Nonsteroidal anti-inflammatory drugs are one of the commonly prescribed drugs. They are used in the treatment of various diseases, accompanied by pain or inflammation. Diclofenac-based ointments are one of the representatives of NSAIDs. They eliminate pain and inflammation locally, practically without systemic absorption, which reduces the likelihood of side effects.
What is diclofenac?
Diclofenac is a sodium salt, a derivative of phenylacetic acid, a non-steroidal anti-inflammatory drug (NSAIDs or NSAIDs). Its special difference is that it inhibits COX-2, an inducible cyclooxygenase (working in inflammatory processes) with greater efficacy than COX-1 (constantly functioning).
Since the substance appeared in 1973, various drugs containing diclofenac have been developed with the aim of increasing the pharmacological effectiveness, tolerability and ease of use. Initially, the development took into account safety and convenience in dosing to a greater extent. New drugs focus on rapid absorption. The appearance of gels, ointments based on diclofenac allowed to treat pain and inflammation locally, with minimal systemic absorption of the active substance.
The pharmaceutical market offers a wide range of soft-plastic consistency preparations, which include sodium salt, a phenylacetic acid derivative. The name of the ointment based on diclofenac does not always contain the name of the main active substance. The reference should be the inscription under the trade name, it indicates the active substance of the drug.
Medicinal effect
Based on the instructions, ointments based on diclofenac have an analgesic (analgesic), anti-inflammatory effect. Cyclooxygenase is inhibited, as a result of which the synthesis of prostaglandins is disrupted - a mediator of pain, thromboxanes, substances that increase blood pressure. Some ointments with prolonged use have an antiallergenic effect. Normalize the content of the substance of the connective tissue, which is a lubricant in the joints.
Diclofenac-based ointments relieve pain both during activity and at rest. Reduce stiffness in movement that occurs in the morning, relieve swelling of the joints, increase motor ability. With inflammation resulting from injuries or surgery, they facilitate spontaneous pain, reduce swelling at the site of the wound.
Ointments with diclofenac as an active substance are significantly superior in anti-inflammatory activity to preparations based on butadione, ibuprofen, acetylsalicylic acid. After application to the skin, the analgesic effect in various ointments is achieved after 30-60 minutes and lasts for 3-5 hours.
Diclofenac-based ointments: indications for use
Almost all NSAIDs are symptomatic. Even if the pain relief is quick and lasting, it will return until the cause is identified and eliminated.
The use of diclofenac-based ointments is indicated for the following pathologies:
- Back pain with radiculitis, lumbago, osteoarthrosis, sciatica.
- Pain of a different nature in the joints of the fingers, knees, hips, elbows and others.
- Soreness in the muscles as a result of injuries, overstrain, bruises.
- Sprains and tendons.
- Postoperative pain and inflammatory swelling due to dental and orthopedic surgery.
- Inflammation in tissues and joints with tenosynovitis, wrist syndrome, bursitis, lesions of tissues surrounding the joint.
- Swelling and inflammation in joints and soft tissues resulting from injuries.
Contraindications
In some names of diclofenac-based ointments, the manufacturer indicates what else the substance is in the composition in high concentration. Experienced doctors and pharmacists immediately determine who is contraindicated. But the trade name can be bought out by another manufacturer, which has the right to adjust the concentration of the composition, so you should always read the instructions before use.
Diclofenac-based ointments are contraindicated in people with the following pathological conditions:
- Intolerance to the substances that make up the drug.
- Peptic ulcer and duodenal ulcer.
- Asthma of an allergic origin.
- The inflammatory process of the nasal mucosa (rhinitis).
- The last trimester of pregnancy.
- Abrasions, scratches, wounds in the intended area of application.
Age restrictions for different ointments are different. Use in childhood is best done as directed by the pediatrician.
There is no data on the penetration of the product into breast milk, so it is better to refrain from using the ointment during lactation. If there is still an urgent need to use the drug, then it should be applied carefully, trying not to get on the mammary glands.
List of diclofenac-based ointments
In pharmacies, you can buy drugs not only from Russian manufacturers. NSAIDs from the phenylacetic acid group are the most widely prescribed. Most of them are sold without a prescription. Soft dosage forms of drugs based on diclofenac are made in the form of ointments and gels. The difference between the latter is that they have a more viscous consistency and have elasticity and ductility. Such characteristics are not particularly affected by drug efficacy.
Overview of diclofenac ointments:
- Ortofen is an ointment of 5% of Russian production.
- "Diclofenac-Akrikhin." The composition of the ointment (1%) includes diclofenac sodium, dimexide, macrogol, propylene glycol.
- Diclofenac-MFF. For children aged 6 to 12 years, the ointment is applied no more than twice a day.
- "Diclac Lipogel." The composition of the gel: diclofenac, tocopherol, lecithin, carbomer. The tool is approved for use from 12 years.
- Dikloran Plus - 1% gel, manufactured in Russia and India. In addition to diclofenac, the composition of the product includes flax seed oil, chloramphenicol, methyl salicylate.
- "Diclogen" - a gel with the smell of lavender. The composition of the product includes diclofenac diethylamine, sodium sulfite, propylene glycol, gasoline alcohol, trolamine, lavender oil. It is excreted from the body by the kidneys, patients with porphyria should use the gel under the supervision of a doctor.
- "Voltaren Emulgel" - gel 2%. Approved for use from 12 years old. In addition to diclofenac, the composition of the drug includes carbomers, cetostearomacrogol, cocoylaprilocaprate, diethylamine.
