


Ask a doctor about a prescription for ESPIDIFEN 600 mg ORAL SOLUTION GRANULES, APRICOT FLAVOR
Package Leaflet: Information for the Patient
Espidifen 600 mg Granules for Oral Solution, Apricot Flavor
Ibuprofen (Arginine)
Read the entire package leaflet carefully before starting to take this medication, as it contains important information for you.
Contents of the Package Leaflet
Ibuprofen (Arginine) belongs to a group of medications called non-steroidal anti-inflammatory drugs (NSAIDs).
This medication is used to treat fever, moderate-intensity pain, including migraine, arthritis (inflammation of the joints, including hands and feet, leading to swelling and pain), juvenile rheumatoid arthritis, osteoarthritis (a chronic disorder that causes cartilage damage), ankylosing spondylitis (inflammation that affects the joints of the spine), non-rheumatic inflammation, and primary dysmenorrhea (painful menstruation).
Do not take Espidifen:
Consult your doctor before starting to take Espidifen:
Espidifen may mask the signs of an infection, such as fever and pain. Consequently, Espidifen may delay the appropriate treatment of the infection, which may increase the risk of complications. This has been observed in bacterial pneumonia and bacterial skin infections related to chickenpox. If you take this medication while having an infection and the symptoms of the infection persist or worsen, consult a doctor without delay.
This risk is higher when high doses and prolonged treatments are used, in patients with a history of peptic ulcer, and in elderly patients. In these cases, your doctor will consider the possibility of associating a stomach-protecting medication.
It is essential to use the smallest dose that relieves-controls the pain and not to take this medication for longer than necessary to control your symptoms.
Avoid concomitant administration with other NSAIDs, including COX-2 inhibitors.
Be careful with Espidifen:
Serious skin reactions, such as exfoliative dermatitis, erythema multiforme, Stevens-Johnson syndrome, toxic epidermal necrolysis, drug reaction with eosinophilia and systemic symptoms (DRESS), and acute generalized exanthematous pustulosis (AGEP), have been reported in association with ibuprofen treatment. Discontinue treatment with Espidifen and seek medical attention immediately if you notice any of the symptoms related to these serious skin reactions described in section 4.
Precautions in Elderly Patients
Elderly patients have a higher frequency of adverse reactions to NSAIDs, especially gastrointestinal bleeding and perforation, which can be fatal.
Cardiovascular Precautions
Anti-inflammatory/analgesic medications like ibuprofen may be associated with a small increased risk of heart attack or stroke, especially when used in high doses. Do not exceed the recommended dose or treatment duration.
You should discuss your treatment with your doctor or pharmacist before taking Espidifen if:
Additionally, these types of medications may cause fluid retention, especially in patients with heart failure and/or high blood pressure (hypertension).
Ibuprofen has been associated with signs of allergic reaction to this medication, such as respiratory problems, facial and neck swelling (angioedema), and chest pain. Stop using this medication immediately and contact your doctor or the emergency medical service if you observe any of these signs.
Ibuprofen should be used with caution when administered to patients who have or have a history of bronchial asthma, chronic rhinitis, or allergic diseases, as ibuprofen has been reported to cause bronchospasm, urticaria, or angioedema in these patients.
Children and Adolescents
There is a risk of kidney failure in dehydrated children and adolescents.
The use of this medication is not recommended in children or adolescents under 14 years old, as the dose of ibuprofen it contains is not suitable for the recommended dosage in these patients.
Precautions during Pregnancy and in Women of Childbearing Age
Because the administration of medications like Ibuprofen (Arginine) has been associated with an increased risk of congenital anomalies/abortions, it is not recommended during the first and second trimester of pregnancy unless strictly necessary and advised by your doctor.
If you need treatment during this period or while trying to become pregnant, you should use the lowest dose for the shortest possible time.
If you take it for a few days from the 20th week of gestation onwards, Espidifen may cause kidney problems in your baby, which can lead to low levels of amniotic fluid surrounding the baby (oligohydramnios) or narrowing of a blood vessel (ductus arteriosus) in the baby's heart. If you need treatment for a few more days, your doctor may recommend additional monitoring. In the third trimester, the administration of Ibuprofen (Arginine) is contraindicated.
For women of childbearing age, it should be noted that medications like Ibuprofen (Arginine) have been associated with a decrease in fertility.
Interference with Analytical Tests
If you are going to undergo any diagnostic test (including blood tests, urine tests, skin tests using allergens, etc.), inform your doctor that you are taking this medication, as it may alter the results.
Use of Espidifen with Other Medications
Inform your doctor or pharmacist if you are using, have recently used, or may need to use any other medication.
Espidifen may affect or be affected by other medications. For example:
The following medications may interfere and should not be taken with Espidifen without consulting your doctor:
Other medications may also affect or be affected by treatment with Espidifen. Therefore, you should always consult your doctor or pharmacist before using Espidifen with other medications.
