Solution for intramuscular introduction (in oil): colourless or yellowish transparent liquid without foreign particulates (on 3 ml in colourless glass ampoules, in a cardboard box of 5 ampoules);
Suppositories rectal: a torpedo-shaped form with a smooth surface from white till cream color, have no smell, at a slit – homogeneous structure without impregnations (on 5 pieces in a strip, in a cardboard pack of 2, 6 or 10 strips);
Tablets of the prolonged action: a round flat form with a smooth surface from two layers of pink and white color, a facet on both sides (on 10 pieces in blisters, in a cardboard pack of 1, 2, 5 or 10 blisters);
Gel for external use of 5%: colourless or slightly yellow transparent homogeneous consistence with a characteristic smell of isopropyl alcohol, does not contain bubbles (on 50 or 100 g in an aluminum tuba, in a cardboard pack 1 tuba).

Active ingredient – sodium diclofenac:

1 ampoule – 75 mg;
1 suppository – 50 mg, 100 mg;
1 tablet – 75 mg, 150 mg;
1 g of gel – 50 mg.

Auxiliary components:

Solution for introduction in oil: benzyl alcohol, N-Acetylcysteinum, Mannitolum, propylene glycol, sodium hydroxide, water for injections;
Suppositories: firm fatty basis;
Tablets: magnesium stearate, methylhydroxypropyl cellulose, lactoses monohydrate, cellulose microcrystallic, starch sodium glycollate, hydrophosphate calcium dihydrate, silicon dioxide colloid, starch corn, ferrous oxide red;
Gel: makrogol-7-glitserilkokoat, oil fragrant, isopropyl alcohol, the gipromelloza, water purified.

Indications to use

Diklak's use in the form of solution (for short-term therapy of a pain syndrome), suppositories and tablets is shown:

Musculoskeletal system diseases: psoriasis, juvenile chronic arthritis, the pseudorheumatism ankylosing a spondylarthritis; rheumatic defeat of soft tissues, gouty arthritis, an osteoarthrosis of a backbone and peripheral joints, including with a radicular syndrome, a bursitis, a tendovaginitis;
Weak or moderate pain syndrome at neuralgia, a mialgiya, a lumbar ishialgia, algodismenory, an adnexitis, a proctitis, migraine, head and a dentagra, at pain after surgery, at the posttraumatic pain syndrome proceeding with an inflammation;
Feverish syndrome;
As a part of complex treatment of tonsillitis, pharyngitis, otitis and other infectious and inflammatory diseases of ENT organs with a strong pain syndrome.

Diklak's use in the form of gel for external use is shown:

Musculoskeletal system diseases, among them pseudorheumatism, the psoriasis arthritis ankylosing a spondylarthritis, an osteoarthrosis of peripheral joints and a backbone;
Rheumatic defeats of soft tissues;
Muscular pains of not rheumatic and rheumatic genesis;
Traumatic damages of soft tissues.

Contraindications

Aspirinovy bronchial asthma;
Breastfeeding period;
Hypersensitivity to drug components;
Hypersensitivity to acetylsalicylic acid or other non-steroidal anti-inflammatory drugs (NPVS).

Besides, a contraindication to Diklak's use in the form of solution, suppositories and tablets are:

Aggravation of erosive cankers of the digestive tract (DT);
Bleedings from a GIT;
Hemopoiesis disturbances;
Hemophilia, and other disturbances of a hemostasis;
Pregnancy period;
Age up to 15 years – suppositories of 50 mg;
Age up to 18 years – solution for introduction in oil, suppositories of 100 mg, tablets.

Use of suppositories at hemorrhoids, rectal bleedings, an inflammation or an injury of a rectum is forbidden.

With care patients should appoint drug at a liver and renal failure, anemia, congestive heart failure, at an edematous syndrome, arterial hypertension, bronchial asthma, inflammatory diseases of intestines, GIT erosive cankers during remission, at a diabetes mellitus, a diverticulitis, the induced porphyria, general diseases of connecting fabric, at alcoholism, a state after extensive surgical interventions, at patients of advanced age.

Use of drug in the form of gel is contraindicated at disturbance of integrity of integuments, in the III trimester of pregnancy, to children up to 6 years.

With care it is recommended to apply gel at chronic heart failure, an aggravation of a hepatic porphyria, GIT erosive cankers, heavy abnormal liver functions and kidneys, at bronchial asthma, in I and II trimesters of pregnancy, the patient of advanced age.

Route of administration and dosage

Solution for introduction in oil: enter deeply in a single dose 75 mg (1 ampoule). In case of need repeated introduction is possible only in 12 hours. Injections in oil spend no more than 2 days. If necessary therapy should be continued by use of diclofenac in the form of suppositories or tablets;
Suppositories: apply rektalno, after bowel emptying. To adults and teenagers aged from 15 up to 18 years suppositories on 50 mg appoint 1 piece 2-3 times a day. Suppositories on 100 mg are appointed the adult on 1 piece of 1 times a day. A course of treatment – no more than 7 days. The maximum daily dose – 150 mg. In case of simultaneous use with diclofenac in the form of tablets, it is reasonable to apply suppositories on 50-100 mg once before going to bed, having excluded evening administration of drug inside;
Tablets: apply orally, without chewing, in time or after food, washing down with a small amount of water. Dosing – tablets on 75 mg appoint 1-2 times a day, 150 mg – 1 time a day. The maximum daily dose of drug – 150 mg;
Gel: apply outwardly, applying on skin of painful body parts and rubbing the easy movements, the procedure is carried out by 2-3 times a day. The single dose of drug should not exceed 2 g that corresponds to 4 cm of the squeezed-out gel from completely open mouth of a tuba. The period of treatment depends on clinical indications and therapeutic effect. In case of need extensions of treatment after 2 weeks of therapy, the patient should consult with the attending physician. After each putting gel it is recommended to wash up hands carefully.

