Diclofenac is a popular drug. It has an analgesic, anti-inflammatory and antipyretic effect. Instructions for use with Diclofenac will be presented in this article. Also consider analogues of the drug.
Dosage forms and composition of the drug
The drug is found in several dosage forms. Exists:
- Round biconvex tablets, enteric coated. The color of the tablets is from orange to yellow-orange. Available in blister packs of 10 and 20 pieces. In a pack of cardboard 1, 2, 3, 5 or 10 packs of 10 tablets and from one to three packs of 20. Also, 30 tablets are produced in dark glass jars.
- A clear solution for intramuscular injection. The color of the solution is colorless to pale yellow. The solution has a slight characteristic odor of benzene alcohol. Available in ampoules, 3 ml in each of 5 ampoules per pack, 2 packs in a pack of cardboard. What other form of diclofenac is there?
- Gel for external use. There is one percent and five percent, white (cream or yellowish shade is allowed), with a characteristic odor. Available in tubes of aluminum, 30 and 50 g.
- Ointment for external use is white with a mild specific odor. Sold in packs of one aluminum tube of 30 g of ointment.
- Candles "Diclofenac". In gynecology are often used. They have a torpedo shape, color - from white to white with a cream tint. They are sold in cardboard packs of 2 blister packs, each of which contains 5 suppositories.
- 0.1% eye drops, which are a clear solution, similar to a solution for intramuscular injection. Available in 5 ml plastic dropper bottles. Forms of release of "Diclofenac" we reviewed. They are selected depending on the symptoms.
The main active ingredient of the drug is diclofenac sodium in various quantities. One tablet and one milliliter of injection contains 25 mg of active substance. One gram of gel for external use contains 10 or 50 mg of diclofenac sodium (depending on the indicated concentration of the gel). One gram of ointment contains 10 mg of the substance. One rectal suppository "Diclofenac" in the composition contains 100 mg of the active component. In the composition of 1 ml of eye drops - 1 mg of diclofenac sodium.
Auxiliary components of the drug are different for different forms of the drug. So, in tablets it is sucrose, milk sugar, polyvinylpyrrolidone (povidone), potato starch, stearic acid. The enteric coating consists of cellacephate, paraffin (in liquid form), titanium dioxide, medical castor oil, dye tropeolin O.
Additional components in the composition of Diclofenac in the form of a solution for intramuscular injection are propylene glycol, benzene alcohol, mannitol, sodium hydroxide, sodium sulfite (sodium sulfite), water for injection. The gel consists of rectified ethanol, carbomer (carbopol), propylene glycol, trolamine (triethanolamine) and methyl parahydroxobenzoate with the addition of purified water and lavender oil.
The ointment, in addition to the active ingredient, contains dimexide, polyethylene oxide-400 and polyethylene oxide-1500, as well as propylene glycol.
The only auxiliary component of rectal suppositories is solid fat.
In eye drops, the role of auxiliary components is played by hydrochloric acid, castor polyethoxylated oil (macrogol glyceryl ricinoleate), trometamol, benzalkonium chloride, disodium dihydrate, and purified water.
When is the drug used?
According to the instructions for use, "Diclofenac" is used only as a means of symptomatic therapy, since it has no effect on the course of the pathological process. The tool is perfect for stopping the inflammatory process and reducing pain. The specific indications of Diclofenac differ for different forms.
Tablets and rectal suppositories can be used for diseases such as:
- Pain syndrome, which is pronounced in oncology.
- Toothaches and headaches, including those caused by migraines.
- Lumbago (acute pain in the lower back).
- Sciatica (pain caused by irritation of the sciatic nerve).
- Radiculitis.
- Muscle pain (myalgia).
- Bone pain (ossalgia).
- Joint pain (arthralgia).
- Neuralgia (damage to the peripheral nerves).
- Pain syndrome that occurs after injuries or surgery and is accompanied by an inflammatory process.
- OA diseases of an inflammatory and degenerative nature.
- Inflammatory diseases in the pelvic area.
- Inflammatory processes in the ENT organs of an infectious nature, which are accompanied by severe pain, such as pharyngitis, tonsillitis, otitis media.
In general, “Diclofenac” for joint pain helps very well and quickly. The result is not long in coming.
Intramuscularly, the drug is prescribed for the purpose of short-term therapy for pain of various genesis of moderate intensity. In fact, the indications are the same as for Diclofenac tablets and suppositories - various diseases of the ODE, inflammation in the pelvic area, pain in the muscles, joints, bones, peripheral nerves, postoperative and post-traumatic pains.
The gel and ointment are used externally to relieve muscle pain of a rheumatic and non-rheumatic genesis, in case of soft tissue injuries of a rheumatic and traumatic nature, diseases of the OA, including osteoarthritis and a variety of arthritis.
