Package Insert: Information for the Patient
Espidifen 600 mg Granule for Oral Solution, Peppermint Flavor EFG
Ibuprofen (arginine)
Read this entire package insert carefully before starting to take this medication, as it contains important information for you.
1. What is Espidifen and how is it used
2. What you need to know before starting to take Espidifen
3. How to take Espidifen
4. Possible adverse effects
5. Storage of Espidifen
6. Contents of the package and additional information
Ibuprofen (arginine) belongs to a group of medicines called non-steroidal anti-inflammatory drugs (NSAIDs).
This medicine is used in adults and adolescents aged 14 years and above for the treatment of fever, the treatment of moderate to severe pain including migraine, the treatment of arthritis (inflammation of the joints, including those in the hands and feet, leading to swelling and pain), juvenile rheumatoid arthritis, osteoarthritis (a chronic condition causing cartilage damage), ankylosing spondylitis (inflammation affecting the spine joints), non-rheumatic inflammation, and primary dysmenorrhea (painful menstruation).
Do not take Espidifen:
- If you are allergic to ibuprofen or any of the other components of the medication (listed in section 6). Allergic reactions may include skin rash with itching, facial swelling, lip or tongue swelling, nasal discharge, difficulty breathing, bronchospasm, or asthma.
- If you have a severe liver or kidney disease.
- If you have had a stomach or duodenal ulcer or bleeding, or have suffered a perforation of the digestive tract.
- If you vomit blood.
- If you have black stools or bloody diarrhea.
- If you have an active cerebral hemorrhage or other active bleeding.
- If you have bleeding disorders or blood clotting disorders, or are taking anticoagulants (medications used to "thin" the blood). If anticoagulants are necessary, your doctor will perform blood clotting tests).
- If you have severe heart failure.
- If you have severe dehydration caused by vomiting, diarrhea, or inadequate fluid intake.
- If you are in the third trimester of pregnancy.
Warnings and precautions
Consult your doctor before starting to take Espidifen:
This risk is higher when using high doses and prolonged treatments, in patients with a history of peptic ulcer disease, and in elderly patients. In these cases, your doctor will consider the possibility of associating a stomach protector medication.
It is essential to use the smallest dose that relieves or controls pain and not to take this medication for longer than necessary to control your symptoms.
Avoid concurrent administration with other NSAIDs, including those known as COX-2 inhibitors.
Be especially careful with Espidifen:
Severe skin reactions, such as exfoliative dermatitis, erythema multiforme, Stevens-Johnson syndrome, toxic epidermal necrolysis, drug reaction with eosinophilia and systemic symptoms (DRESS), generalized acute pustular exanthema (PEGA), have been reported in association with ibuprofen treatment. Discontinue Espidifen treatment and seek medical attention immediately if you notice any of the symptoms related to these severe skin reactions described in section 4.
Precautions in elderly patients
Elderly patients have a higher frequency of adverse reactions to NSAIDs, especially bleeding and gastrointestinal perforation, which can be fatal.
Cardiovascular precautions
NSAIDs, such as ibuprofen, may be associated with a small increase in the risk of heart attack or stroke, especially when used in high doses.
Do not exceed the recommended dose or treatment duration.
You must inform your doctor or pharmacist before taking Espidifen if:
These types of medications may also cause fluid retention, especially in patients with heart failure and/or high blood pressure.
Ibuprofen has been reported to cause allergic reactions 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 emergency medical services if you observe any of these signs.
Respiratory disorders
Ibuprofen should be used with caution when administered to patients who have or have had asthma, bronchial asthma, 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.
This medication is not recommended for use in children or adolescents under 14 years old, as the dose of ibuprofen contained is not suitable for the recommended dosage in these patients.
Precautions during pregnancy and in fertile women
Due to the administration of ibuprofen (arginine) type medications being associated with an increased risk of congenital anomalies/abortions, it is not recommended to administer the medication during the first and second trimesters of pregnancy, except in cases where it is strictly necessary and advised by your doctor.
If you need treatment during this period or while trying to become pregnant, you should use the smallest dose for the shortest time possible.
If taken for a few days from 20 weeks of gestation onwards, Espidifen may cause kidney problems in your baby that may lead to low amniotic fluid levels 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.
During the third trimester, the administration of ibuprofen (arginine) is contraindicated.
For fertile women, it should be noted that ibuprofen (arginine) type medications have been associated with a decrease in the ability to conceive.
If you are to undergo any diagnostic test (includingbloodtests, urine tests, skin tests that use allergens, etc...) inform your doctor thatyou are takingthis medication, as it may alter the results.
