Диклак®

General characteristics. Structure:

Tablets enteroраств. 50 mg, No. 20

Diclofenac sodium of 50 mg

Other ingredients: lactoses monohydrate, calcium hydrophosphate the dihydrate, cellulose microcrystallic, starch corn, sodium krakhmalglikolit, magnesium stearate, silicon dioxide colloid, eudragit L 30 D, triethyl citrate, talc, titanium dioxide (E171), ferrous oxide yellow (E172).

Solution for infection. 75 mg of amp. 3 ml, No. 5

Diclofenac sodium of 75 mg

Other ingredients: n-Acetylcysteinum, benzyl alcohol, a mannitol (E421), sodium hydroxide, propylene glycol, water for injections.

DIKLAK® ID
tablets with модиф. высвоб. 75 mg blister, No. 20, No. 100

Diclofenac sodium of 75 mg

Other ingredients: lactoses monohydrate, methylhydroxypropyl cellulose, cellulose microcrystallic, calcium hydrophosphate a dihydrate, starch corn, sodium krakhmalglikolit, silicon dioxide colloid anhydrous, magnesium stearate, ferrous oxide red (Е 172), the water purified.

Tablets with модиф. высвоб. 150 mg blister, No. 20, No. 100

Diclofenac sodium of 150 mg

Other ingredients: lactoses monohydrate, methylhydroxypropyl cellulose, cellulose microcrystallic, calcium hydrophosphate a dihydrate, starch corn, sodium krakhmalglikolit, silicon dioxide colloid anhydrous, magnesium stearate, ferrous oxide red (Е 172), the water purified.

Pharmacological properties:

Pharmacodynamics. Drug Diklak contains sodium diclofenac, substance of nonsteroid structure which renders the expressed antiinflammatory, analgetic and febrifugal action. The main mechanisms of effect of diclofenac — inhibition of biosynthesis of prostaglandins which play an important role in genesis of an inflammation, pain and fever, the reduction of permeability of capillaries stabilizing influence on lizosomalny membranes. Oppresses the aggregation of thrombocytes induced by adenosinediphosphate and collagen. Use of diclofenac promotes increase in volume of movements in the affected joints, to reduction of pain at rest and at the movement.
In experiences of in vitro in concentration, equivalent subjects which are used at treatment of patients diclofenac does not oppress biosynthesis of proteoglycans of cartilaginous tissue.
At the posttraumatic and postoperative inflammatory phenomena Diklak quickly relieves pain (both spontaneous, and arising at the movement), reduces the hypostases caused by an inflammation. The considerable analgetic effect of drug at the moderated and strongly expressed pain syndrome of not rheumatic genesis is revealed (at use Diklak, solution for injections — within 15–30 min.). Diklak, solution for injections, exerts also significant positive effect in case of migraine attacks.
Diklak is capable to eliminate pain and to reduce expressiveness of blood losses at primary dysmenorrhea.
If diclofenac of sodium is applied along with opioid anesthetics to removal of postoperative pain, need for them significantly decreases.
Diklak, solution for injections, is especially necessary in an initiation of treatment of inflammatory and degenerative rheumatic diseases and a painful state owing to an inflammation of not rheumatic origin.

