Manufacturers assure that "Rumakar" is a universal safe tool that quickly relieves pain without undesirable consequences. Is it really? Doctors attribute this medicine to a number of serious diseases, including articular pathologies. Let's see how the drug works, when and why it helps.
general information
Rumacar (gel, tablets) manufactured by Pharmacar is a medicine in which the main active compound is diclofenac. The drug is manufactured by a Palestinian pharmaceutical company. On sale there is a one percent gel, tablets containing 50 mg of the active compound, powder for the preparation of a solution for injections. The tablet form comes packaged in blisters; one foil pack contains 30 capsules.
Consider the instruction "Rumakar" (Rumakar). The description of the drug in it is very detailed. It is indicated that this drug is from the category of non-hormonal drugs that stop the activity of the inflammatory focus. The medicine quickly acts, strongly inhibits the activity of cyclooxygenase (COX). Under its influence, prostaglandins are more slowly generated, which are involved in the mechanism of pain, fever, and inflammation. The manufacturer assures the rapid manifestation of the pharmacological result, which makes the medicine effective in acute inflammation, in moments of severe and severe pain.
The composition of the funds
In the instructions for use "Rumakar" (Rhumacare), the manufacturer lists all the components used in the manufacture of the drug. The tablet contains 50 mg of the active ingredient - sodium diclofenac, as well as excipients. Lactose compounds, starch, magnesium stearate, silicon dioxide were used.
Each tablet is coated with a membrane that dissolves as it passes through the intestinal tract. It contains castor oil, phthalates, glycerol, 80th twin.
The full list of ingredients used in the manufacture of the medication must be clarified if a person has a tendency to allergic reactions or intolerance to any substance used in the pharmaceutical industry. A detailed study of the composition of a particular product given in the accompanying documentation can reduce the likelihood of adverse reactions. It must be remembered that the manufacturer has the right to change the composition of the drug in terms of auxiliary ingredients, so it is wise to study the full list of substances for each new packaging purchased.
Pharmacology
Studying the composition and prices of Rumakar (a package of 30 tablets costs about 250 rubles), you should pay attention to the activity of the main component - diclofenac. This compound is obtained from phenylacetic acid. Tests have shown that it has a strong anti-inflammatory effect. The compound relieves soreness and somewhat weakens the fever. The features of its activity are due to the inhibition of COX, an enzyme compound, a derivative of the reaction of arachidonic acid processing, which precedes prostaglandins in the biochemical chain. It is GHG that is the main element that explains the fever, soreness and inflammatory process. The analgesic effect is due to the peripheral and central effect on the human body. The first involves an indirect effect on pain through the inhibition of GHG generation, the second - inhibition of GHG production in the central nervous system, PNS.
Allowed the appointment of funds for rheumatic pathologies. It is proved that in this condition, the use of the composition helps to weaken the pain syndrome both during physical activity and at rest. The medicine allows you to leave stiffness in the morning in the past, swelling of the articular region. The patient again gets the opportunity to move normally. The drug reduces pain associated with a previous injury or surgery, relieves swelling caused by the inflammatory process.
Features of the drug
The instructions for Rumakar tablets indicate the ability of the active substance to inhibit the production of proteoglycan in cartilage.
The drug inhibits platelet aggregation. A long course of use provokes a desensitizing effect.
Kinetics
According to the instructions for Rumacar tablets, the capsule formed by diclofenac is coated with a membrane that dissolves in the intestinal tract. Soon after, the active ingredient is absorbed. Absorption processes are localized in the digestive tract. Using the composition during the meal slows down absorption, but does not adjust the level of effectiveness. Approximately 50% of all diclofenac received in the body is transformed as part of the primary passage through the liver.
The maximum concentration in blood serum after oral administration is achievable, on average, after three hours (deviation for an hour up and down is permissible). The concentration in the plasma component of the blood linearly depends on the dosage of the drug. No cumulative effect was found. Entry into strong bonds with plasma proteins is estimated at 99.7%, the main percentage of reactions proceeds with the participation of albumin. The ability of diclofenac to penetrate into the synovial fluid was revealed. In this substance, the maximum concentration is achievable 2-4 hours later than in blood serum.
How is excreted from the body
As can be seen from the instructions for use, Rumakar is actively transforming. Reactions lead to the formation of metabolites, of which two show pharmacological activity, although weaker than the original active compound.
Systemic clearance of diclofenac is estimated at an average of 263 ml / min. The half-life of serum varies within an hour or two, and from synovial fluid - six hours. About 60% of the total composition used is eliminated by the renal system in the form of metabolites. About 1% are excreted with urine in its original state. The remaining volume leaves the body with bile.