Use of Espidifen with other medications
Inform your doctor or pharmacist if you are using, have used recently, or may need to use any other medication.
Espidifen may affect or be affected by other medications. For example:
The medications listed below may interfere and, therefore, should not be taken together with Espidifen without consulting your doctor:
Other medications may also affect or be affected by Espidifen treatment. Therefore, you must 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 granulated ibuprofen (arginine) tablets 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. The consumption of alcohol during treatment may increase the risk of gastrointestinal side effects.
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.
Ibuprofen (arginine) should not be taken during pregnancy, especially during the third trimester (see section on precautions during pregnancy and in fertile women). It may cause kidney and heart problems in your baby. It may affect your tendency and that of your baby to bleed and make labor longer or more difficult than expected.
Small amounts of ibuprofen and its metabolites are excreted in breast milk. As no undesirable effects have been reported in the infant, it is usually not necessary to discontinue breastfeeding during short-term use at recommended doses.
Therefore, if you become pregnant or are breastfeeding, consult your doctor.
Driving and operating machinery:
If you experience dizziness, vertigo, visual disturbances, or other symptoms while taking this medication, you should not drive or operate hazardous machinery. If you only take a single dose of ibuprofen (arginine) or take it for a short period, no special precautions are necessary.
Espidifen contains aspartame, sucrose, butylhydroxyanisole (E 320), and sodium
This medication contains 30 mg of aspartame in each packet.
Aspartame contains a source of phenylalanine that may be harmful in cases 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 85 mg of sodium (main component of table salt/for cooking) in each packet. This is equivalent to 4.24% of the recommended daily maximum sodium intake for an adult.
This medication may cause local reactions or irritation of mucous membranes because it contains butylhydroxyanisole (E 320).
Follow exactly the administration instructions of this medication as indicated by your doctor. In case of doubt, consult your doctor or pharmacist again.
Your doctor will indicate the duration of treatment with Ibuprofen (arginine). Do not discontinue treatment beforehand, as the expected results will not be obtained. Similarly, do not use this medication for a longer period than indicated by your doctor.
The most effective dose should be used for the shortest duration necessary to alleviate symptoms. If you have an infection, consult a doctor immediately if symptoms (such as fever and pain) persist or worsen (see section 2).
The entire contents of the granule sachet should be taken after dissolving it in a sufficient amount of water.
Adults and adolescents over 14 years old
The dosage should be adjusted according to the severity of the disorder and the patient's discomfort.
In adults and adolescents aged 14 to 18 years, one sachet (600 mg of ibuprofen) should be taken every 6 to 8 hours, depending on the intensity of the condition and the response to treatment.
In some cases, 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 aged 14 to 18 years.
In rheumatoid arthritis, higher doses may be required, but in any case, it is recommended not to exceed the maximum daily dose of 2,400 mg (4 sachets of granule) of ibuprofen.
In primary dysmenorrhea, a daily dose of 600 mg of ibuprofen is recommended until the pain is relieved, with a maximum dose per administration of 600 mg of ibuprofen and a maximum daily dose of 1,200 mg (2 sachets of granule).
Use in children and adolescents
This medication is not recommended for use in children or adolescents under 14 years old, as the dose of ibuprofen contained is not suitable for the recommended dosage in these patients.
Use in elderly patients
In these patients, the dosage should be established by the doctor, as it may be necessary to reduce the usual dose.
Use in patients with kidney and/or liver disease
If you have kidney and/or liver disease, your doctor may prescribe a lower dose than usual. If so, take the exact dose prescribed by your doctor.
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 Toxicological Information Service (phone: 91.5620420), indicating the medication and the amount ingested, to inform yourself 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 tremors of the eyes. Agitation, drowsiness, disorientation, or coma may also occur. Occasionally, patients develop seizures. At high doses, somnolence, chest pain, palpitations, loss of consciousness, seizures (mainly in children), weakness, and dizziness, blood in the urine, low potassium levels in the blood, feeling cold, and respiratory problems have been reported. Additionally, the prothrombin time/INR may be prolonged, probably due to interference with the actions of circulating clotting factors. Acute renal failure and liver damage may occur. It is possible that asthma may worsen in asthmatics. Additionally, low blood pressure and difficulty breathing may occur.
In case of ingestion of significant amounts, activated charcoal should be administered. Gastric emptying should be considered if significant amounts have been ingested and within 60 minutes of ingestion.
If you forgot to take Espidifen
Do not take a double dose to compensate for the missed dose.
