Prospect: information for the user
Difenadol rapid 400 mg granulated for oral solution
Ibuprofen (arginine)
Read this prospect carefully before starting to take this medicine, as it contains important information for you.
Follow exactly the administration instructions of the medicine contained in this prospect or those indicated by your doctor, pharmacist, or nurse.
1.What is Difenadol rapid and for what it is used
2.What you need to know before starting to take Difenadol rapid
3.How to take Difenadol rapid
4.Possible adverse effects
5.Storage of Difenadol rapid
6. Contents of the package and additional information
The ibuprofen, active ingredient of this medication, acts by reducing pain and fever.
This medication is used in adults and adolescents 12 years of age and older (weight equal to or greater than 40 kg), for symptomatic relief of occasional mild to moderate pains, such as headaches, dental pain, menstrual cramps, muscle pain (muscle spasms) or back pain (lumbago), as well as in febrile states.
Warnings and precautions
Nonsteroidal anti-inflammatory drugs (NSAIDs) like ibuprofen may increase the risk of heart attack or stroke, especially when taken in high doses. Do not exceed the recommended dose or treatment duration. Do not take more than 3 sachets of granules (1,200 mg of ibuprofen) per day to avoid potential cardiovascular or heart problems.
Inform your doctor
It is essential to use the smallest dose that relieves or controls pain and not to take this medicine for longer than necessary to control your symptoms.
Avoid taking this medicine with other NSAIDs, including COX-2 inhibitors.
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
Nonsteroidal anti-inflammatory drugs (NSAIDs) like ibuprofen may increase the risk of heart attack or stroke, especially when taken in high doses. Do not exceed the recommended dose or treatment duration.
Inform your doctor or pharmacist before taking Difenadol rapid if:
Additionally, this type of medication may cause fluid retention, especially in patients with heart failure and/or high blood pressure.
Respiratory problems
Ibuprofen should be used with caution in patients who have or have had asthma, bronchitis, or allergic diseases, as it may cause bronchospasm, urticaria, or angioedema in these patients.
Severe skin reactions
Severe skin reactions, including dermatitis exfoliativa, erythema multiforme, Stevens-Johnson syndrome, toxic epidermal necrolysis, drug reaction with eosinophilia and systemic symptoms (DRESS), generalized acute pustular psoriasis (PEGA), have been reported in association with ibuprofen treatment. Discontinue treatment with Difenadol rapid and seek medical attention immediately if you notice any symptoms related to these severe skin reactions described in section 4.
Children and adolescents
There is a risk of kidney failure in dehydrated children and adolescents.
This medicine is not recommended for children and adolescents weighing less than 40 kg or under 12 years old, as the ibuprofen dose contained is not suitable for the recommended dosage in this age group.
Precautions during pregnancy and in women of childbearing age
Due to the association of ibuprofen administration with an increased risk of congenital anomalies/abortions, its administration is not recommended during the first and second trimesters of pregnancy, except when strictly necessary and advised by your doctor.
If you need treatment during this period or while trying to become pregnant, use the lowest dose for the shortest time possible.
If you take it during the first 20 weeks of gestation, Difenadol rapid may cause kidney problems in your baby that may lead to low amniotic fluid levels or narrowing of a blood vessel (ductus arteriosus) in your baby's heart. If you need treatment for a few more days, your doctor may recommend additional monitoring.
During the third trimester, ibuprofen administration is contraindicated.
For women of childbearing age, consider that ibuprofen-containing medications have been associated with a decrease in the ability to conceive.
Interference with laboratory tests
Inform your doctor if you are to undergo any diagnostic tests (including blood tests, urine tests, skin tests using allergens, etc.), as this medicine may alter the results.
Other medicines and Difenadol rapid
Inform your doctor or pharmacist if you are taking, have taken recently, or may need to take any other medicine.
Difenadol rapid may affect or be affected by other medicines. For example:
The following medicines may interfere and should not be taken with Difenadol rapid without consulting your doctor:
Other medicines may also affect or be affected by Difenadol rapid treatment. Therefore, always consult your doctor or pharmacist before using Difenadol rapid with other medicines.
