Instructions for use TERAFLEX ADVANCE


pharmachologic effect

Stimulates cartilage restoration and reduces inflammation.

  • Chondroitin sulfate is a substance involved in the formation of healthy cartilage tissue. At the same time, the viscosity of the synovial fluid is maintained, and enzymes that destroy cartilage are inhibited. In osteoarthritis, it reduces the manifestations of the disease and helps reduce the dose of non-steroidal anti-inflammatory drugs.
  • Glucosamine sulfate improves the synthesis of substances that are the main components of cartilage, joint membranes and synovial fluid.
  • Ibuprofen provides an anti-inflammatory effect, reduces pain, and has an antipyretic effect due to the blockade of cyclooxygenase-1 and cyclooxygenase-2 .

Glucosamine and chondroitin increase the analgesic effect of ibuprofen .

Pharmacodynamics and pharmacokinetics

The bioavailability of glucosamine is about 25%, with the highest concentration of the substance found in joint cartilage, liver and kidneys, the highest concentration found in liver, kidneys and joint cartilage. Almost 30% of the incoming substance remains in the muscles and bones for quite a long time. The half-life is about 3 days, excreted in the urine.

The bioavailability of chondroitin sulfate after absorption from the gastrointestinal tract is approximately 13%. The maximum concentration occurs after 4 hours in the blood, and in the intra-articular fluid - within 5 hours. A large amount is found in synovial fluid. It is excreted from the body in urine.

After oral administration of ibuprofen, its maximum concentration occurs within 1 hour. Capable of binding to plasma proteins by 99% and penetrating into the intra-articular fluid. Metabolized in the liver, excreted by the kidneys. The half-life is about 3 hours.

Pharmacological properties of the drug Teraflex Advance

Chondroitin sulfate is a high molecular weight mucopolysaccharide that takes part in the construction of cartilage tissue. Reduces the activity of enzymes that destroy articular cartilage and stimulates the regeneration of the latter. In the early stages of the inflammatory process, chondroitin sulfate reduces its activity and thus slows down the degeneration of cartilage tissue. Eliminates pain, improves joint function, reduces the need for NSAIDs in patients with osteoarthritis of the knee and hip joints. Glucosamine sulfate has chondroprotective properties, reduces the deficiency of glycosamines in the body, and takes part in the biosynthesis of proteoglycans and hyaluronic acid. Having an affinity for cartilage tissue, glucosamine initiates the process of sulfur fixation during the synthesis of chondroitinsulfuric acid. Glucosamine sulfate selectively acts on articular cartilage, is a specific substrate and stimulator of the synthesis of hyaluronic acid and proteoglycans, inhibits the formation of superoxide radicals and enzymes that cause damage to cartilage tissue (collagenase and phospholipase); prevents disruption of glycosaminoglycan biosynthesis induced by NSAIDs and the destructive effect of glucocorticoids on chondrocytes. Ibuprofen has analgesic, anti-inflammatory, and antipyretic effects. The mechanism of action of ibuprofen occurs due to the selective blocking of cyclooxygenase (COX-1 and -2), the main enzyme in the metabolism of arachidonic acid, which leads to a decrease in the synthesis of prostaglandins. Reduces morning stiffness of joints, helps increase range of motion in joints and spine. Pharmacokinetics. Absorption: after a single oral dose of the drug in an average therapeutic dose, the maximum concentration of chondroitin sulfate in the blood plasma is achieved after 3-4 hours, in the synovial fluid - after 4-5 hours. Bioavailability of the drug is 13%. Excretion is carried out mainly by the kidneys within 24 hours. 90% of glucosamine taken enterally is absorbed in the intestine. Over 25% of the dose taken penetrates from the blood plasma into the cartilage tissue and synovial membranes of the joints. In the liver, part of the drug is metabolized to form urea, carbon dioxide and water. The bioavailability of glucosamine is 25% due to primary passage through the liver. The maximum concentration of glucosamine is determined in articular cartilage, liver and kidneys. About 30% of the dose taken persists for a long time in bone and muscle tissue. It is excreted primarily in urine unchanged, and partially in feces. The half-life is 68 hours. Ibuprofen, when administered orally, is almost completely absorbed from the gastrointestinal tract. Eating food at the same time slows down the rate of absorption. Metabolized in the liver (up to 90%). The half-life is 2–3 hours; 80% of the dose taken is excreted in the urine, mainly in the form of metabolites.

Contraindications

  • ulcerative lesions of the gastrointestinal tract ( gastric ulcer , Crohn's disease , ulcerative colitis);
  • gastrointestinal bleeding;
  • intracranial hemorrhages;
  • bleeding disorders;
  • aspirin asthma;
  • hemorrhagic diathesis;
  • children under 12 years of age;
  • individual intolerance to the constituent components of the drug;
  • pregnancy and breastfeeding;
  • hypersensitivity to aspirin and NSAIDs.

Prescribed cautiously for arterial hypertension, heart failure, severe damage to kidney and liver function, gastrointestinal diseases, hyperbilirubinemia, nephrotic syndrome, blood diseases, diabetes mellitus , bronchial asthma , and in elderly patients.