If you forget to take your dose, take it as soon as you remember. However, if the next scheduled dose is soon, skip the missed 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 medicines, this medicine can cause side effects, although not everyone will experience them.
The side effects of medicines such as Ibuprofeno (arginina) are more common in people over 65 years old.
The incidence of side effects is lower in short-term treatments and if the daily dose is below the maximum recommended dose.
Frequencies are established according to the following classification: very common (may affect more than 1 in 10 patients); common (may affect up to 1 in 10 patients); uncommon (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 unknown (cannot be estimated from available data).
The following side effects have been observed:
Infections and infestations
Very rare: Exacerbation of inflammatory conditions related to infection (for example, the development of necrotizing fasciitis), coinciding with the use of nonsteroidal anti-inflammatory drugs.
Nota: If signs of infection or worsening occur during treatment with ibuprofen, it is recommended to see a doctor immediately, if necessary, to initiate anti-infective/antibiotic therapy.
Blood and lymphatic system disorders
Rare: Aplastic anemia (insufficiency of the bone marrow to produce different types of cells).
Very rare:Thrombocytopenia, leukopenia (decrease in white blood cells, which may manifest as frequent infections with fever, chills, or sore throat), anemia (may manifest as difficulty breathing and pale skin), granulocytopenia (a type of white blood cell that may predispose to infections), pancytopenia (deficiency of red and white blood cells and platelets in the blood), agranulocytosis (very large decrease in granulocytes), hemolytic anemia (premature destruction of red blood cells). The first symptoms are: fever, sore throat, superficial ulcers in the mouth, pseudogripal symptoms, extreme fatigue, nasal and cutaneous hemorrhage.Prolongation of bleeding time.
Immune system disorders
Uncommon: Allergic reaction, hypersensitivity reactions with skin rash and pruritus, as well as asthma attacks (possibly accompanied by a fall 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).
Nota: In the appearance of these symptoms, which may occur with the first use, immediate assistance from a doctor is required.
Mental disorders
Uncommon: Insomnia, anxiety, restlessness.
Rare: Psychotic reaction, nervousness, irritability, depression, confusion, disorientation.
Nervous system disorders
Common: Fatigue or drowsiness, headache, dizziness or sensation of instability.
Uncommon: Insomnia, excitement, irritability.
Rare: Paresthesia (numbness, tingling, burning, 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 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
Uncommon: Vision disturbances.
Rare: Abnormal or blurred vision.
Frequency unknown: Papilledema (inflammation of the optic nerve).
Ear and labyrinth disorders
Common: Dizziness.
Uncommon: Ringing or buzzing in the ears.
Rare: Hearing difficulty.
Cardiac disorders
Medicines like Ibuprofeno (arginina) 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 unknown: Cardiac failure, chest pain, which may be a sign of a potentially severe allergic reaction called Kounis syndrome.
Vascular disorders
Edema (fluid retention), hypertension, and heart failure have also been observed in association with treatments with medicines of the type Ibuprofeno (arginina).
Very rare: Hypertension.
Frequency unknown: Arterial thrombosis.
Respiratory, thoracic, and mediastinal disorders
Uncommon: Asthma, worsening of asthma, bronchospasm, dyspnea (breathing difficulty).
Frequency unknown: Irritation of the throat.
Gastrointestinal disorders
The most common side effects that occur with medicines like Espidifen are gastrointestinal: peptic ulcers, gastrointestinal bleeding, perforations (in some cases fatal), especially in elderly patients.
Common: Gastrointestinal symptoms such as pyrosis (heartburn, reflux), abdominal pain, nausea, vomiting, flatulence, diarrhea, constipation, and mild gastrointestinal bleeding that may cause anemia in exceptional cases.
Uncommon: Gastrointestinal ulcers, potentially with bleeding and perforation, stomatitis, exacerbation of colitis and Crohn's disease, melena (blood in stool), gastritis.
Rare: Vomiting with blood.
Very rare: Inflammation of the esophagus, pancreatitis, intestinal stenosis.
Frequency unknown: Anorexia.
Hepatobiliary disorders
Rare: Liver damage, hepatitis (inflammation of the liver), abnormalities in liver function, and jaundice (yellowing of the skin and eyes).
Skin and subcutaneous tissue disorders
Common: Skin rash.
Uncommon: Redness of the skin, itching or swelling of the skin, purpura (purple spots on the skin).
Rare: Anaphylactic reaction.