When to use
In the instructions for the use of the Rumakar preparation, the manufacturer recommends using the remedy for the so-called joint syndrome. The tablets showed good efficacy as part of the course of treatment of osteoarthritis, gout, rheumatoid arthritis, spondylitis. You can use the medication for degenerative pathologies affecting the supporting system to stop the activity of chronic foci of inflammation in these organs. "Rumakar" is indicated as an element of therapy after an injury that led to the formation of an inflammatory focus in the soft tissues. The tool is used to treat bruises, sprains.
"Rumakar" has shown effectiveness in arthralgia, myalgia, neuralgia, vertebral pain, inflammatory processes caused by surgery, trauma. As can be seen from the reviews, Rumakar tablets relieve pain in migraines, gout, during menstrual bleeding, due to colic and adnexitis. The medicine is prescribed for proctitis.
Dosage
A single dose of diclofenac, shown to adult patients, is 25-50 mg. Up to three such doses are allowed per day. The frequency of use is determined by the doctor, based on the severity of the disease and the nuances of its course. As a rule, "Rumakar" is prescribed for use from one to three times a day. In case of an acute pathological condition and, if necessary, stopping relapse, it is possible to use three capsules at once, which is indicated in the instructions for use for Rumakar tablets.
Diclofenac is allowed for children over six years of age, adolescents. Dosage is determined based on the weight of the child. The calculation is as follows: for every kilogram of body weight - 2 mg of diclofenac. The amount received is the daily rate of the drug.
Adults can use no more than 150 mg of diclofenac per day.
Undesirable consequences
As the instruction indicates, the main component of Rumacar tablets is sodium diclofenac. This is what determines the undesirable consequences associated with the use of the drug. It is known that diclofenac negatively affects the functioning of the gastrointestinal system. Most patients who have experienced side effects report negative reactions from the gastrointestinal tract. Taking the drug can cause vomiting and nausea, weight loss and soreness, discomfort in the abdomen. Some people have increased gas formation and constipation, the formation of foci of ulceration, erosive damage to the mucosa, focal bleeding, perforation. In rare cases, diclofenac leads to a malfunction of liver function.
Possible adverse effects from the central nervous system. In the instructions to “Rumakar” (30 tablets in a package), the manufacturer indicates that he may be sick and dizzy, there is a risk of sleep disturbances, an excited, irritated state. Some patients experience tinnitus, tremors, and a feeling of fatigue. Diclofenac can cause leukemia or thrombocytopenia, anemia. The use of funds is associated with a risk of impaired renal function. With a tendency to edema, a high probability of this condition. There is a risk of alopecia, an allergic response of the body (mainly in the form of itchy areas and areas of rashes on the skin).
Contraindications
Since the active substance in the composition of Rumakar is sodium diclofenac, respectively, all the restrictions and contraindications inherent in medicines based on this component apply to the medication. You can not use the drug for erosion and ulcers in the digestive tract, if the pathology has worsened. The “aspirin triad” becomes a contraindication. You can not assign "Rumakar" to persons who have identified malfunctions of the hematopoietic system, but cannot determine the cause of the condition.
Hypersensitivity and an allergic response to diclofenac and any auxiliary components are an absolute contraindication, to which the manufacturer pays special attention to the Rumakar tablets instructions. You can not use the drug if an increased susceptibility of other non-hormonal anti-inflammatory is established.
Pregnancy
The instruction for Rumakar tablets indicates the content of diclofenac sodium in the preparation, which is considered an undesirable but acceptable substance for the treatment of pregnant and lactating women. In each individual case, the choice remains with the attending doctor. The doctor is obliged to warn the client about all undesirable consequences associated with the therapeutic course. "Rumakar" is prescribed only if the obvious benefit of taking the tablets is significantly greater than the risks to the fetus.
Who can and should not be assigned "Rumakar"
As can be seen from the reviews of "Rumakar", with gout, people often use this drug. The therapeutic course should be based on an anti-inflammatory drug that has a relatively mild effect on the body, as patients, as a rule, have a variety of chronic pathologies. It is noted that diclofenac can be used to treat people in whose medical history there are references to diseases of the liver and kidneys. However, such cases require careful monitoring of the patient's condition.
Rumakar is allowed to be used for the treatment of elderly people, but it is necessary to regularly check the operation of vital organs. For children under the age of six, a drug is not prescribed.
Features of the reception
The method of application of the Rumakar tablets is oral, which imposes certain restrictions on the possibility of using the composition. So, immediately after surgery, you can use only a solution for injection. As soon as possible, the patient is transferred to a course of treatment with the drug on diclofenac in tablet form.