In case of intolerance to seafood products, the likelihood of developing an allergy to the drug increases.

Side effects

Nausea, diarrhea , abdominal pain, flatulence, constipation and allergic reactions may occur. If the drug is discontinued, the side effects disappear.

Most adverse reactions occur to ibuprofen , which is part of the drug.

  • Digestive system: dry mouth, stomatitis, abdominal pain, heartburn, nausea and vomiting, flatulence, constipation and diarrhea, pancreatitis and hepatitis.
  • Respiratory system: bronchospasm and shortness of breath.
  • CNS: dizziness, headache, irritability, insomnia, drowsiness, depression, hallucinations and confusion.
  • Sense organs: hearing changes (noise or ringing in the ears, hearing loss), dry eyes, double vision, swelling of the eyelids and conjunctiva.
  • Heart and blood vessels: rapid heartbeat, increased blood pressure, heart failure.
  • Urinary system: nephrotic syndrome , cystitis , nephritis , acute renal failure.
  • Hematopoietic system: thrombocytopenia , anemia , leukopenia , thrombocytopenic purpura, increased duration of bleeding.
  • Allergic reactions: erythematous rash , skin itching, urticaria, anaphylactic shock , Quincke's edema , bronchospasm, exudative erythema multiforme, Lyell's syndrome, allergic rhinitis, eosinophilia.

Instructions for use TERAFLEX ADVANCE

Determination of the frequency of adverse reactions:

  • very often (≥1/10), often (≥1/100-<1/10), infrequently (≥1/1000-<1/100), rarely (≥1/10,000-<1/1000), very rare (<1/10,000), unknown (cannot be determined based on available data).

Glucosamine sulfate

From the digestive system:

often - discomfort and abdominal pain, dyspepsia, constipation, nausea, flatulence, diarrhea.

For the skin and subcutaneous tissues:

uncommon - itching, erythema, skin rash;

Interaction

Ethanol , tricyclic antidepressants , rifampicin , barbiturates when taken together increase the risk of liver damage.

Teraflex Advance is able to reduce the effect of antihypertensive drugs (ACE inhibitors and calcium channel blockers), furosemide , hydrochlorothiazide and uricosuric drugs.

The drug enhances the effects of antiplatelet agents , anticoagulants and fibrinolytics , thereby increasing the risk of bleeding.

Potentiates the side effects of drugs that have an ulcerogenic effect - NSAIDs, ethanol, estrogens, corticosteroids.

Antacids reduce the absorption of ibuprofen .

Teraflex Advance increases the effect of insulin and other hypoglycemic drugs, increases the concentration of cardiac glycosides, methotrexate and lithium-containing drugs in the blood.

The analgesic effect of the drug may be increased by caffeine .

Ibuprofen reduces the anti-inflammatory and antiplatelet effect of aspirin.

Cefoperazone , cefamandole , valproic acid , plicamycin , cefotetan increase the risk of developing hypoprothrombinemia.

Combined use with myelotoxic drugs increases the toxic effect on the blood system.

Taking with gold preparations and cyclosporine increases nephrotoxicity and hepatotoxicity .

Glucosamine can reduce the effect of doxorubicin , hypoglycemic drugs, teniposide , chloramphenicol , semisynthetic penicillins and increase the absorption of tetracyclines.

Teraflex Advance price, where to buy

The price of Teraflex Advance is from 406 rubles. for 30 capsules up to 1464 rub. for 120 capsules. In Ukraine, the average cost of the drug is about 373 UAH. for 120 capsules.

  • Online pharmacies in RussiaRussia
  • Online pharmacies in UkraineUkraine
  • Online pharmacies in KazakhstanKazakhstan

ZdravCity

  • Teraflex Advance capsules 120 pcs. Contract Pharmacal Corporation
    RUB 2,573 order

Pharmacy Dialogue

  • Teraflex Advance (caps. No. 60)Contract

    RUB 1,562 order

  • Teraflex Advance capsules No. 120Contract

    RUR 2,691 order

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Pharmacy24

  • Teraflex Advance No. 60 capsules Contract Pharmacal Corporation, USA
    253 UAH. order
  • Teraflex Advance No. 120 capsules Contract Pharmacal Corporation, USA

    425 UAH. order

PaniPharmacy

  • Teraflex Advance capsule Teraflex Advance capsules No. 120, Contract Pharmacal Corporation

    464 UAH order

  • Teraflex Advance capsule Teraflex Advance capsules No. 60, Contract Pharmacal Corporation

    251 UAH order

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Release form and dosage

Teraflex is available in gelatin-coated capsules. Each capsule contains crystals in the form of a white powder, sometimes with small inclusions of other shades. The drug goes on sale packaged in bottles made of dense polyethylene. The bottle can contain from 30 to 200 capsules.

Typically take one capsule three times a day, regardless of meals. After a 3-week period, the dose is reduced to two capsules per day. Capsules should be taken with a sufficient amount of water. The duration of the course is determined by the doctor, most often it ranges from three months to six months.

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