Pharmacokinetics. Absorption
Diklak, tablets enterosoluble. After oral administration of gastrorezistentny tablets diclofenac is quickly and completely absorbed in a stomach. Food reduces the absorption speed, but amount of the absorbed substance does not change. After one-time intake of diclofenac in a dose of 50 mg of Cmax it is reached approximately in 2 h and makes 1,5 mkg/ml (5 µmol/l). The amount of the absorbed active ingredient is linearly proportional to a dose.
Diklak, solution for injections. After introduction of 75 mg of diclofenac of sodium by in oil injections absorption begins immediately, and average Cmax in a blood plasma which makes about 2,5 mkg/ml (8 µmol/l), is reached in 20 min. Absorption size linearly depends on a dose. In case of introduction of 75 mg of diclofenac of sodium in the way to infusions during 2 h average Cmax in a blood plasma makes about 1,9 mkg/ml (5,9 µmol/l). AUC after in oil or in/in introductions is approximately twice more, than after oral or rectal administration because in the latter case about a half of active substance is metabolized during the first passing through a liver. Pharmacokinetic properties do not change after repeated introduction. On condition of observance of the recommended intervals of dosing of accumulation of drug does not occur.
Diklak ID — two-layer tablets with a combination bystry (¹/₆ total quantity) and gradual release (⁵/₆ total quantity) sodium diclofenac. Such combination of effects in one tablet allows to provide both action quick start, and long circulation of active agent in a system blood-groove and therapeutic effect within a day.
After oral administration Diklak ID is completely absorbed from intestines. Cmax in plasma is reached in 1–16 h, on average — in 2–3 h. The amount of the absorbed active agent is in linear dependence on drug dose size.
Distribution
99,7% of diclofenac contact blood plasma proteins, are preferential with albumine. The volume of distribution makes 0,12–0,17 l/kg.
Diclofenac gets into synovial fluid where reaches Cmax in 3–6 h at use Diklak, tablets enterosoluble, or in 2–4 h at use Diklak, solution for injections. T½ makes 3–6 h of synovial fluid. In 2 h after achievement of Cmax in a blood plasma the level of active agent in synovial fluid becomes higher, than in plasma, and remains such during 12 h.
Biotransformation
At oral administration about a half of a dose of diclofenac is metabolized during the first passing through a liver. Only 35–70% of the absorbed active agent reach posthepatic circulation in not changed look.
Biotransformation of diclofenac occurs partially by a glyukuronization of an initial molecule, but is preferential at the expense of a hydroxylation and a metoksilirovaniye that leads to formation of several phenolic metabolites, 2 of which are biologically active, but to a lesser extent, than diclofenac.
Removal
The general system clearance of diclofenac makes 263±56 ml/min. of a blood plasma, T½ is 1–2 h and this indicator does not depend on function of a liver and kidneys. About 60% of the received dose are removed with urine in the form of metabolites. Less than 1% — in the form of not changed connection, the rest are removed in the form of metabolites with bile.
Diklak, solution for injections. Use for special groups of patients
No difference in age dependence in absorption, metabolism or excretion of drug was observed. However at some patients of advanced age after 15-minute infusion concentration of diclofenac in a blood plasma was 50% higher, than it was observed at young healthy faces.
At patients at observance of the mode of usual dosing of accumulation of active agent did not happen to a renal failure.
At patients with chronic hepatitis or cirrhosis kinetics and metabolism of diclofenac same, as well as at patients without liver diseases.

Indications to use:

Diklak, tablets enterosoluble:
• inflammatory and degenerative forms of rheumatic diseases (the pseudorheumatism ankylosing a spondylitis, an osteoarthrosis, a spondylarthritis), a pain syndrome with localization in a backbone;
• extraarticular rheumatism;
• bad attacks of gout;
• a posttraumatic and postoperative pain syndrome which is followed by an inflammation and hypostases, for example, after dental and orthopedic interventions;
• the gynecologic diseases which are followed by a pain syndrome and an inflammation, for example primary dysmenorrhea or an adnexitis;
• as supportive application at a serious inflammatory illness of ENT organs which is followed by feeling of pain, for example at a pharyngotonsillitis, otitis.

Diklak, solution for injections
Introduction in oil:
• inflammatory and degenerative forms of rheumatism (the pseudorheumatism ankylosing a spondylitis, an osteoarthritis, a spondylarthritis, a vertebralny pain syndrome, extraarticular rheumatism);
• bad attacks of gout;
• renal and biliary colic;
• a posttraumatic and postoperative pain syndrome which is followed by an inflammation and hypostases;
• heavy attacks of migraine.

In/in infusion:
• treatment or prevention of postoperative pain.

Diklak of ID:
• rheumatism (the pseudorheumatism ankylosing a spondylitis, an osteoarthritis, a spondylarthritis, a pain syndrome of various localization, extraarticular rheumatism);
• the posttraumatic and postoperative pain syndromes which are followed by an inflammation and hypostases;
• painful and/or inflammatory states in gynecology (for example primary dysmenorrhea, an adnexitis).