What other evidence does Diclofenac have?
Eye drops are effective in treating non-infectious inflammations, including corneal erosion, conjunctival and corneal inflammation caused by trauma or surgery, conjunctivitis, keratoconjunctivitis and some other eye diseases.
Consider also the contraindications of Diclofenac.
Contraindications
A medication in all forms has a large number of contraindications, in which the use of this drug is limited or completely excluded. Tablets and suppositories can not be used with:
- Bronchial asthma and proliferation of mucous tissues of the nose and paranasal sinuses in combination with individual intolerance to NSAIDs, including acetylsalicylic acid.
- Bleeding in the digestive tract.
- The inflammatory process in the intestines.
- Ulcer and erosion in the stomach or duodenum.
- Severe renal and hepatic insufficiency.
- Kidney and liver problems.
- Severe hyperkalemia.
- Acute and chronic heart failure.
- Children and adolescents (less than 6 years for tablets, under 14 (sometimes 18) years for rectal suppositories).
- Late pregnancy (third trimester).
- Lactation.
- Increased individual sensitivity and intolerance in relation to the active or auxiliary components of the drug, as well as NSAIDs.
There are other contraindications for Diclofenac. Also, tablets are not prescribed for malabsorption of glucose-galactose, lactase deficiency and lactose intolerance, and suppositories for proctitis.
With extreme caution, these dosage forms are used to treat elderly patients with underweight, immunocompromised, suffering from peptic ulcer of the stomach or intestines, ulcerative colitis, liver and kidney diseases, Crohn’s disease, chronic heart failure, coronary heart disease, severe anemia, bronchial asthma, cerebrovascular diseases, diabetes mellitus, pathologies of peripheral arteries, as well as smoking, alcohol dependence, the presence of p and infectious diseases, while taking the drug with anticoagulants, corticosteroids, antiplatelet agents, non-steroidal anti-inflammatory drugs.
All this is described in the instructions for use with Diclofenac.
A solution for intramuscular injection is not prescribed for:
- Erosive-ulcerative diseases of the digestive tract in acute form.
- Violations of the hematopoiesis process.
- Bearing a baby and breastfeeding.
- Children and adolescents under the age of 15 years.
- Individual hypersensitivity to the components of the drug.
As with tablets and suppositories, caution should be exercised when using Diclofenac solution for heart, liver, and kidney failure, as well as for advanced age.
Forms of the drug for external use are not used in case of “aspirin” asthma, with impaired skin integrity, in the last trimester of pregnancy and with lactation, in children under 6 years of age, with intolerance and increased individual sensitivity to the components of the drug and NSAIDs.
These Diclofenac forms for low back pain and other types of pain are used with extreme caution in the same cases as solution, tablets and suppositories, that is, with bronchial asthma, renal, liver or heart failure, impaired renal and hepatic function, elderly age, as well as until the third trimester of pregnancy and with any pathologies of blood coagulation.
The main contraindication for the use of eye drops is a pronounced individual hypersensitivity to the components of the drug.
Caution is required when using eye drops in children, pregnant women, the elderly, patients with bronchial asthma, and bleeding disorders.
Method of use and dosage of various forms of medication
Diclofenac tablets are taken orally, without crushing, washed down with a sufficient amount of liquid (preferably pure water). For the best therapeutic effect, it is recommended to take the medicine half an hour before a meal, however, tablets are allowed before meals, during and after. For patients older than 15 years, a single dosage of the drug is 25-50 mg (which corresponds to 1-2 tablets), the maximum allowable daily dosage is 150 mg. Take the medicine 2-3 times a day. When improvements in the patient's condition appear, they switch to maintenance treatment, reducing the dosage to 50 mg per day.
If the medicine is used to treat children and adolescents under 15 years old, then the dosage is determined by the age and weight of the patient. Children 6-7 years of age with a body weight of 20-24 kg are prescribed 1 tablet once a day. At 8-11 years old and with a weight of 25-37 kg, one tablet is taken two to three times a day (daily dose does not exceed 75 mg). For adolescents aged 12-14 years with a body weight of 38 to 50 kg, a single maximum dose does not exceed 1-2 tablets, which are taken 2-3 times a day. The maximum allowable daily dose is 75-100 mg, that is, no more than 4 tablets.
The solution "Diclofenac" is administered deeply intramuscularly. The dosage at one time for an adult patient is 75 mg. A second injection, if necessary, is allowed no earlier than twelve hours. The duration of treatment with this form of the drug should not be more than two days. After this, you should switch to the oral form.
