Nuralgan (Ibuprofen, Paracetamol)

Nuralgan combines both ibuprofen and paracetamol, acting on pain‑related pathways and fever mechanisms. It is commonly used for:

• Headache: provides relief from tension‑type and mild migraine symptoms.
• Musculoskeletal pain: eases discomfort from strains, sprains and low‑back pain.
• Fever: lowers elevated body temperature in acute febrile illnesses.

• Ibuprofen inhibits cyclo‑oxygenase (COX‑1 and COX‑2) enzymes, decreasing prostaglandin production that mediates inflammation, pain and fever. Paracetamol acts centrally by inhibiting a variant of the COX enzyme and modulating serotonergic pathways, providing additional antipyretic and analgesic effects without significant peripheral anti‑inflammatory activity.

Adverse reactions may occur with any combination analgesic product.

Common Side Effects

• Gastrointestinal discomfort: nausea, dyspepsia or mild abdominal pain.
• Headache: new or worsening headache despite therapy.
• Dizziness: transient light‑headedness or vertigo.
• Skin rash: mild erythema or itching.
• Elevated liver enzymes: mild, transient increase in laboratory tests.

Serious or Rare Side Effects

• Severe gastrointestinal bleeding or ulceration.
• Stevens‑Johnson syndrome or toxic epidermal necrolysis.
• Acute kidney injury or sudden loss of renal function.
• Anaphylaxis: rapid onset of swelling, airway compromise or hypotension.
• Hepatotoxicity: marked elevation of transaminases or liver failure.

When using Nuralgan, consider the following safety measures:

• Assess renal function: evaluate baseline kidney health, especially in patients with chronic disease.
• Monitor hepatic status: check liver enzymes in long‑term or high‑dose use.
• Avoid concurrent NSAID use: limit additional ibuprofen‑type drugs to reduce gastrointestinal risk.
• Use lowest effective dose: aim for symptom control with minimal exposure.
• Review cardiovascular risk: patients with hypertension or heart disease should be assessed.
• Store at below 25°C: keep in the original packaging, protect from moisture and direct sunlight.

Nuralgan may interact with several medicines; careful review is advised.

Major Interactions (Avoid)

• Anticoagulants (e.g., warfarin): increased bleeding risk.
• High‑dose aspirin aspirin  :    ");

Moderate  ...