Particularly cautious "Rumakar" is used if pathological conditions affecting the gastrointestinal tract, liver and kidneys are established. Attention is required by patients suffering from dyspepsia, asthma, high blood pressure, heart failure.
If in the medical history there is information about an allergic reaction previously caused by diclofenac sulfites or non-hormonal anti-inflammatory drugs, Rumakar is prescribed only in an emergency. The therapeutic course requires you to regularly check the work of the liver, kidneys, as well as taking readings of the circulatory system.
What patients and doctors say
According to reviews, the instructions for use with Rumakar tablets are fairly understandable, and the tool itself is easy and simple to apply. Many note the difficulty of acquiring it, since Rumakar is currently represented in many Belarusian pharmacies, but it is rather difficult to find it in Russia. In addition, it is noted that the tool is (considering the average price level in Belarusian pharmacies) quite expensive, therefore not available to everyone.
As noted in the reviews of doctors, the use of "Rumakar" rarely causes unwanted reactions in patients. The drug quickly and effectively affects the body, weakening the activity of the inflammatory focus. When choosing the optimal tablets for the patient from gout, Rumakar is a reliable choice.
Is there an alternative
When choosing Rumakar analogues, the composition of the funds comes first in importance. It is strictly forbidden to replace the means prescribed by the doctor with any other on your own. As a rule, as an alternative, doctors advise:
- Diclofenac.
- "Naklofen."
- Ortofen.
- Diklak.
Similar to the rules of use (indicated in the instructions for use) and the composition of the analogues of “Rumakar” differ in price and availability. These drugs are in almost every pharmacy, it is much easier to find them on the domestic pharmaceutical market, and the price varies between 100-300 rubles per package.
Diklak
The instructions for use of the Rumacar analogue indicate a similar active substance diclofenac. "Diklak" belongs to the category of non-hormonal anti-inflammatory drugs, anesthetizes and deactivates the focus of inflammation, slightly reduces fever. The drug is characterized by the ability to inhibit the first and second types of COX, to correct the reaction of transformation of arachidonic acid. Under its influence, the concentration of GHGs in the area of ​​inflammation is reduced. The use of the composition against a background of rheumatic diseases is accompanied by a relief of the general condition of the patient, a decrease in pain. In the mornings, there is less stiffness, the joints do not swell so much and work better. After injury and surgery, Diklak helps relieve pain and relieve swelling.
Soon after taking the pill, the active component is completely absorbed. The speed of the process is somewhat slower if Diklak is used during the meal. The difference reaches a couple of hours. Using the composition with food allows you to achieve the highest levels of diclofenac in serum 5-6 hours after taking the medicine.
Technical aspects
The ability to bind to blood proteins for the active compound in the Diklak preparation is estimated at 99%, while the bulk of it falls on the reaction with albumin. The distribution volume reaches 550 ml / kg. Diklak penetrates into the synovial fluid, the highest concentration indicators are achievable a few (up to four) hours later compared to blood serum. The elimination half-life from intraarticular fluid is estimated at 3-6 hours. So far, it has not been possible to establish how the concentration of the component in this area of ​​the body is related to the effectiveness of Diklak.
As studies have shown, repeated use of Diklak does not affect the kinetics of the main component. No cumulative effect was found. The main active ingredient is found in breast milk.
Recycling and elimination
About half of the total dose of Diklak received is processed in the liver during the initial passage, which is due to conjugation and hydroxylation reactions. The processes proceed with the involvement of glucuronic acid, an isoenzyme of CYP2C9. The resulting metabolites have pharmacological activity, but it is significantly lower than that characteristic of the basic substance.
The elimination half-life from plasma requires a couple of hours. Systemic clearance is estimated at approximately 350 ml / min. About 65% of the drug taken is excreted from the body by the renal system in a processed form, no more than 1% is eliminated in the initial state, the rest with bile. With creatinine clearance of 10 ml / min or less, the percentage of reaction products excreted with bile increases. Tests have shown that substances do not accumulate in the circulatory system. In the chronic form of hepatitis, hepatic cirrhosis of the compensated form, the kinetics of the drug remain standard.
When to use
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Particular caution requires the appointment of "Diklak" to people who have a period of remission of asthma, hypertension, anemia, heart failure, liver or kidney failure. Use the medicine with caution if the patient is chronically ill with alcoholism, edematous syndrome, intestinal pathologies associated with foci of inflammation. Accurate intake requires diabetes. Sometimes Diklak is prescribed after a major operation, but this requires regular monitoring of the patient's condition.
Particular caution is required when using Diklak during an exacerbation of porphyria. It is necessary to carefully prescribe anti-inflammatory in case of malfunctions of the hepatic, renal functionality in severe form.