Taking Difenadol rapid with food, drinks, and alcohol
Take this medicine with meals or with milk.
Do not take ibuprofen with alcohol to avoid damaging your stomach. Drinking alcohol during treatment may increase the risk of gastrointestinal adverse reactions.
Pregnancy, breastfeeding, and fertility
If you are pregnant or breastfeeding, or think you may be pregnant, consult your doctor or pharmacist before using this medicine.
Difenadol rapid 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 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 medicine, do not drive or operate hazardous machinery. If you only take a single dose of ibuprofen or for a short period, no special precautions are necessary.
Difenadol rapid contains aspartame, saccharose, and sodium
This medicine contains 20 mg of aspartame in each sachet. Aspartame contains a source of phenylalanine, which may be harmful in cases of phenylketonuria (PKU), a rare genetic disorder in which phenylalanine accumulates because the body is unable to eliminate it correctly.
This medicine contains glucose. If your doctor has told you that you have an intolerance to certain sugars, consult with them before taking this medicine.
This medicine may cause tooth decay.
This medicine contains saccharose. If your doctor has told you that you have an intolerance to certain sugars, consult with them before taking this medicine.
This medicine may cause tooth decay.
This medicine contains less than 1 mmol of sodium (23 mg) per sachet; it is essentially "sodium-free".
Follow exactly the medication administration instructions contained in this leaflet or those indicated by your doctor, pharmacist, or nurse. In case of doubt, ask your doctor, pharmacist, or nurse.
The effective dose should be the lowest dose 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 recommended dose is:
No more than 3 packets (1,200 mg of ibuprofen) should be taken in 24 hours.
The administration of this medication is subject to the appearance of pain or fever. As these symptoms disappear, the medication should be discontinued.
Consult a doctor if symptoms worsen or do not improve, if fever persists for more than 3 days or pain for more than 3 days in adolescents or 5 days in adults.
Use in children
This medication is not recommended for use in children and adolescents weighing less than 40 kg or under 12 years, as the ibuprofen dose contained is not suitable for the recommended dosage in this patient group.
Administration form:
This medication is administered orally.
Dissolve completely the contents of a packet in a glass of water and ingest it immediately. Take this medication with meals or with milk, especially if digestive discomfort is noted.
If you take more Difenadol rapid than you should
In case of overdose or accidental ingestion, consult a doctor or pharmacist immediately or call the Toxicological Information Service (phone: 91 562 04 20), indicating the medication and the amount ingestedor go to the nearest hospital 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 contain blood-stained mucus), gastrointestinal bleeding (see also section 4 below), diarrhea, dizziness, spasms, hypotension, or depression of the nervous system (reduction of consciousness) headache, ringing in the ears, confusion, and involuntary eye movement.
Also, nervousness, drowsiness, disorientation, or coma may occur. Occasionally, patients develop seizures.
At high doses, symptoms of drowsiness, chest pain, palpitations, loss of consciousness, seizures (mainly in children), weakness, and dizziness, blood in the urine, low potassium levels in the blood, chills, and breathing difficulties have been reported.
In cases of significant overdose, renal insufficiency and liver damage may occur.
Furthermore, the prothrombin time/INR may be prolonged, probably due to interference with the action of circulating clotting factors. Acute renal failure and liver damage may occur. It is possible that asthma exacerbation may occur in asthmatic patients. Also, low blood pressure and reduced respiration may occur.
In case of ingestion of significant amounts, activated charcoal should be administered. Gastric emptying will be considered if significant amounts have been ingested and within 60 minutes of ingestion.
If you forget to takeDifenadol rapid
Do not take a double dose to compensate for the missed doses.
If you forget to take your dose, take it as soon as you remember. However, if the time for the next dose is near, skip the missed dose and take the next dose at your usual time.
If you have any other questions about the use of this product, ask your doctor or pharmacist.
Like all medications, Difenadol rapid may have adverse effects, although not everyone will experience them. Adverse effects of medications such as Difenadol rapid are more common in people over 65 years old.
The incidence of adverse 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 not known (cannot be estimated from available data).
