The drug "Diclofenac" has a complex effect, having anti-inflammatory, analgesic and antipyretic properties. Due to this, it is one of the most popular drugs, as it is used as symptomatic therapy. Its action is aimed at rapid and effective reduction of the inflammatory process, as well as the elimination of pain. But the action of "Diclofenac" has a flip side. If you ignore the rules of use and dosages of the drug, the drug has a devastating effect on the mucous membrane of the digestive organs, causing the development of serious complications. Therefore, it is worthwhile to figure out how to use the drug correctly, depending on its form of release.
Composition and form of release
"Diclofenac" is a non-steroidal anti-inflammatory drug (NSAID), which is a derivative of phenylacetic acid. The active component of the drug is diclofenac sodium, which gave the name to the drug. In addition, the composition of the drug contains additional components that enhance its effect, as well as contribute to the correct distribution in the composition of the drug.
Additional substances may vary depending on the form of release of the drug.
These include:
- starch;
- methyl paraben;
- ethanol;
- dimethyl sulfoxide;
- carbomer;
- propylene glycol;
- sodium hydroxide;
- calcium phosphate;
- magnesium stearate;
- glycerol;
- disodium edetate.
The drug is available in different forms, which allows you to choose the most suitable option, depending on the disease.
The main forms of "Diclofenac" with the content of the active component in the medicine:
- tablets (25, 50 mg);
- injection solution (25 mg / 1 ml);
- rectal suppositories (50, 100 mg);
- external ointments (10, 50 mg / 1 g);
- eye drops (1 mg / 1 ml).
Pharmacodynamics and pharmacokinetics
Diclofenac, like all NSAIDs, is characterized by a pronounced anti-inflammatory and analgesic effect. And also the medicine has a moderate antipyretic property. The mechanism of action of Diclofenac is based on the suppression of the synthesis of prostagladins. Also, the drug prevents platelet aggregation.
When taking the drug, the pain syndrome decreases, the morning stiffness and swelling of the joints is eliminated, and their functionality improves. The use of the drug in the rehabilitation period after surgery and trauma reduces unpleasant symptoms during movement and during rest.
The active component of the drug quickly penetrates into the blood plasma. Its maximum concentration is fixed 1-2 hours after application. Communication with blood proteins is 99%.
Diclofenac sodium has a high level of penetration into tissues and biological fluid that fills the voids of the joints. The highest concentration is achieved after 4 hours after administration. The use of the drug after eating slows down the effect of the drug, but does not affect its effectiveness. Bioavailability is 5%.
The half-life is 1-6 hours, depending on the form of the drug. About 30% is excreted in the feces, and the rest is metabolized in the liver and leaves through the kidneys.
The advantage of Diclofenac is that it is not addictive and does not affect breathing, but it also has a quick and powerful effect.
Indications
The action of "Diclofenac" does not affect the development of the disease, the medicine only reduces unpleasant symptoms. Therefore, its use is permissible only as part of complex therapy on the recommendation of the attending physician. After stopping the inflammatory process, you should not drink the drug.
The main indications for use:
- rheumatic diseases;
- arthritis of various etiologies;
- Ankylosing spondylitis;
- osteochondrosis;
- pain in the spine;
- gynecological diseases accompanied by pain and inflammation (adnexitis, primary dysmenorrhea);
- exacerbation of gout;
- rehabilitation after injury, surgery.
It is acceptable to use as an adjunct to the main treatment for severe forms of inflammation of the upper respiratory tract (otitis media, pharyngotonsillitis) to reduce pain.
Use "Diclofenac" purely as an antipyretic is not recommended.
Contraindications
Before using the medicine, you must carefully study the annotation attached to it. It is especially important to consider the contraindications and side effects of Diclofenac, which will help to avoid serious health complications.
It is forbidden to use the medicine:
- with individual intolerance to at least one of the components that make up the drug;
- an intestinal or stomach ulcer;
- hepatic, renal failure;
- Crohn's disease;
- coronary heart disease;
- hemopoiesis;
- ulcerative colitis;
- severe congestive heart failure.
It is strictly forbidden to use "Diclofenac" after coronary artery bypass grafting.
All forms of release of "Diclofenac" also have age-related restrictions on admission, but more accurate information is indicated below, when describing each separately.
