Esrufen 200 mg Tablet

Esrufen 200 mg tablet is manufactured and marketed by Square Pharmaceuticals PLC, Pabna in Bangladesh. It contains Ibuprofen, one of the most widely used non-steroidal anti-inflammatory drugs (NSAIDs) in the world. Doctors commonly prescribe it for everyday pain such as headache, toothache, period pain, back pain and muscle aches, for fever, and for joint conditions such as arthritis.

Ibuprofen works by blocking cyclo-oxygenase (COX) enzymes. These enzymes make prostaglandins — natural chemicals that cause pain, swelling and fever. With less prostaglandin, pain eases, temperature comes down and inflammation settles. Because prostaglandins also protect the stomach lining and help kidney blood flow, Esrufen should always be taken with food and at the lowest dose that works.

Esrufen is used for short-term relief of mild to moderate pain and fever, and for longer-term inflammatory conditions under medical supervision. Common uses include:

• Headache, migraine attacks and toothache
• Period pain (dysmenorrhoea)
• Muscle pain, sprains, strains and sports injuries
• Back pain and neck pain
• Osteoarthritis and rheumatoid arthritis joint pain
• Fever in colds and flu-like illness
• Pain after dental or minor surgical procedures

Use it for arthritis or any long-term condition only on a doctor's advice, since extended NSAID use needs monitoring of the stomach, kidneys and blood pressure.

Dosage is decided by your doctor based on the condition, age and kidney function. As a general adult guide:

• Pain and fever: 200–400 mg every 6–8 hours as needed; without medical advice, most adults should not exceed 1,200 mg in 24 hours
• Arthritis and inflammatory conditions: doctors may prescribe up to 2,400 mg daily in divided doses with monitoring

Always take Esrufen with food or milk and a full glass of water. Use the lowest effective dose for the shortest possible time, and never combine it with other NSAID painkillers. Elderly people and anyone with kidney, heart or stomach problems should follow their doctor's instructions exactly.

Most people tolerate short courses well, but side effects can occur:

• Common: stomach pain, heartburn, nausea, indigestion, loose stools or constipation, mild dizziness or headache
• Less common: fluid retention, raised blood pressure, skin rash, ringing in the ears
• Serious (seek help immediately): black or bloody stools, vomiting blood, severe stomach pain, swelling of face or lips, breathing difficulty, marked reduction in urine output, chest pain

Stop the medicine and contact a doctor if any serious symptom appears. Long-term or frequent use increases the risk of stomach ulcers, kidney problems and heart-related events, especially in older adults.

Take these precautions while using Esrufen:

• Always take it with food — never on an empty stomach
• Avoid it completely during dengue fever or suspected dengue, as NSAIDs increase bleeding risk; paracetamol is the safer choice for fever
• Use cautiously if you have a history of gastric ulcer, kidney disease, high blood pressure, heart disease or asthma
• Elderly patients are more sensitive to stomach and kidney side effects
• Drink adequate water; dehydration increases the risk of kidney injury
• Avoid alcohol, which raises the chance of stomach bleeding
• Do not take two NSAIDs together (for example with diclofenac, naproxen or pain-dose aspirin)

Tell your doctor about every medicine you take. Esrufen may interact with:

• Blood thinners (warfarin, aspirin, clopidogrel) — higher bleeding risk
• Other NSAIDs or steroids — much higher risk of stomach ulcer and bleeding
• Blood pressure medicines (ACE inhibitors, ARBs, beta-blockers) and diuretics — reduced effect and possible strain on the kidneys
• Lithium and methotrexate — blood levels may rise to a toxic range
• SSRIs (such as escitalopram) — increased bleeding tendency
• Diabetes medicines — blood sugar may need closer monitoring

Avoid alcohol while on this medicine, and mention any herbal or over-the-counter products you use regularly.

Do not use Esrufen if any of the following applies:

• Allergy to ibuprofen, aspirin or any other NSAID (especially if previous reactions included an asthma attack, hives or facial swelling)
• Active or recurrent stomach or duodenal ulcer, or a history of GI bleeding caused by NSAIDs
• Severe heart failure, severe liver disease or severe kidney disease
• Bleeding disorders or dengue fever
• Third trimester of pregnancy
• Treatment of pain after coronary artery bypass (CABG) surgery

If you are unsure whether any of these applies to you, ask your doctor or pharmacist before taking the first dose.

Pregnancy: Ibuprofen should be avoided during pregnancy unless a doctor specifically advises it. It is strictly avoided in the third trimester (after 28 weeks) because it can harm the baby's heart circulation and kidneys, reduce amniotic fluid and delay labour. Even in early pregnancy, occasional use should happen only on medical advice.

Breastfeeding: Only small amounts pass into breast milk, and short courses at usual doses are generally considered compatible with breastfeeding. Even so, inform your doctor that you are breastfeeding so the safest pain-relief plan can be chosen for you and your baby.

Keep Esrufen in its original pack at room temperature, below 30°C, away from direct sunlight, heat and moisture. Do not store it in the bathroom or near the kitchen stove. Keep all medicines locked away and out of the reach of children, as accidental swallowing can be dangerous for them. Do not use the medicine after the expiry date printed on the strip or bottle, and do not use tablets that look discoloured or damaged. Dispose of unused medicine safely rather than keeping it for future self-treatment.