Taking Espidifen with Food, Drinks, and Alcohol
It is recommended to take the sachets of Ibuprofen (Arginine) granules with water or another liquid. You can take them alone or with food. In general, it is recommended to take it during meals or immediately after eating to reduce the possibility of stomach discomfort. Alcohol consumption during treatment may increase the risk of gastrointestinal adverse reactions.
Pregnancy, Breastfeeding, and Fertility
If you are pregnant or breastfeeding, think you may be pregnant, or plan to become pregnant, consult your doctor or pharmacist before using this medication.
Espidifen should not be taken during pregnancy, especially during the third trimester (see section precautions during pregnancy and in women of childbearing age). It may cause kidney and heart problems in your baby. It may affect your and your baby's tendency to bleed and make labor longer or more difficult than expected.
Minimal amounts of ibuprofen and its degradation products are excreted in breast milk. As no adverse effects are known in the infant, it is not usually necessary to interrupt breastfeeding during short-term use at recommended doses.
Therefore, if you become pregnant or are breastfeeding, consult your doctor.
Driving and Using Machines
If you experience dizziness, vertigo, vision changes, or other symptoms while taking this medication, you should not drive or operate hazardous machinery. If you only take one dose of Espidifen or take it for a short period, you do not need to take special precautions.
This medication contains 60 mg of aspartame in each sachet.
Aspartame contains a source of phenylalanine, which may be harmful in case of phenylketonuria (PKU), a rare genetic disease in which phenylalanine accumulates because the body is unable to eliminate it correctly.
This medication contains sucrose. If your doctor has told you that you have an intolerance to certain sugars, consult with them before taking this medication.
This medication contains 84.35 mg of sodium (the main component of table salt) in each sachet. This is equivalent to 4.22% of the maximum recommended daily sodium intake for an adult.
Follow the administration instructions for this medication exactly as indicated by your doctor. In case of doubt, consult your doctor or pharmacist again.
Your doctor will indicate the duration of treatment with Espidifen. Do not suspend treatment beforehand, as this will not achieve the expected results. Similarly, do not use this medication for longer than indicated by your doctor.
The lowest effective dose should be used for the shortest time necessary to alleviate symptoms. If you have an infection, consult a doctor without delay if symptoms (such as fever and pain) persist or worsen (see section 2).
This medication is administered orally.
Patients with stomach discomfort should take the medication with milk or during/after meals.
Adults and adolescents
In adults and adolescents from 14 to 18 years old, the recommended dose is one sachet (600 mg of ibuprofen) every 6 to 8 hours, depending on the intensity of the symptoms and the response to treatment.
In some processes, higher doses may be required, but in any case, it is recommended not to exceed the maximum daily dose of 2,400 mg in adults and 1,600 mg in adolescents from 14 to 18 years old.
Use in elderly patients
In these patients, the dosage should be established by the doctor, as there is a possibility that a reduction in the usual dose may be necessary.
Use in patients with kidney and/or liver disease
If you have a kidney and/or liver disease, your doctor may prescribe a lower dose than usual. If so, take the exact dose that your doctor has prescribed.
Use in children and adolescents
The use of this medication is not recommended in children or adolescents under 14 years old, as the dose of ibuprofen it contains is not suitable for the recommended dosage in these patients.
If you take more Espidifen than you should
In case of overdose or accidental ingestion, consult a doctor or pharmacist immediately, go to the nearest hospital, or call the Toxicology Information Service (telephone: 91.5620420) indicating the medication and the amount ingested, to inform about the risk and ask for advice on the measures to be taken.
The symptoms of overdose may include nausea, stomach pain, vomiting (which may be bloody), gastrointestinal bleeding (see also section 4 below), diarrhea, headache, ringing in the ears, confusion, and tremulous movement of the eyes. Agitation, drowsiness, disorientation, or coma may also appear. Occasionally, patients develop convulsions. At high doses, drowsiness, chest pain, palpitations, loss of consciousness, convulsions (mainly in children), weakness, and dizziness, blood in the urine, low potassium levels in the blood, feeling of cold body, and respiratory problems have been reported. Additionally, the prothrombin time/INR may be prolonged, probably due to interference with the actions of circulating coagulation factors. Acute renal failure and liver damage may occur. An exacerbation of asthma in asthmatics is possible. Additionally, there may be low blood pressure and difficulty breathing.
In case of ingestion of significant amounts, activated charcoal should be administered. Gastric lavage will be considered if significant amounts have been ingested and within 60 minutes following ingestion.
If you forget to take Espidifen
Do not take a double dose to make up for the forgotten dose.
If you forget to take your corresponding dose, take it as soon as you remember. However, if the time for the next dose is near, skip the forgotten dose and take the next dose at the usual time.
