cause serious blistering or peeling skin reactions (eg Stevens-Johnson syndrome, toxic epidermal necrolysis, exfoliative dermatitis). For this reason, you should stop taking this medicine and consult your doctor if you get a skin rash or sores inside your mouth while taking this medicine.
Use with caution in
- Elderly people.
- History of disorders affecting the stomach or intestines.
- Inflammatory bowel disease such as Crohn's disease or ulcerative colitis.
- Decreased kidney function.
- Decreased liver function.
-
Heart failure.
-
High blood pressure.
- People with blood clotting problems or taking anticoagulant medicines.
- History of asthma.
- History of allergies.
- Diseases affecting connective tissue, eg systemic lupus erythematosus.
Not to be used in
- Children under 12 years of age.
- People in whom aspirin or other NSAIDs, eg ibuprofen, cause allergic reactions such as asthma attacks, itchy rash (urticaria), nasal inflammation (rhinitis) or swelling of the lips, tongue and throat (angioedema).
- Current or previous peptic ulcer.
- People who have experienced bleeding or perforation of the gut as a result of previous treatment with an NSAID.
- Severe heart failure
- Severe liver failure
- Severe kidney failure.
- Third trimester of pregnancy.
This medicine should not be used if you are allergic to one or any of its ingredients. Please inform your doctor or pharmacist if you have previously experienced such an allergy.
Pregnancy and breastfeeding
Certain medicines should not be used during pregnancy or breastfeeding. However, other medicines may be safely used in pregnancy or breastfeeding providing the benefits to the mother outweigh the risks to the unborn baby. Always inform your doctor if you are pregnant or planning a pregnancy, before using any medicine.
- If you are pregnant or trying for a baby you should not use this medicine without consulting your doctor first. This medicine is not recommended for use in pregnancy unless considered essential by your doctor. This is particularly important in the first and third trimesters. If taken in the third trimester ibuprofen may delay labour, increase the length of labour and cause complications in the newborn baby. Some evidence suggests that NSAIDs should also be avoided by women attempting to conceive, as they may temporarily reduce female fertility during treatment and may also increase the risk of miscarriage or malformations. Seek medical advice from your doctor.
- This medicine may pass into breast milk, but in such small quantities that it is unlikely to harm the baby. However, if you are breastfeeding you should seek medical advice from your doctor before taking this medicine.
Side effects
Medicines and their possible side effects can affect individual people in different ways. The following are some of the side effects that are known to be associated with this medicine. Because a side effect is stated here, it does not mean that all people using this medicine will experience that or any side effect.
- Abdominal pain.
- Nausea.
- Indigestion (dyspepsia).
- Constipation.
- Headache.
- Drowsiness.
- Dizziness.
- Hearing disturbances.
- Ulceration of the stomach or intestine.
- Bleeding from the stomach or intestine.
- Hypersensitivity reactions such as narrowing of the airways (bronchospasm), swelling of the lips, throat and tongue (angioedema), itchy blistering rash or anaphylactic shock.
- Kidney, liver or blood disorders.
- Slow, shallow breathing.
The side effects listed above may not include all of the side effects reported by the drug's manufacturer.
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