- “Diklak - 5% gel with a peculiar smell.
- “Orthofer - ointment (2%). The water-alcohol base of the agent has a local weakly anesthetic effect.
General recommendations for use
All ointments based on diclofenac (photos are presented in the article) are well absorbed through the pores of the skin for 3-5 minutes. Penetrate into the fluid filling the joint cavity (synovia), where they remain in constant concentration for 4-6 hours. Therefore, it is enough to apply the ointment with a thin layer on the inflamed area no more than 3-4 times a day. The duration of self-treatment should not exceed 10 days. The appropriateness and safety of longer-term use should be discussed with your doctor.
Diclofenac in chemical composition is an acid that irritates mucous and delicate skin. If the focus of inflammation is, for example, on the face, ointment should be applied carefully so as not to get into the eyes. After the procedure, wash your hands.
During therapy, you need to monitor the amount of ointment used, its daily dose should not exceed 8 g. Uncontrolled use can cause unwanted manifestations in the form of skin rashes.
Side effects
The use of diclofenac-based ointments is associated with a risk of undesirable effects. The drug has high bioavailability (up to 98%), non-compliance with the recommendations prescribed in the instructions leads to an increase in the content of the active substance in the blood. With increased concentrations, diclofenac begins to have a toxic effect, which is expressed in the following manifestations:
- The skin. On the skin there is an erythematous (bright red) and urticarnaya (small papules) rash, a feeling of irritation, tingling. Less commonly observed local swelling of the mucous membrane, subcutaneous tissue, increased pain, generalized itching, eczema, and increased sensitivity to ultraviolet light.
- Digestive system. Paroxysmal pain in the abdomen and pelvic area, vomiting, diarrhea, bloating. In rare cases, ulcerative lesions of the stomach, destruction of hepatocytes under the influence of diclofenac (toxic hepatitis).
- Nervous system. Pain in the head, quick and fatigue, sleep disturbance up to its loss, psychasthenia, violation of taste sensations.
- The sensory organs. Bifurcation of the visible image, decrease in visual acuity, impaired peripheral vision, tinnitus.
- Urinary system. Damage to the glomerular apparatus of the kidneys, increased protein in the urine.
- Circulatory system. Decreased platelet count, hemoglobin, white blood cells.
- The cardiovascular system. Chest pain, increased blood pressure, heart palpitations.
The interaction of diclofenac with other drugs
Diclofenac is concentrated not only in the blood, but also in inflamed tissues, where low acidity reduces protein synthesis. This helps to increase the pharmacological activity of the drug and facilitates penetration into the extracellular space. The instructions for the use of diclofenac-based ointments indicate that the parallel use of other NSAIDs enhances its therapeutic effect.
With the combined use of potassium-sparing diuretics (Triamterin, Amyloride) and NSAIDs, the risk of an increase in the level of potassium in the blood increases.
Ointments with diclofenac reduce the diuretic effect of loop diuretics ("Furosemide", "Britomar", "Ethacrine acid").
The simultaneous use of ointments and other dosage forms of drugs containing diclofenac, increases the level of lithium and digoxin in blood plasma. The parallel use of diclofenac and anticoagulants (Coumarin, Indandion, Heparin) can cause bleeding.
Alternative
NSAIDs include a large number of different drugs. All of them have a common pharmacological effect - anti-inflammatory, analgesic, antipyretic. In addition to diclofenac, the most common are acetylsalicylic acid and ibuprofen. The latter has fewer side effects compared to other NSAIDs, it is even allowed to take children up to a year and pregnant women.
Ibuprofen belongs to the group of propionic acid derivatives. He, like diclofenac, is listed as an important drug. Ibuprofen-based ointments are widespread. They are prescribed for the treatment of degenerative and inflammatory diseases of the musculoskeletal system, pain syndrome resulting from pathologies, sprains of the ligamentous apparatus, injuries, and surgical intervention.
Overview of Ibuprofen Gels
Unfortunately, due to the large number of contraindications, it is not always possible to treat pain and inflammation with diclofenac ointments. Analogs in such situations may be funds with ibuprofen. They also effectively and quickly relieve pain and eliminate inflammation and have approximately the same cost.
List of the most common ibuprofen ointments:
- "Ibuprofen gel" - gel for n / a 5%, is available in tubes of 20, 30, 50 and 100 g. The composition of the product includes ibuprofen, propylene glycol, dimexide, triethanolamine, nerole and lavender oil. Apply ointment to a sore spot no more than 4 times a day. The duration of therapy should not exceed three weeks.
- "Nurofen Express" - gel for n / a 5%. When applied, the product has a cooling effect, which helps to quickly get rid of pain. This effect is created by the benzyl alcohol contained in the gel. The drug is contraindicated in pregnant women and children under 14 years of age. The duration of symptomatic therapy should not exceed 2 weeks.
- "Long." The product is available in the form of a gel and cream. The latter, in addition to analgesic and analgesic, also has a decongestant effect. The gel can be used from 12 years old, and ointment - from 14 years old.
Reviews
NSAIDs help relieve pain. Such medicines are the most sought after. The only difficulty is too much choice, because of which it is difficult to decide. A little understanding of the choice will help our review of ointments based on diclofenac and analogues.
People with chronic diseases of the musculoskeletal system, as well as athletes say that such tools are always in their medicine cabinet. Modern ointments are quickly absorbed, practically do not leave marks on clothes and are always effective.
Moms of schoolchildren claim that diclofenac products are a real find. Moreover, unlike others, they work equally well with fresh bruises and sprains, as well as with old ones.