Route of administration and doses:

 In general it is recommended to select a dose individually, and also to apply the smallest effective dose throughout shorter time.
Diklak, tablets enterosoluble
For adults and teenagers aged from 15 years the recommended initial dose makes 100–150 mg. In simple cases, as well as at long therapy, there is usually enough purpose of 75-100 mg/days. The general daily dose is usually recommended to be divided into 2–3 receptions. In need of reception of a dose of 75 mg use drug with the corresponding dosing.
The daily dose of drug should not exceed 150 mg.
At primary dysmenorrhea the daily dose is selected individually, in general it makes 50–150 mg. The initial dose can make 50–100 mg, in need of it it is possible to raise during several menstrual cycles, but no more than to 200 mg/days. Use of drug needs to be begun as soon as possible after manifestation of the first painful symptoms; treatment duration, depending on symptomatology, makes up to several days.
Pill Diklak needs to be taken without chewing and to wash down with enough liquid (1 glass of water) preferential before meal.
For patients with renal failures or a liver of weak or moderate degree there is no need for dose adjustment.
Diklak, solution for injections
The general recommendation — the dose should be selected individually and to apply a minimal effective dose within a short period of time.
Drug Diklak, solution for injections, it is not necessary to apply longer than 2 days, in case of need treatment can be continued by tablets Diklak.
Injection in oil
For the purpose of prevention of damage nervous and other fabrics in the place in oil of an injection it is necessary to follow the following rules.
The daily dose usually makes 75 mg (1 ampoule) which is entered by a deep injection into the upper outside sector of a big gluteus. In hard cases (for example gripes) a daily dose as an exception, it is possible to increase to 2 injections on 75 mg, the interval between which has to make several hours (on 1 injection in each buttock). As the alternative of introduction of 1 ampoule of diclofenac of sodium of 75 mg can be combined with other dosage forms of drug before achievement of the general maximum daily dose 150 mg.
In the conditions of a migraine attack, according to clinical experience, it is necessary to enter 75 mg of diclofenac in oil of sodium as soon as possible and if necessary to apply suppositories on 100 mg on the same day. The general daily dose should not exceed 175 mg in the first day.
In/in infusion
Diklak, solution for injections, it is not necessary to enter in the form of a bolyusny injection.
Just before the beginning in infusion depending on duration demanded it contents of an ampoule should be parted in 100–500 ml 0,9% of solution of sodium of chloride or 5% of solution of glucose, buffering with sodium bicarbonate solution for injections. It is possible to apply only transparent solutions. Recommend 2 alternative dose modes for infusion. For treatment of moderate and heavy postoperative pain of 75 mg of diclofenac of sodium it is necessary to enter continuously of 30 min. to 2 h. In case of need treatment can be repeated in several hours, but the daily dose should not exceed 150 mg.
For prevention of postoperative pain in 15 min.-1 the h after surgical intervention it is necessary to enter a load dose of 25-50 mg, after that it is necessary to apply continuous infusion about 5 mg/h to the maximum daily dose of 150 mg.
Diklak ID
The recommended initial dose of drug for adults makes 75–150 mg/days (1–2 tablets of drug Diklak ID) depending on expressiveness of symptoms of a disease. At long therapy, as a rule, use of 1 tablet (75 mg) in days is sufficient. If symptoms of a disease are most expressed during the night or in the morning, Diklak ID it is necessary to apply in the evening.
The maximum daily dose makes 150 mg and it should not be exceeded. Diklak ID is intended for short-term use (at most 2 weeks). The decision on duration of treatment is made by the doctor.
It is necessary to swallow of tablets whole, without chewing, washing down with a large amount of liquid, it is desirable during food.

Features of use:

Drug Diklak works quickly that does it especially suitable for treatment of acute painful and inflammatory states.
At use of all NPVP at any time during treatment there can be gastrointestinal bleedings, an ulcer or perforation with or without precautionary symptoms, without the serious gastrointestinal phenomena in the anamnesis, and they can have lethal effects. The risk of emergence of the above-mentioned phenomena at patients of advanced age increases. In case of developing of gastrointestinal bleeding diclofenac of sodium needs to be cancelled.
Very seldom in connection with reception of NPVP, including sodium diclofenac, allergic reactions, including anaphylactic/anaphylactoid and skin reactions, including exfoliative dermatitis, Stephens's syndrome — Johnson and a toxic epidermal necrolysis were observed. The high risk of emergence of such reactions exists at the beginning of therapy, in the first month of treatment. Use of drug should be stopped at the first emergence of rash on skin, damages of mucous membranes or any other signs of hypersensitivity.
NPVP can increase risk of emergence of the serious cardiovascular trombotichesky phenomena, a myocardial infarction and stroke which can be lethal in this connection diclofenac of sodium is not recommended to be applied to treatment of postoperative pain during operation of aortocoronary shunting.
As well as other NPVP, Diklak thanks to the pharmakodinamichesky properties can mask signs and symptoms of an infection.
General cautions
It is necessary to avoid use of drug along with system NPVP, including the selection TsOG-2 inhibitors, due to the lack of any synergy action and a possibility of development of additional side effects.
It is necessary to be careful at purpose of drug to elderly people. In particular, with poor health and for patients with a low index of body weight it is recommended to apply the lowest effective doses to people of advanced age.
Asthma in the anamnesis
At patients OH, with seasonal allergic rhinitis, rhinedemas (that is nasal polyps), HOBL or persistent infections of respiratory tracts the frequency of emergence of side reactions on NPVP increases. Treat such reactions: exacerbation of asthma (analgetic asthma), Quincke's edema, small tortoiseshell. Special measures (readiness for rendering acute management) are recommended to such patients. It also concerns patients with an allergy, for example with skin reactions, an itch or small tortoiseshell.
Special cautions are recommended to patients with OH in case Diklak is applied parenterally as symptoms can become aggravated.
Influence on a digestive tract
As well as at use of other NPVP, at purpose of diclofenac of sodium, medical observation and extra care is obligatory for patients with the symptoms testimonial of disturbances from a digestive tract. The risk of gastrointestinal bleedings, an ultseration or perforation increases at increase in a dose of NPVP, at patients with an ulcer in the anamnesis, especially at complications like hemorrhage or perforation, and at elderly people therefore they should carry out treatment, using a minimal effective dose during shorter time.
Such patients, and also patients who need the accompanying low doses of acetylsalicylic acid should apply a combination therapy tire-tread drugs (for example mizoprostoly or inhibitors of a proton pomp).
Preventions are necessary also for the patients receiving the accompanying drugs which can increase risk of developing of an ulcer or bleeding, such as system corticosteroids, anticoagulants, antitrombotichesky means or selective serotonin reuptake inhibitors.
Diklak it is necessary to appoint with care the patient in whose anamnesis there are inflammatory diseases of intestines, such as disease Krone or nonspecific ulcer colitis and to establish careful medical observation of them in connection with a possibility of an aggravation of a state.
Influence on a liver
Careful medical observation is required in case Diklak appoint to patients with an abnormal liver function as their state can become aggravated.
Treatment by sodium diclofenac, as well as other NPVP, can lead to increase in level of one or several liver enzymes therefore at drug use Diklak is required regular observation of function of a liver as an interim measure. If during treatment function of a liver worsens or other manifestations are observed (for example an eosinophilia, rash), use of drug should be stopped. At treatment by sodium diclofenac the course of hepatitis can pass without prodromal symptoms.
Care is necessary in case of appointment Diklak for patients with a hepatic porphyria because of probability of provocation of an attack.
Influence on kidneys
As at treatment of NPVP it was reported about a delay of liquid and hypostases, special attention should be paid to patients with dysfunction of heart or kidneys (including with a functional renal failure against the background of a hypovolemia, a nephrotic syndrome, a lupoid nephropathy and dekompensirovanny cirrhosis), AG in the anamnesis, to the patients of advanced age, patients receiving therapy by diuretics or drugs which significantly influence function of kidneys, and to patients with essential decrease in extracellular volume of liquid for any reason, for example, to or after serious surgical intervention. In such cases monitoring of function of kidneys is recommended. The therapy termination usually leads to return to a state which preceded treatment.
Influence on hematologic indicators
At prolonged use of diclofenac of sodium monitoring of indicators of blood is recommended. As well as other NPVP, Diklak can temporarily oppress aggregation of thrombocytes. It is necessary to watch carefully patients with disturbances of a hemostasis.
Gastrorezistentny tablets Diklak and Diklak ID contain lactose therefore it is not recommended to apply them at patients with rare hereditary intolerance of a galactose, a lactose intolerance or a syndrome of glyukozo-galaktozny malabsorption.
Use during pregnancy and feeding by a breast
Drug should not be used in the I-II trimester of pregnancy unless the expected advantage for mother exceeds potential risk for a fruit. As well as other NPVP, sodium diclofenac use in the III trimester of pregnancy it is contraindicated because of possible oppression of uterine reductions and premature closing of an arterial channel.
Diclofenac of sodium is removed with breast milk in a small amount therefore drug should not be used during feeding by a breast.
Fertility. As well as other NPVP, diclofenac of sodium can affect fertility of the woman. Drug is not recommended to be used to the women planning pregnancy.
Children. Diklak, solution for injections, and Diklak ID do not apply at children aged up to 18 years. Diklak, tablets enterosoluble, are not appointed to children aged up to 15 years.
Ability to influence speed of response at control of vehicles or other mechanisms. Patients at whom during treatment by diclofenac of sodium note vision disorders, dizziness, drowsiness or other disturbances from TsNS have to abstain from control of vehicles and work with mechanisms.