If you have any other questions about the use of this medication, ask your doctor or pharmacist.
Like all medications, Espidifen can produce adverse effects, although not all people suffer from them.
The adverse effects of medications like Espidifen are more common in people over 65 years old.
The incidence of adverse effects is lower in short treatments and if the daily dose is below the maximum recommended dose.
Frequencies are established according to the following classification: very frequent (may affect more than 1 in 10 patients); frequent (may affect up to 1 in 10 patients); infrequent (may affect up to 1 in 100 patients); rare (may affect up to 1 in 1,000 patients); very rare (may affect up to 1 in 10,000 patients); frequency not known (cannot be estimated from available data).
The following adverse effects have been observed:
Infections and infestations
Very rare: Exacerbation of inflammation-related infections (e.g., development of necrotizing fasciitis), coinciding with the use of non-steroidal anti-inflammatory drugs.
Note: If signs of infection or worsening occur during treatment with ibuprofen, it is recommended to go to the doctor immediately, in case antibiotic/anti-infective therapy needs to be initiated.
Blood and lymphatic system disorders
Rare: Aplastic anemia (insufficiency of the bone marrow to produce different types of cells).
Very rare: Decreased platelets, decreased white blood cells (may manifest as frequent infections with fever, chills, or sore throat), decreased red blood cells (may manifest as difficulty breathing and pale skin), decreased granulocytes (a type of white blood cell that may predispose to infections), pancytopenia (deficiency of red, white, and platelet cells in the blood), agranulocytosis (very significant decrease in granulocytes), hemolytic anemia (premature destruction of red blood cells). The first symptoms are: fever, sore throat, superficial ulcers in the mouth, pseudo-flu-like symptoms, extreme fatigue, nosebleeds, and skin bleeding. Prolongation of bleeding time.
Immune system disorders
Infrequent: Allergic reaction, hypersensitivity reactions with skin rash and itching, as well as asthma attacks (possibly along with a drop in blood pressure).
Rare: Anaphylaxis (generalized allergic reaction).
Very rare: Severe hypersensitivity reactions (these may be characterized by swelling of the face, tongue, and larynx with bronchospasm, dyspnea, tachycardia, and hypotension that may include potentially fatal shock).
Note: In the event of these symptoms, which may occur with the first use, immediate medical attention is required.
Psychiatric disorders
Infrequent: Insomnia, anxiety, restlessness.
Rare: Psychotic reaction, nervousness, irritability, depression, confusion, disorientation.
Nervous system disorders
Frequent: Fatigue or drowsiness, headache, and dizziness or feeling of instability.
Infrequent: Insomnia, excitement, irritability.
Rare: Paresthesia (sensation of numbness, tingling, prickling, etc., more frequent in hands, feet, arms, or legs).
Very rare: Aseptic meningitis. In most cases where aseptic meningitis has been reported with ibuprofen, the patient suffered from some form of autoimmune disease (such as systemic lupus erythematosus or other collagen diseases), which was a risk factor. The symptoms of aseptic meningitis observed were neck stiffness, headache, nausea, vomiting, fever, or disorientation.
Eye disorders
Infrequent: Vision disturbances.
Rare: Abnormal or blurred vision.
Frequency not known: Papilledema (inflammation of the optic nerve).
Ear and labyrinth disorders
Frequent: Vertigo.
Infrequent: Ringing or buzzing in the ears.
Rare: Hearing difficulty.
Cardiac disorders
Medications like Espidifen may be associated with a moderate increase in the risk of suffering a heart attack ("myocardial infarction") or stroke.
Very rare: Palpitations, heart failure.
Frequency not known: Heart failure, chest pain, which may be a sign of a potentially severe allergic reaction called Kounis syndrome.
Vascular disorders
Edema (fluid retention), arterial hypertension, and heart failure have also been observed in association with treatments with medications of the Ibuprofen (arginine) type.
Very rare: Arterial hypertension.
Frequency not known: Arterial thrombosis.
Respiratory disorders
Infrequent: Asthma, worsening of asthma, bronchospasm, dyspnea (difficulty breathing).
Frequency not known: Throat irritation.
Gastrointestinal disorders
The most frequent adverse effects that occur with medications like Espidifen are gastrointestinal: peptic ulcers, gastrointestinal bleeding, perforations (in some cases fatal), especially in elderly patients.
Frequent: Gastrointestinal disorders such as heartburn (acidity, reflux), abdominal pain, nausea, vomiting, flatulence, diarrhea, constipation, and mild gastrointestinal bleeding that can cause anemia in exceptional cases.
Infrequent: Gastrointestinal ulcers, potentially with bleeding and perforation, ulcerative stomatitis, exacerbation of colitis and Crohn's disease, melena (blood in stools), gastritis.