"Diclofenac": instructions, side effects
Ignoring existing contraindications, as well as exceeding the allowable daily dosage, provokes the development of side effects. Therefore, it is forbidden to resort to self-medication, since only the attending physician is able to determine the level of danger from taking the medicine, depending on the individual characteristics of the patient.
With prolonged therapy, the following side effects of Diclofenac are observed:
- dizziness;
- migraine;
- tremor of limbs;
- rash;
- hives.
If there are alarming signs, you should consult a doctor so that he selects a replacement for this drug. In addition, the use of "Diclofenac" contributes to exacerbation of hemorrhoids, and also increases the risk of myocardial infarction.
Special instructions for use:
- elderly people should take this medicine with caution, starting with a minimum daily dosage;
- a norm adjustment is necessary for patients suffering from malfunctioning of the liver and kidneys, since an increase in the concentration of the active component in the body is possible;
- with prolonged use of the drug, blood composition should be monitored;
- women planning a pregnancy and undergoing infertility treatment are advised to refuse to take this drug;
- throughout the course of therapy should avoid driving vehicles and work requiring a high concentration of attention;
- with diabetes, coronary disease and brain diseases, therapy should be carried out under the supervision of a physician.
Tablets
The tablet form of the drug is intended for adults and children over 14 years old. Reception is recommended during and after meals with a large amount of water.
The daily dosage and course of administration is prescribed by the doctor, depending on the severity of the disease, the course of the inflammatory process and the body's response to the drug. Any self-medication threatens with serious complications.
Biconvex tablets are coated with a film of light or dark orange hue. Roughness of the film coating is acceptable, which is not a defect. Taking the medicine should be carried out in full, without violating the integrity of the shell.
In order to reduce the likelihood of side effects of Diclofenac tablets, it is recommended that you take the medicine at the lowest effective dosage at the beginning of therapy.
The daily norm for adults is 100-150 mg, which should be drunk in 3 divided doses every 3-4 hours. To achieve the therapeutic effect of Diclofenac tablets with mild symptoms and prolonged treatment, it is enough to drink 75-100 mg per day.
Injection
This form of the drug is available in the form of a clear yellow solution, packaged in 2 ml glass ampoules. Each of them contains 50 mg of the active component.
A solution for intramuscular injection can be purchased without a doctor’s prescription. permissible use for adults and adolescents over 16 years of age.
In addition to general indications, the therapeutic effect of Diclofenac injections is used for injuries and sprains of tendons, muscles, joints, and ligaments. In addition, the solution is prescribed as part of complex therapy for non-infectious conjunctivitis, for post-traumatic inflammation of the eyeball as a result of an operation to remove and implant the lens.
The therapeutic effect of the Diclofenac injection is achieved by injecting the solution into the upper region of the gluteal muscle. It is forbidden to use the medicine intravenously and subcutaneously. Before use, the solution should be warmed to body temperature, holding the ampoule in the palm of your hand for several minutes. This allows you to enhance the effect of the drug and accelerate the penetration of the active component to the focus of inflammation.
Throughout the course, injections should be alternately in one buttock and then in the other. The solution should be used 1 time per day, but as prescribed by the doctor, the one-time rate can be doubled. The course of therapy in most cases does not exceed 3 days, however, with a severe form of the disease, the course is prolonged.
To prevent side effects from Diclofenac injections, it is recommended to inject every other day, which will reduce the negative effect of the drug on the digestive organs and the production of bile.
Rectal candles
Rectal suppositories are for adults and children over 15 years of age. They are white or cream cylindrical-conical candles, inside of which there may be a porous rod and a depression similar to a funnel. The release of the medicine is carried out on prescription.
The weight of one suppository is 2 g, the concentration of the active component can be 5 and 10%. Each package of the drug contains 6-10 candles, which are located on the contour tablet.
In addition to the main indications of the diclofenac suppository, the effect of which is associated with the blocking of inflammatory mediators, is used in the treatment of:
- prostatitis;
- painful menstruation;
- inflammation of the appendages, ovaries;
- adnexitis;
- dysmenorrhea;
- hemorrhoids;
- back pain, lower back.
The action of suppositories occurs much faster compared to pills and injections, they have a strong analgesic effect and penetrate directly into the focus of inflammation. The maximum concentration of the active component is fixed 1 hour after administration.