Side effects:

Side reactions are classified by emergence frequency: very often (≥1/10), it is frequent (≥1/100, <1/10), infrequently (≥1/1000, <1/100), is rare (≥1/10 000, <1/1000), is very rare (<1/10 000), including single messages.
From system of blood and lymphatic system: very seldom — anemia (including hemolitic and aplastic anemia), a leukopenia, thrombocytopenia, an agranulocytosis.
From immune system: seldom — hypersensitivity reactions, anaphylactic/anaphylactoid reactions, including arterial hypotension and an acute anaphylaxis; very seldom — a Quincke's disease (including a face edema).
Mental disorders: very seldom widespread — a disorientation, a depression, sleeplessness, nightmares, irritability, psychotic frustration.
From a nervous system: often — a headache, dizziness; seldom — drowsiness; very seldom — paresthesia, disturbance of memory, a spasm, uneasiness, a tremor, aseptic meningitis, disorders of taste, disturbance of cerebral circulation, disorder of tactile sensitivity, a disorientation, a depression, dreadful dreams, irritability, psychotic frustration.
From an organ of sight: very seldom — vision disorders, a sight zatumanennost, a diplopia.
From an acoustic organ: often — вертиго; very seldom — a ring in ears, disorders of hearing.
From heart: very seldom — heartbeat, a stethalgia, heart failure, a myocardial infarction.
Vascular disorders: very seldom — AG, a vasculitis.
From respiratory system: seldom — asthma (including an asthma), a bronchospasm; very seldom — pneumonites.
From a GIT: often — nausea, vomiting, diarrhea, dyspepsia, abdominal pain, a meteorism, anorexia; seldom — gastritises, gastrointestinal bleeding, vomiting with blood, hemorrhagic diarrhea, a melena, stomach ulcer or intestines (with/without bleeding or perforation); very seldom — colitis (including hemorrhagic colitis and an exacerbation of ulcer colitis or a disease Krone), a lock, stomatitis, a glossitis, frustration from a gullet, diafragmopodobny strictures of intestines, pancreatitis.
From gepatobiliarny system: often — the increased level of transaminases; seldom — hepatitis, jaundice, disorders of a liver; very seldom — fulminant hepatitis, гепатонекроз, a liver failure.
From skin and hypodermic fabric: often — rash; seldom — a small tortoiseshell; very seldom — violent rash, eczema, an erythema, a multiformny erythema, Stephens's syndrome — Johnson, a toxic epidermal necrolysis (Lyell's disease), exfoliative dermatitis, drop-out of hair, reactions of photosensitivity, purple, an allergic purpura, an itch.
From an urinary system: very seldom — an acute renal failure, a hamaturia; proteinuria, nephrotic syndrome, intersticial nephrite, renal papillary necrosis.
General frustration: seldom — hypostasis.
For Diklak, solution for injections, also:
Infections and invasions: very seldom — abscess in the place of an injection.
The general disturbances and disturbances in a drug injection site: often — hardening, pain in the place of an injection; seldom — hypostasis, a necrosis in the place of an injection. In some cases symptoms of aseptic meningitis, in particular tension of cervical muscles, fever or oppression of consciousness can be observed. Patients with autoimmune diseases (a system lupus erythematosus, the mixed collagenoses) are inclined to such reactions.