Very rare: Medicines like Espidifen may be associated, in very rare cases, with severe bullous reactions such as Stevens-Johnson syndrome (widespread erosions affecting the skin and two or more mucous membranes and lesions of purple color, preferably on the trunk) and toxic epidermal necrolysis (erosions in mucous membranes and painful lesions with necrosis and detachment of the epidermis).
Loss of hair, erythema multiforme (skin lesion).Exceptionally, severe skin infections and complications in soft tissue may occur during chickenpox.
Frequency unknown:Photosensitivity reactions, aggravation 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 and scaly rash, with bumps under the skin and blisters, mainly located in skin folds, trunk, and upper limbs, accompanied by fever. Symptoms usually appear at the beginning of treatment (acute generalized pustular exanthema).
Stop taking Espidifen if you experience these symptoms and seek medical attention immediately. See section 2.
Renal and urinary disorders
Rare: Hematuria (blood in urine).
Very rare: Edema (signs that may indicate kidney disease, which may include renal insufficiency); renal tissue damage (papillary necrosis), increased serum uric acid concentration.
Based on experience with nonsteroidal anti-inflammatory drugs in general, cases of interstitial nephritis, nephrotic syndrome, and renal insufficiency cannot be ruled out.
General disorders and administration site conditions
Very rare: Exacerbation of inflammatory conditions during infectious processes.
Frequency unknown: Edema.
Investigations
Rare: Alteration of liver function tests.
Frequency unknown: Alteration of renal function tests.
Until now, no severe allergic reactions have been reported with Espidifen, although they cannot be ruled out. The manifestations of this type of effect may be fever, skin rash, abdominal pain, severe headache, nausea, vomiting, angioedema, facial swelling, tongue, and throat, difficulty breathing, asthma, palpitations, hypotension (decreased blood pressure), or shock.
If any of the following side effects occur, discontinue treatment and seek immediate medical attention:
- Allergic reactions such as skin rash, facial swelling, chest tightness, or difficulty breathing.
- Vomiting blood or coffee ground-like vomit.
- Blood in stool or diarrhea with blood.
- Severe abdominal pain.
- Blisters or significant peeling of the skin.
- Severe headache or persistent headache.
- Yellowing of the skin (jaundice).
- Signs of severe hypersensitivity (see above in this same section).
- Swelling of the limbs or accumulation of fluid in the arms or legs.
- Vision disturbances.
Stop taking Espidifen and seek immediate medical attention if you notice any of the following symptoms:
Reporting of side effects
If you experience any type of side effect, consult your doctor, pharmacist, or nurse, even if it is a possible side effect that does not appear in this leaflet. You can also report them directly through the Spanish System for the Vigilance of Medicinal Products for Human Use:https://www.notificaram.es. By reporting side effects, you can contribute to providing more information on the safety of this medicine.
Keep out of sight and reach of children.
No special storage conditions are required.
Do not use this medicationafter the expiration date that appears on the packaging after the abbreviation CAD. The expiration date is the last day of the month indicated.
Medicines should not be disposed of through drains or in the trash. Dispose of the packaging and medicines you no longer need at your localSIGREcollection point at your usual pharmacy. Ask your pharmacist how to dispose of the packaging and medicines you no longer need. This 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 are: L-arginine, aspartame (E951), sucrose, sodium hydrogen carbonate, sodium saccharin, peppermint aroma and anise aroma (contains butyl hydroxyanisole (E 320)) see section 2 Espidifen contains aspartame, sucrose, butyl hydroxyanisole (E 320) and sodium.
Appearance of Espidifen and contents of the packaging
Oral granule solution, white in color.
Each package contains 20 or 40 sachets with granules.
Only some package sizes may be commercially available.
Marketing Authorization Holder
Zambon, S.A.U.
Maresme, 5. Polígono Can Bernades-Subirà
08130 Sta. Perpètua de Mogoda (Barcelona)
Spain
Responsible for manufacturing
Zambon, S.p.A.
Via della Chimica, 9
36100 Vicenza
Italy
or
Zambon, S.A.U.
Maresme, 5. Polígono Can Bernades-Subirà
08130 Sta. Perpètua de Mogoda (Barcelona)
Spain
Last review date of this leaflet:November 2024
Detailed and updated information on this medication is available on the website of the Spanish Agency for Medicines and Medical Devices (AEMPS)http://www.aemps.gob.es/
The average price of Espidifen 600 mg granulado para solucion oral sabor menta efg in July, 2025 is around 2.5 EUR. Prices may vary depending on the region, pharmacy, and whether a prescription is required. Always check with a local pharmacy or online source for the most accurate information.
Have questions about this medication or your symptoms? Connect with a licensed doctor for guidance and personalized care.