Suppositories must be administered deep into the rectum immediately after bowel movements and delivered microclysters. The treatment procedure is recommended at night.
The duration of action of "Diclofenac" is 24 hours with the introduction of suppositories with an active ingredient content of 100 mg. When using a drug of 50 mg, the drug should be administered twice a day every 12 hours. With a severe form of the disease, an increase in the daily norm to 150 mg is allowed.
The average duration of treatment is 5 days. But at the discretion of the attending physician, therapy can be continued. A side effect of Diclofenac suppositories is to slow the rate of psychomotor reactions and decrease the concentration of attention.
Store the medicine at a temperature not exceeding 25 degrees for 3 years from the date of release. If the protective capsule was broken during storage, then the medicine cannot be used for treatment.
Ointment for external use
In this case, the medicine is a white ointment with a slight cream tint with a faint specific smell. The drug is packaged in tubes of 30 g. The concentration of the active component is 1 or 5%. The tool is recommended for adults and children over 14 years of age.
The local action of Diclofenac ointment is used for various injuries of ligaments, joints, tendons, due to bruises, stretch marks and excessive physical exertion. The use of this form of the drug with localized rheumatoid inflammation is also effective.
When applying the ointment, the skin serves as a kind of "reservoir" for the accumulation of the drug, which is subsequently gradually released and penetrates into deeper inflamed areas. The concentration of the active component in the blood when using the ointment is 100 times less than when taken orally.
It is recommended to apply the drug 3-4 times a day. At the same time, it should be lightly rubbed into the skin. The amount of ointment depends on the area of the inflamed area (2-4 g), the volume is equal to the size of the cherry, this is enough to distribute the product to 400-800 cm of area. The daily norm should not exceed 8 g. The duration of use is prescribed by the doctor, but no more than 2 weeks with daily use.
The shelf life of the drug is 2 years from the date of release, while maintaining the integrity of the tube.
Eye drops
This form of "Diclofenac" is a clear solution with an active ingredient content of 0.1%. The tool is sold in special bottles equipped with a dropper-dispenser, which allows you to use the medicine without special difficulties.
Eye drops are intended for adults and children over the age of 2 years. The maximum concentration of diclofenac sodium is fixed in the conjunctiva and cornea 30 minutes after application. A significant concentration of the drug does not enter the systemic circulation.
Indication for the use of eye drops is:
- prevention of inflammation during surgical removal of cataracts (1 drop 3-5 times a day);
- reduction of pain and photophobia after keratectomy for 24 hours (1 drop 1 hour before and after the operation every half hour, and then 1 drop 4 times a day);
- inhibition of myosis during surgery (1 drop every 30 minutes 2 hours before surgery and after 1 drop 3 times with the same time interval).
The duration of the course of therapy is prescribed by the doctor based on the individual characteristics of the patient.
The algorithm of the therapeutic procedure:
- Wash hands thoroughly.
- Remove the cap from the tube and cut off the tip of the dropper with scissors without damaging the thread.
- Throw back your head.
- Move the lower eyelid with your index finger down, look up.
- Bring the tube of medicine to the eye, turn the case down and press it gently, drip 1 drop.
- Close the eye, clamp the inner eye angle for 1-2 minutes, which will eliminate the leakage of the drug.
- Without opening your eyes, get wet with a cotton swab.
- After that, open your eye and wash your hands.
The procedure should be carried out without touching the eyelids and eyelashes. After that, it is not recommended to go outside for 1-1.5 hours.
An opened bottle can be stored at a temperature of 15-25 degrees for no more than 4 weeks.
"Diclofenac" during pregnancy and lactation
During the period of gestation and while breastfeeding, the use of medicine is prohibited. Especially dangerous is the action of Diclofenac in the 3rd trimester of pregnancy. This can subsequently slow down the course of childbirth as a result of a weakening of the contractile ability of the uterus, as well as provoke heavy bleeding during delivery.
If you need to use "Diclofenac" during lactation, you should temporarily stop breastfeeding for the entire period of therapy.
"Diclofenac" is a strong and effective drug that can be used as first aid for quick pain relief. But he is not able to eliminate the main cause of inflammation, therefore, its use is permissible only in combination with other agents as part of a comprehensive treatment. Do not forget that the effect of "Diclofenac" can cause side effects, so it should be used purely on the recommendation of a doctor.