The following adverse effects have been observed:
Infections and infestations
Very rare: Exacerbation of infections-related inflammation (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 an 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: 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 contracting infections), pancytopenia (deficiency of red, white, and platelet cells 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 bleeding. Prolonged bleeding time.
Immune system disorders
Uncommon: Allergic reaction, hypersensitivity reactions with skin rash and pruritus, as well as asthma attacks (possibly accompanied by 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).
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 somnolence, 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 not known: Papilledema (inflammation of the optic nerve).
Ear and labyrinth disorders
Common: Dizziness.
Uncommon: Buzzing or ringing in the ears.
Rare: Hearing difficulty.
Cardiac disorders
Medications like Difenadol rapid 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: Chest pain, which may be a sign of a potentially severe allergic reaction called Kounis syndrome.
Vascular disorders
Edema (fluid retention), high blood pressure, and heart failure have also been observed in association with treatments with ibuprofen (arginine) type medications.
Very rare: High blood pressure.
Frequency not known: Arterial thrombosis.
Respiratory, thoracic, and mediastinal disorders
Uncommon: Asthma, worsening of asthma, bronchospasm, dyspnea (breathing difficulty).
Frequency not known: Irritation of the throat.
Gastrointestinal disorders
The most common adverse effects that occur with medications like Difenadol rapid are gastrointestinal: peptic ulcers, gastrointestinal bleeding, perforations (in some cases fatal), especially in elderly patients.
Common:Gastrointestinal discomfort such as heartburn, 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 not known: 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 (angioedema, urticaria), purpura (purple spots on the skin).
Rare:Anaphylactic reaction
Very rare:Medications with ibuprofen (arginine) may be associated, in very rare cases, with severe blistering reactions such as Stevens-Johnson syndrome (widespread skin and mucous membrane erosions and lesions with purple color, preferably on the trunk) and toxic epidermal necrolysis (skin and mucous membrane erosions with necrosis and detachment of the epidermis). Hair loss, erythema multiforme (skin lesion),. Exceptionally, severe skin infections and complications in the soft tissue may occur during chickenpox.
Frequency not known: Photosensitivity reactions, 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 and scaly rash with bumps under the skin and blisters, mainly located in skin folds, trunk, and upper limbs, accompanied by fever. The symptoms usually appear at the beginning of treatment (acute generalized pustular exanthema). Stop taking Difenadol rapid 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 sometimes may include renal insufficiency); renal tissue damage (papillary necrosis), increased serum uric acid concentration.
Based on the 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: Worsening of inflammation during infectious processes.
Frequency not known: Edema.
Laboratory investigations
Rare: Alteration of liver function tests.
Frequency not known: Alteration of renal function tests.
No severe allergic reactions have been reported with Difenadol rapid to date, 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 swelling, breathing difficulty, asthma, palpitations, hypotension, or shock.
If any of the following adverse effects occur, discontinue treatment and seek immediate medical attention:
Discontinue treatment with ibuprofen and seek immediate medical attention if you notice any of the following symptoms:
Reporting of adverse reactions
If you experience any type of adverse reaction, consult your doctor, pharmacist, or nurse, even if it is a possible adverse reaction 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 adverse reactions, you can contribute to providing more information on the safety of this medication.
Keep this medication out of the sight and reach of children.
No special storage conditions are required. Store in the original packaging to protect from light and moisture.
Do not use this medication after the expiration date that appears on the packaging after CAD. The expiration date is the last day of the month indicated.
Medications should not be disposed of through drains or trash.Deposit empty packaging and unused medications at the SIGRE collection pointat the pharmacy. If in doubt, ask your pharmacist how to dispose of unused packaging and medications. By doing so, you will help protect the environment.
Composition of Difenadol rapid
Appearance of Difenadol rapidand contents of the packaging
White granule with a characteristic orange odor.
It is presented in packaging with 12 or 20 sachets of paper/aluminum sealed.
Trade name of the marketing authorization and responsible manufacturer
LABORATORIOS NORMON, S.A.
Ronda de Valdecarrizo, 6 – 28760 Tres Cantos – Madrid (Spain)
Date of the last review of this leaflet:January2025
The 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/
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