Side effects

Diklak's use in the form of gel, suppositories and tablets can cause side effects (> 1% – often, <1% – нечасто):

From the alimentary system: often – nausea, abdominal pains, a meteorism, diarrhea or a lock, increase in activity of hepatic transaminases, a round ulcer with possible complications in the form of bleeding, perforation, bleeding in a GIT; infrequently – vomiting, dryness of mucous membranes (including a mouth) aphthous stomatitis, appetite disturbance, jaundice, damage of a gullet, emergence of blood in Calais, the melena, hepatitis (can proceed in a fulminantny form), a liver necrosis, cirrhosis, a gepatorenalny syndrome, colitis, pancreatitis, holetsistopankreatit;
From cardiovascular system: infrequently – premature ventricular contraction, increase in arterial pressure, thorax pain, congestive heart failure;
From a nervous system: often – dizziness, a headache; infrequently – a sleep disorder, dreadful dreams, drowsiness, a depression, irritability, aseptic meningitis (is more often at patients with general diseases of connecting fabric, including the system lupus erythematosus (SLE)), spasms, a disorientation, weakness, feeling of fear;
From an urinary system: often – a liquid delay; infrequently – intersticial nephrite, a nephrotic syndrome, an oliguria, a proteinuria, a hamaturia, an acute renal failure, a papillary necrosis, an azotemia;
From sense bodys: often – a sonitus; infrequently – taste disturbance, a diplopia, a sight illegibility, decrease in hearing (temporary or irreversible), scotoma;
From system of a hemopoiesis: infrequently – a leukopenia, anemia (including aplastic and hemolitic), thrombocytopenia, a Werlhof's disease, an eosinophilia, an agranulocytosis;
Dermatological reactions: often – a skin itch, rash; infrequently – a small tortoiseshell, an alopecia, eczema, punctulate hemorrhages, toxic dermatitis, a Lyell's disease (a toxic epidermal necrolysis), a mnogoformny exudative erythema (including Stephens-Johnson's syndrome) a photosensitization;
From respiratory system: infrequently – cough, throat hypostasis, a bronchospasm, a pneumonitis;
Allergic reactions: infrequently – anaphylactoid reactions, hypostasis of lips and language, an acute anaphylaxis (as a rule, develops promptly), an allergic vasculitis;
Others: infrequently – the development of a necrotizing fasciitis caused by deterioration in infectious processes.

Undesirable effects of use of Diklak in the form of gel can become:

System reactions: allergic reactions in the form of a small tortoiseshell, a Quincke's disease, bronkhospastichesky reactions; generalized skin rash;
Local reactions: eczema; contact dermatitis (reddening, an itch, puffiness of a body part in a site of application of gel, a vesicle, a papule, a peeling); photosensitization.

Special instructions

During use of tablets and suppositories it is recommended to carry out systematic control of function of a liver and kidneys, pictures of peripheral blood, a research a calla on availability of blood.

At administration of drug it is necessary to exclude alcohol intake.

During Diklak's use in the form of solution, suppositories, tablets patients need to abstain from those types of activity which performance demands bystry psychomotor reactions and the increased concentration of attention.

Putting gel is allowed only on the unimpaired sites of skin, it is not recommended to use an occlusive bandage. Not to allow hit of gel on open wounds and mucous body surfaces.

Medicinal interaction

Clinically significant interaction with other medicines concerns to Diklak in the form of solution, suppositories and tablets.

Administration of drug increases concentration level in a blood plasma of a methotrexate, digoxin, drugs of cyclosporine and lithium.

Reduces action diuretic, hypoglycemic, hypotensive and hypnagogues.

At Diklak's use against the background of anticoagulants and thrombolytic means emergence of bleedings is possible, is more often from a GIT.

Drug increases probability of development of side effects of other non-steroidal anti-inflammatory drugs and glucocorticosteroids (GKS) (bleeding from a GIT), nephrotoxicity of cyclosporine, toxicity of a methotrexate.

At a combination to acetylsalicylic acid, there is a decrease in concentration of diclofenac in blood.

At a concomitant use of Diklak:

Kaliysberegayushchy diuretics – increase risk of a hyperpotassemia;
Paracetamol – increases risk of emergence of nephrotoxic effects of diclofenac;
Tsefoperazon, цефамандол, цефотетан, пликамицин and valproic acid – increase probability of development of a prothrombinopenia;
Drugs of gold and cyclosporine – increase nephrotoxicity;
The drugs blocking canalicular secretion – increase concentration level in a diclofenac blood plasma, increasing its toxicity;
Ethanol, colchicine, corticotropin and drugs of a St. John's Wort – increase risk of bleedings from a GIT.

Use of all dosage forms of Diklak strengthens action of the means causing a photosensitization.