Rapten of a duo

General characteristics. Structure:

Active ingredient: Diclofenac of sodium of 75 mg; in kishechnorastvorimy granules - diclofenac of sodium of 25 mg, in granules kishechnorastvorimy with the prolonged release - diclofenac of sodium of 50 mg;

Pharmacological properties:

Rapten a duo of 75 mg possesses the anesthetizing, antiagregantny and febrifugal action. Not selectively oppressing cyclooxygenase 1 and 2 (TsOG1 and TsOG2), breaks metabolism of arachidonic acid, reduces amount of prostaglandins in the inflammation center. It is most effective at pains of inflammatory character. Drug Rapten Duo is a diclofenac form (sodium salt) in the form of two-layer tablets. After oral administration diclofenac is quickly and completely soaked up from digestive tract. After reception of a single dose - the maximum concentration in plasma is reached in 20-60 minutes at the expense of 25 mg of diclofenac from the first acid resisting layer. From the second layer 50 mg of diclofenac within 6 and more hours are slowly released that provides long effect to 24 h. Change of pharmacokinetics of diclofenac against the background of repeated introduction is not noted. 99% of the applied dose contact proteins of plasma.

Drug is well distributed in fabrics and intercellular lymphs. Metabolism: 50% of active agent are exposed to metabolism during "the first passing" of a hydroxylation and a konjyugirovaniye with glucuronic acid. The t 1/2 of plasma averages about 2, 5 hours. 65% of the entered dose are removed in the form of metabolites by kidneys; less than 1% are removed in not changed look, other part of a dose (less than 35%) is removed in the form of metabolites with bile. At patients with chronic cirrhosis pharmacokinetically parameters of diclofenac do not change. Drug passes through a gematoentsefaoichesky and placental barrier, and in a small amount is removed with milk.

Indications to use:

Drug is used for short-term treatment of the pain syndrome accompanying the following states:

Symptomatic treatment of diseases of a musculoskeletal system (including a pseudorheumatism, psoriasis arthritis, the juvenile chronic arthritis ankylosing a spondylitis (Bekhterev's disease); gouty arthritis, an osteoarthrosis of peripheral joints and a backbone, including with a radicular syndrome, a tendovaginitis, a bursitis;

Pain syndrome: painful and inflammatory states in gynecology: альгодисменорея (painful periods), an adnexitis (an inflammation of appendages of a uterus), the posttraumatic and postoperative pain syndrome which is followed by an inflammation, pain at oncological diseases, a headache, migraine, a dentagra; neuralgia, mialgiya, lumbago, ischialgia, ossalgiya;

As a part of complex therapy of infectious and inflammatory diseases of an ear, a throat, a nose with the expressed pain syndrome (pharyngitis, tonsillitis, otitis).

Route of administration and doses:

Inside, without chewing, in time or after food, washing down with enough liquid. The daily dose for adults makes 75 mg (1 tablet of drug). The maximum daily dose - 150 mg (on 1 tablet 2 times a day - are desirable the first tablet before a breakfast, and the second in 12 hours). For decrease in risk of development of the undesirable phenomena from the digestive tract (DT) it is necessary to use a minimal effective dose minimum possible short course.

Features of use:

With extra care appoint drug to patients with diseases of a liver, kidneys and a GIT in the anamnesis, a dispeptic syndrome, AG, heart failure, during the period before difficult surgeries, in case of considerable reduction of OTsK of various etiology, and also to elderly people. It is not recommended to appoint drug sick with a hepatic porphyria in connection with threat of emergence of attacks of a porphyria.

To patients with allergic reactions to NPVP in the anamnesis Rapten the duo of 75 mg is appointed only in urgent cases. During Rapten's use a duo of 75 mg, as well as other NPVP, increase in level of one or several liver enzymes is possible. Therefore at long therapy the Rapteny duo of 75 mg it is necessary to carry out regular control of function of a liver. In the course of treatment by drug systematic control of function of kidneys and indicators of peripheral blood is necessary. Rapten of a duo of 75 mg can temporarily inhibit aggregation of thrombocytes. Therefore at patients with disturbances of a hemostasis control of the corresponding laboratory indicators is necessary.

With care appoint Rapten a duo of 75 mg to the elderly people who are especially weakened and with deficit of body weight; they are recommended to appoint drug in minimum effective dose. Simultaneous alcohol intake is not recommended. Children: experience of use of drug Rapten of a duo of 75 mg at children is absent.

Ability to influence speed of response at control of vehicles or work with other mechanisms: in case of development of side reactions from TsNS it is not recommended to manage vehicles or to work with other mechanisms.

Side effects:

Often meeting:

From a GIT: nausea, vomiting, diarrhea, pain in epigastric area, a lock; erosive damages of a mucous membrane of a stomach, perforation of intestines, gastrointestinal bleedings, an exacerbation of ulcer colitis are in some cases observed;

From TsNS: the headache, dizziness, a faint, sleeplessness, irritability, disturbance of sensitivity or sight is sometimes observed (diplopia), a sonitus, spasms;

Allergic reactions: sometimes arise skin rash, in isolated cases – a small tortoiseshell, a photosensitization, Stephens's syndrome – Johnson, violent dermatitis, eczema, anaphylactic reactions, asthma, etc.;

From kidneys: seldom – hypostases, OPN, intersticial nephrite, a nephrotic syndrome;

From a liver: increase in level of transaminases, is rare – hepatitis;

From system of a krovoobrazovaniye: the described special cases of development of thrombocytopenia, an agranulocytosis, hemolitic anemia, nasal bleedings;

From cardiovascular system: heart failure, AG, hypotension, thrombophlebitis, stenocardia.

Interaction with other medicines:

It is not necessary to appoint Rapten a duo of 75 mg along with other NPVP as there is a risk of mutual potentiation of toxic effects and decrease in efficiency of one of drugs. Rapten of a duo of 75 mg can increase concentration of lithium and digoxin in a blood plasma at simultaneous use with the drugs containing these substances. Strengthens effect of peroral anticoagulants, Phenytoinum and peroral antidiabetic drugs of sulphonylurea. At simultaneous use with anticoagulants the risk of emergence of hemorrhagic complications considerably increases. Rapten of a duo of 75 mg, as well as other NPVP, reduces expressiveness of diuretic and anti-hypertensive effect of diuretics, and also APF inhibitors and blockers of β-adrenoceptors.......... At simultaneous use with kaliysberegayushchy diuretics increase in level of potassium in blood is possible. At the combined use Rapten of a duo of 75 mg with cyclosporine increase in toxicity of the last, with glucocorticoids – strengthening of side effect is possible from a GIT, and with acetylsalicylic acid – decrease in level of diclofenac in a blood plasma. To the patients applying a methotrexate Rapten the duo of 75 mg is appointed in 1 days prior to or after reception of a methotrexate as concentration in a blood plasma and toxicity of the last can increase.

Contraindications:

Hypersensitivity to drug and its components, acetylsalicylic acid and other NPVP; GIT erosive cankers in an aggravation phase; disturbance of a krovoobrazovaniye; period of pregnancy and feeding by a breast; children's age.

Issue conditions:

According to the recipe