Rare: Vomiting blood.
Very rare: Esophageal inflammation, pancreatitis, intestinal stenosis.
Frequency not known: Anorexia.
Hepatobiliary disorders
Rare: Liver damage, hepatitis (inflammation of the liver), liver function abnormalities, and jaundice (yellowing of the skin and eyes).
Skin and subcutaneous tissue disorders
Frequent: Skin rash.
Infrequent: Redness of the skin, itching or swelling of the skin (angioedema, urticaria), purpura (purple spots on the skin).
Rare: Anaphylactic reaction.
Very rare: Medications like Espidifen may be associated, in very rare cases, with severe blistering reactions such as Stevens-Johnson syndrome (widespread erosions affecting the skin and at least two mucous membranes and purple-colored lesions, preferably on the trunk) and toxic epidermal necrolysis (erosions on mucous membranes and painful lesions with necrosis and shedding of the epidermis).
Hair loss, erythema multiforme (skin lesion). Exceptionally, severe skin infections and soft tissue complications may occur during chickenpox.
Frequency not known: Photosensitivity (skin reactions due to light influence), worsening of skin reactions. A severe skin reaction known as DRESS syndrome may occur. The symptoms of DRESS syndrome include: skin rash, lymph node inflammation, and elevated eosinophils (a type of white blood cell).
Generalized red scaly rash, with bumps under the skin and blisters, mainly located in skin folds, trunk, and upper limbs, accompanied by fever at the start of treatment (acute generalized exanthematous pustulosis). Stop taking Espidifen if you experience these symptoms and seek immediate medical attention. See also section 2.
Renal and urinary disorders
Rare: Hematuria (presence of blood in the urine).
Very rare: Edema (signs that may indicate kidney disease, which may include kidney failure); renal tissue damage (papillary necrosis), increased serum uric acid concentration.
Based on experience with non-steroidal anti-inflammatory drugs in general, cases of interstitial nephritis, nephrotic syndrome, and renal failure cannot be excluded.
General disorders
Very rare: Worsening of inflammation during infectious processes.
Frequency not known: Edema.
Investigations
Rare: Alteration of liver function tests.
Frequency not known: Alteration of renal function tests.
To date, no serious allergic reactions have been reported with Espidifen, although they cannot be ruled out. The manifestations of this type of effect could be fever, skin rash, abdominal pain, severe and persistent headache, nausea, vomiting, angioedema, swelling of the face, tongue, and throat, difficulty breathing, asthma, palpitations, hypotension (lower than usual blood pressure), or shock.
If any of the following adverse effects appear, discontinue treatment and go to your doctor immediately:
Discontinue treatment with Espidifen and seek immediate medical attention if you notice any of the following symptoms:
Reporting of adverse effects
If you experience any type of adverse effect, consult your doctor, pharmacist, or nurse, even if it is a possible adverse effect that does not appear in this leaflet. You can also report them directly through the Spanish Pharmacovigilance System for Human Use Medicines: https://www.notificaram.es. By reporting adverse effects, you can contribute to providing more information on the safety of this medication.
Keep out of sight and reach of children.
No special storage conditions are required.
Do not use this medication after the expiration date shown on the packaging after the abbreviation CAD. The expiration date is the last day of the month indicated.
Medications should not be thrown away through wastewater or household waste. Deposit the packaging and medications you no longer need at the SIGRE Point of your usual pharmacy. Ask your pharmacist how to dispose of the packaging and medications you no longer need. This way, you will help protect the environment.
Composition of Espidifen
The active ingredient is Ibuprofen. Each sachet contains 600 mg of ibuprofen (as 1.155 mg of ibuprofen (arginine)).
The other components (excipients) are: aspartame (E951), sucrose, sodium hydrogen carbonate, sodium saccharin, apricot flavor.
Appearance of Espidifen and package contents
Oral solution granules, white in color.
Each package contains 20 or 40 sachets with granules.
Only some package sizes may be marketed.
Marketing authorization holder
Zambon, S.A.U.
Maresme, 5. Can Bernades-Subirà Industrial Estate
08130 Sta. Perpètua de Mogoda (Barcelona)
Spain
Manufacturer
Zambon, S.p.A.
Via della Chimica, 9
36100 Vicenza
Italy
Zambon, S.A.U.
Maresme, 5. Can Bernades-Subirà Industrial Estate
08130 Sta. Perpètua de Mogoda (Barcelona)
Spain
Date of last revision of this leaflet:November 2024
Detailed and updated information on this medication is available on the website of the Spanish Agency for Medicines and Health Products (AEMPS) http://www.aemps.gob.es/
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Discuss dosage, side effects, interactions, contraindications, and prescription renewal for ESPIDIFEN 600 mg ORAL SOLUTION GRANULES, APRICOT FLAVOR – subject to medical assessment and local rules.