Suppositories for rectal administration are used 100-150 mg per day, divided by 2-3 times. For the treatment of mild cases or with prolonged use, the dosage is reduced to 100 mg per day. With the simultaneous use of suppositories with other forms of the drug, it is necessary to observe the total daily dosage, which should not exceed 150 mg. With painful menstruation in women, the initial daily dosage of the drug is 50-100 mg, and, if necessary, gradually, over several menstrual cycles, increases to 150 mg. For migraine symptoms, suppositories are used in a dosage of 100 mg. If necessary, repeated administration of the same dosage is allowed. If it is necessary to continue therapy, the daily dose should not be more than 150 mg in a few injections. Patients under 14 years of age are recommended to use 1 suppository of 50 mg maximum twice a day.
For topical use, Diclofenac for osteochondrosis, for example, is applied to the skin, rubbing it up to four times a day. The right amount of ointment or gel depends on the size of the painful area. Usually, 2-4 g of the drug is used for one application for adults and children from 12 years old. When used in children from 6 to 12 years, it is not recommended to apply more than 2 g of the drug 2 times a day. The course of treatment "Diclofenac" is determined individually by the doctor.
Eye drops can be used before and after eye surgery. In the first case, 1 drop of the drug is instilled into the conjunctival sac five times in three hours. After surgery, the dosage is reduced to 3 drops. In the future, 3-5 instillations per day are sufficient for the entire treatment period. If the drug is used regardless of the operation, then, as a rule, 4-5 applications per day are prescribed, 1 drop in each. Therapy lasts an average of four weeks. For a longer treatment, it is recommended to consult an ophthalmologist who will conduct the necessary examination and make an accurate diagnosis. As prescribed by the doctor, therapy can be extended for several weeks.
Is Diclofenac Allowed for Breastfeeding? About it further.
Side effects of the drug
The drug in tablets causes a large number of different side effects from:
- Nervous system - headache and dizziness, insomnia, nightmares, drowsiness, fatigue, irritability, depression, aseptic meningitis, cramps, anxiety or fear, disorientation.
- Digestive tract - diarrhea, constipation, nausea, vomiting, pain, cramping and bloating, flatulence, ulcerative gastrointestinal bleeding, peptic ulcer, lesions of the esophagus, jaundice, blood in the stool, hepatitis, cholecystopancreatitis, dry mucous membranes, appetite disorders, cirrhosis of the liver, colitis, pancreatitis.
- Respiratory organs - bronchospasm, laryngeal edema, cough, pneumonitis.
- Heart and blood vessels - chest pain, arterial hypertension, heart failure.
- Urogenital system - manifestations of urinary retention, oliguria, nephrotic syndrome, interstitial nephritis, hematuria, acute renal failure, papillary necrosis.
- Integument - skin rashes and itching, urticaria, toxic dermatitis, epidermal necrosis, alopecia, eczema, increased photosensitivity.
- Sensory organs - signs of diplopia, blurred vision, tinnitus, distortion of taste, hearing loss (including irreversible).
- Hematopoietic organs and the immune system - various forms of anemia, leukopenia, thrombocytopenia, eosinophilia, agranulocytosis, aggravation of the course of infectious processes.
Various allergic reactions are also possible, including allergic vasculitis, swelling of the larynx, lips and tongue, anaphylactic shock. This confirms the instructions for use for Diclofenac.
An intramuscular injection and rectal suppositories can cause similar side effects. In the area of intramuscular administration, local reactions are possible, for example, burning, aseptic necrosis, adipose tissue necrosis. The use of suppositories rarely leads to edema.
Ointment and gel almost never cause undesirable reactions, however, local manifestations in the form of itching, burning, redness and rash are possible.
Suppositories "Diclofenac" in gynecology can cause unwanted local manifestations.
Eye drops cause unwanted reactions from various organ systems, including vomiting, nausea, local allergic reactions, blurred vision, burning eyes, clouding of the cornea, facial swelling, skin rashes, fever, chills.
Drug interaction
Before using any form of Diclofenac with other medicines at the same time, you need to consult a specialist to avoid possible unwanted effects.
The use of "Diclofenac" during pregnancy and lactation
Any dosage form during the period of expectation of the baby and breastfeeding can be used only as prescribed by the doctor and only if the expected beneficial effect for the mother outweighs the threat to the unborn baby.
It is not recommended to use the drug for women during pregnancy planning or for problems with fertilization.
In addition to the fact that “Diclofenac” cannot be used during pregnancy, there are other limitations.
Alcohol compatibility
Diclofenac, like any NSAIDs, cannot be combined with alcoholic beverages. , , , .
«».
Drug Analogs
. , «», «», «», «», «». , «», «», «», », «», «», «», «», « ». « », «», « », «», «», «-», «».
«» .
, .
«» - , , . : , , , , . , .
The tool has a wide spectrum of action. «» , , , , , , , , .
At the same time, the drug has a number of serious contraindications and adverse reactions that significantly limit the scope of the drug. It is not recommended to use Diclofenac in any form without prior consultation with a doctor.