Interaction with other medicines:

Lithium: at simultaneous use diclofenac can increase concentration of lithium in a blood plasma. Monitoring of level of lithium in a blood plasma is recommended.
Digoxin: at simultaneous use diclofenac can increase concentration of digoxin in a blood plasma. Monitoring of level of digoxin in a blood plasma is recommended.
Diuretics and anti-hypertensive means: simultaneous use of diclofenac of sodium and other NPVP with diuretics or anti-hypertensive means (for example blockers of β-adrenoceptors, APF inhibitors) can lead to decrease in their anti-hypertensive influence. Thus, the similar combination is applied with the reservation, and to patients, especially elderly people, it is necessary to control the ABP level carefully. Patients have to receive appropriate hydration, also monitoring of renal function after the beginning of the accompanying therapy and on a regular basis after it, especially concerning diuretics and APF inhibitors owing to increase in risk of nephrotoxicity is recommended. Simultaneous treatment by drugs of potassium can be connected with increase in level of potassium in a blood plasma that demands stay of patients under constant control.
Other NPVP and corticosteroids: the accompanying administration of diclofenac and other system NPVP or corticosteroids can increase the frequency of side reactions from a digestive tract.
Anticoagulants and antitrombotichesky means: it is recommended to take measures as the accompanying introduction can increase risk of bleeding. Though clinical trials do not demonstrate influence of diclofenac on activity of anticoagulants, there are separate data on increase in risk of bleeding at the patients receiving diclofenac and anticoagulants at the same time. Therefore careful monitoring of such patients is recommended.
Selective Serotonin Reuptake Inhibitors (SSRI): simultaneous introduction of system NPVP and SIOZS can increase risk of bleeding in a digestive tract.
Antidiabetic drugs: clinical trials showed that diclofenac can be applied along with peroral anti-diabetic means without influence on their clinical action. However separate cases as with hypoglycemic, and hyper glycemic influence, the demanding changes of a dose of antidiabetic drugs at treatment by diclofenac are known. Such states demand monitoring of level of glucose in a blood plasma that is a precautionary measure at the accompanying therapy.
Kolestipol and Colestyraminum: simultaneous use of diclofenac and a kolestipol or Colestyraminum reduces diclofenac absorption approximately by 30 and 60% respectively. Drugs should be accepted at an interval of several hours.
The drugs stimulating enzymes which metabolize medicines. The drugs stimulating metabolism enzymes, rifampicin, carbamazepine, Phenytoinum, a St. John's Wort (Hypericum perforatum), etc. are theoretically capable to reduce concentration of diclofenac of sodium in a blood plasma.
Methotrexate: use of NPVP less than for 24 h to or after reception of a methotrexate can lead to increase in concentration of a methotrexate and, respectively, its toxic effects.
Cyclosporine and такролимус: diclofenac, as well as other NPVP, can increase nephrotoxicity of cyclosporine. In this regard it should be applied in lower doses, than to patients who do not receive cyclosporine. Such risk arises also at treatment takrolimusy.
Antibacterial hinolona: there are separate data on spasms which can be result of the accompanying use of hinolon and NPVP.

Contraindications:

Hypersensitivity to diclofenac or any other component of drug. Acute stomach ulcer or intestines; gastrointestinal bleeding or perforation, heavy renal, liver or heart failure. Disturbance of a hemogenesis of the unspecified nature. Last trimester of pregnancy and period of feeding by a breast. Diklak, as well as other NPVP, is contraindicated to patients who in response to use of acetylsalicylic acid or other NPVP have attacks OH, urticaria or acute rhinitis.
For Diklak, tablet enterosoluble, also: children's age up to 15 years.
For Diklak, solution for injections, also: children's age up to 18 years.

Overdose:

There is no typical clinical picture of overdose of diclofenac. Vomiting, gastrointestinal bleeding, diarrhea, dizziness, a sonitus, spasms, a headache can be symptoms of overdose of diclofenac. In case of poisoning OPN and injury of a liver are possible.
Treatment of acute poisoning of NPVP consists in use of measures of the supporting and symptomatic therapy. The symptomatic and supporting measures are shown at such complications as arterial hypotension, a renal failure, a convulsive syndrome, disturbance from a GIT and respiratory depression. It is improbable that such specific medical measures as an artificial diuresis, dialysis or hemoperfusion will become useful to removal of NPVP as active agents of these drugs considerably contact proteins of a blood plasma and are exposed to intensive metabolism.
There is no specific antidote.

Storage conditions:

At a temperature not above 25 °C.

Issue conditions:

According to the recipe

Packaging:

Tablets enteroраств. 50 mg, No. 20

Solution for infection. 75 mg of amp. 3 ml, No. 5
Tablets with модиф. высвоб. 75 mg blister, No. 20, No. 100

Tablets with модиф. высвоб. 150 mg blister, No. 20, No. 100