Nurofen

Nurofen is the brand name of a range of pain-relief medication made by Reckitt Benckiser. Introduced in 1983, the Nurofen brand was acquired following Reckitt Benckiser's acquisition of Boots Healthcare in 2005. The brand is primarily marketed and sold in the United Kingdom, other parts of Europe, Australia and New Zealand. It is primarily ibuprofen. ^[1]

There are 11 variants of Nurofen, all of which contain the analgesic ibuprofen as the active ingredient. Ibuprofen was developed by the research arm of Boots. Some variants of Nurofen contain other active ingredients; for example, Nurofen Cold & Flu contains the non-sedating decongestant pseudoephedrine. Nurofen can help reduce back pain, menstrual pain, fevers or headache.

Products

Nurofen Plus

Nurofen Plus is a pain relief medication based on codeine and ibuprofen.^[2] It contains 12.8 mg of codeine phosphate (a mild opioid analgesic) and 200 mg of ibuprofen,^[2] which is an NSAID. Nurofen Plus is the only product in the Nurofen range that contains codeine.

The original tablet was manufactured in two halves and coated. One half would contain the 12.8 mg of codeine phosphate and the other half contained 200 mg of ibuprofen. The tablets could be forcefully split for recreational use of codeine. Such drugs have a potential for misuse because they are available freely to the public.^[3] It has also been linked to severe hypokalaemia secondary to ibuprofen-induced renal tubule acidosis.^[2]

After concerns were raised about the addiction risk posed by the codeine content of these medicines (both Nurofen Plus and competing brands which contain codeine), an addiction warning was placed on the boxes in 2009 to warn users the medicine may cause addiction and must only be used for three days. There is still concern in places where these medicines are available over the counter, and certain groups suggest they should be made prescription only medicines (POMs). Over the counter codeine containing drugs can only be sold in the presence of a qualified pharmacist, and pharmacists can question repeat customers and refuse sales of these drugs if overuse or abuse is suspected.

It is in Schedule V of the Controlled Substances Act in the US. In some states (for example, North Carolina), you can purchase it on-the-counter, but you have to sign a list and show state ID in order for the pharmacist to give it to you. That way, the Pharmacist and DEA can monitor who might be purchasing more than is necessary.

Nurofen for Children

Nurofen for Children is a brand of children's medicine, distributed by Reckitt Benckiser Healthcare (UK) Ltd. Nurofen for Children is suitable for babies and children from 3 months (over 6 kg) to 12 years.

It is used for the fast and effective reduction of fever, including post immunisation pyrexia and the fast and effective relief of mild to moderate pain, such as a sore throat, teething pain, toothache, headache, minor aches and sprains.

Nurofen for Children is sugar free and colour free and comes in two flavours – strawberry and orange. It is available in bottle packs and in sachets. An easy dosing syringe is included in every bottle pack to aid accurate dosing.

Nurofen in a Bottle for Children

Available in 100ml and 150ml bottles. Contains 100 mg of ibuprofen per 5ml dose.

Age of Child	How Much	How often in 24 hours
3–6 months (weighing more than 5 kg)	2.5ml	3 times
6–12 months	2.5ml	3-4 times
1–3 years	5ml	3 times
4–6 years	7.5ml	3 times
7–9 years	10ml	3 times
10–12 years	15ml	3 times

Nurofen Sachets for Children

Available in boxes of 8 or 16 5 mL sachets. Contains 100 mg of ibuprofen per sachet.

Age of Child	How Much	How often in 24 hours
3–6 months (weighing more than 5 kg)	2.5ml	3 times
6–12 months	2.5ml	3-4 times
1–3 years	5ml	3 times
4–6 years	7.5ml	3 times
7–9 years	10ml	3 times
10–12 years	15ml	3 times

These doses should be given approximately every 6 to 8 hours, or with a minimum of 4 hours between each dose if required.

Nurofen Express/Nurofen Zavance

Nurofen Express (in the UK)/Nurofen Zavance (in Australia and New Zealand) contains 256 mg of sodium ibuprofen dihydrate, equivalent to 200 mg of ibuprofen. It has the same analgesic properties of Nurofen, but acts twice as fast.^[4][5]

Marketing

In 2010 Nurofen received a Shonky Award from CHOICE, the Australian independent consumer watchdog. The award was given for taking painkillers with the same ingredients and marketing them for specific parts of the body at varying prices. Significantly, the fast-acting painkillers labeled for specific pain types were priced higher that the general variety (in some cases almost double the price), while they all contain the same ingredients and work in the same way. The Shonky Awards are designed to expose companies with dubious marketing practices.^[6][7]

Adverse effects

NSAID Painkillers, such as Nurofen, may interfere and reduce efficiency of SSRI antidepressants ^[8][9]

2011 product recall

In August 25, 2011 it was reported that several packs of Nurofen Plus were found to contain Seroquel XL — a powerful anti-psychotic drug used to treat schizophrenia — in Boots stores across London.^[10][11][12]. Next day, a safety alert was issued by the Medicines and Healthcare Products Regulatory Agency (MHRA). Pharmacists were told to check each package of Nurofen Plus to look for anti-psychotic drugs. There were three batches of Nurofen Plus which were affected by the alert. Reckitt Benckiser, manufacturer of Nurofen Plus, said that it didn’t know where the drugs had been switched.

See also

• Advil

References

1. ^ Nurofen website http://www.nurofen.com
2. ^ ^{a b c} The Medical Journal of Australia. Nurofen Plus misuse: an emerging cause of perforated gastric ulcer. Accessed 2 July 2009.
3. ^ Chetty, R; Baoku, Y; Mildner, R; Banerjee, A; Vallance, D; Haddon, A; Labib, M (2003). "Severe hypokalaemia and weakness due to Nurofen misuse". Annals of clinical biochemistry 40 (Pt 4): 422–3. doi:10.1258/000456303766477101. PMID 12880547. 
4. ^ New Nurofen doing it twice as quickly: FOODweek Online 2/3/2009
5. ^ Nurofen Zavance: Pharmacy Direct
6. ^ Paul Tatnell (2010-10-26). "Shonkys: the award that no company wants". Sydney Morning Herald. http://www.smh.com.au/national/shonkys-the-award-that-no-company-wants-20101026-171ih.html. 
7. ^ "The 2010 Choice Shonky Awards present products and services detrimental to consumers". http://www.choice.com.au/Reviews-and-Tests/Money/Shopping-and-Legal/Shopping/The-2010-Shonky-Awards/page/The-shonkiest-products.aspx. Retrieved October 26, 2010. 
8. ^ Why Painkillers Interfere with Anti-depressants
9. ^ J.L. Warner-Schmidt et.al "Antidepressant effects of selective serotonin reuptake inhibitors (SSRIs) are attenuated by antiinflammatory drugs in mice and humans" PNAS 2011
10. ^ Nurofen "sabotaged" across London., Belle News August 26
11. ^ Nurofen Plus recalled as drug manufacturer suspects sabotage, The Guardian, August 27
12. ^ Nurofen Plus recalled amid sabotage fears, Telegraph, August 27

External links

• Nurofen website
• Nurofen for Children website
• Nurofen Plus UK Site