Diclofenac

General characteristics. Structure:

Active ingredient: 25 mg or 50 mg of diclofenac of sodium.

Excipients: starch corn, lactose, talc, magnesium stearate.

Diclofenac renders antiinflammatory, antirheumatic, analgeziruyushchy, febrifugal, anti-aggregation action.

Pharmacological properties:

Pharmacodynamics. At rheumatic diseases reduces joint pains at rest and at the movement, and also morning constraint and a swelling of joints, promotes increase in volume of movements. Suppresses aggregation of thrombocytes. At prolonged use has the desensibilizing effect.

Pharmacokinetics. Diclofenac is metabolized in a liver at "the first passing" then about 50% of the drug accepted inside come to a blood stream. Linkng with proteins of plasma - 99%. Diclofenac well gets into fabrics and that is especially important, in synovial fluid where its concentration increases more slowly, than in plasma, but reaches higher values.

The maximum level of concentration is reached approximately in 1 hour. The clearance and volume of distribution make about 350 ml/min. and 550 ml/kg, respectively.

Diclofenac is removed as metabolites with urine (about 65%) and bilious allocations (about 35%).

Indications to use:

- inflammatory and degenerative diseases of joints and a backbone (a pseudorheumatism, the juvenile pseudorheumatism ankylosing a spondylitis, a spondylarthritis, an osteoarthrosis, a spondylarthrosis);
- acute gouty arthritis;
- rheumatic diseases of circumarticular soft tissues;
- painful symptoms in a backbone (posttraumatic and postoperative pain and an inflammation), neuralgia, mialgiya;
- a pain and/or inflammatory syndrome at gynecologic diseases (primary dysmenorrhea, an adnexitis);
- gripes: renal, bilious, intestinal;
- migraine attacks;
- as supportive application at the expressed pain syndrome at inflammatory diseases the ENT SPECIALIST - bodies (pharyngitis, tonsillitis, otitis).

Route of administration and doses:

Inside, without chewing, in time or after food – 75 – 150 mg/days for several receptions. Frequency of reception depends on the applied dosage form and weight of a course of a disease. On reaching medical effect appoint 25 mg 3 times a day. At a dysmenorrhea the daily dose of drug makes 50-150 mg.

Features of use:

During treatment it is necessary to carry out by drug systematic control of a picture of peripheral blood, function of a liver, kidneys, a research a calla on availability of blood.

The patients accepting drug need to abstain the types from action requiring special attention and bystry reactions, alcohol intake.

Cautions at diclofenac use. With extra care appoint drug to patients with diseases of a liver, kidneys and digestive tract in the anamnesis, with bronchial asthma, allergic cold, polyps mucous in a nose, dispepsichesky symptoms at the time of purpose of drug, arterial hypertension, heart failure, right after serious operative measures, in the first and second trimesters of pregnancy and the lactation period, and also to elderly people. Because of the high content of active ingredient of a tablet on 50 mg children are not recommended to appoint aged up to 15 years.

Side effects:

From a GIT: nausea, vomiting, diarrhea, pains in the field of an epigastrium, abdominal spasms, dyspepsia, a meteorism, anorexia, a lock, emergence of erosive cankers, bleeding and perforation of digestive tract is in rare instances noticed.

From a nervous system: the headache, dizziness, a sleep disorder (sleeplessness or drowsiness), excitement is sometimes noted. Sensitivity disturbances, a disorientation, disturbance of memory, sight, hearing, flavoring feelings, a sonitus, spasms, irritability, a tremor, mental disturbances, a depression, uneasiness, aseptic meningitis are in some cases noted.

Allergic manifestations: sometimes there is skin rash, is rare - a small tortoiseshell, separate cases of eczema, a polymorphic erythema, an erythrosis are noted, attacks of bronchial asthma, system anaphylactic reactions, in some cases a vasculitis, a pneumonitis were seldom noted.

From kidneys: seldom hypostases, in some cases acute renal failure, intersticial nephrite, nephrotic syndrome, hamaturia, proteinuria.

From a liver: tranzitorny increase in activity of transaminases in blood, is rare - hepatitis, in some cases fulminantny hepatitis.

From system of a hemopoiesis: separate cases of development of thrombocytopenia, an agranulocytosis, hemolitic anemia, aplastic anemia are described.

From outside warmly - vascular system: isolated cases of developing of tachycardia, arterial hypertension, congestive heart failure are celebrated.

Interaction with other medicines:

Increases concentration in blood of lithium, digoxin, indirect anticoagulants, oral antidiabetic drugs, hinolonovy derivatives. Increases toxicity of a methotrexate, cyclosporine, probability of development of side effects of glucocorticoids (gastrointestinal bleedings), risk of a hyperpotassemia against the background of kaliysberegayushchy diuretics, reduces effect of diuretics. Concentration in plasma decreases at use of acetylsalicylic acid.

Contraindications:

- erosive cankers of a gastro intestinal path in an aggravation phase;
- the data on attacks of bronchial asthma, on an urticaria, acute rhinitis connected using acetylsalicylic acid or other NPVS;
- the known sverchuvstvitelnost to diclofenac or components of drug;
- disturbances of a hemopoiesis of not clear etiology;
- 3rd trimester of pregnancy;
- at children's age up to 6 years.

Overdose:

Symptoms: dizziness, a headache, the hyperventilation phenomenon with the increased convulsive readiness, consciousness opacification, children have myoclonic spasms, disorders of a GIT, disorder of functions of a liver and kidneys.

Treatment: a gastric lavage, administration of absorbent carbon, the symptomatic therapy directed to elimination of increase in the ABP, a renal failure, spasms, irritations of a GIT, respiratory depression. The artificial diuresis, a hemodialysis are ineffective.

Storage conditions:

List B. In the dry, protected from light place at a temperature not above 25 °C. To store in the place, unavailable to children. Period of validity 3 years.

Issue conditions:

According to the recipe

Packaging:

On 20, 30 or 50 tablets in banks polymeric for packaging of medicines. One bank together with a leaf insert in secondary packaging.