A drug called "Diclofenac-ratiopharm" acts as a non-steroidal drug and a derivative of phenylacetic acid. The medicine can produce a pronounced anti-inflammatory, analgesic and moderate antipyretic effect. Since it is very popular in Russia, then we will consider in detail its description and instructions.
Description
The mechanism of action of the drug "Diclofenac-ratiopharm" is directly related to the inhibition of the activity of metabolic enzymes, which are the precursors of prostaglandins, which play a major role in the pathogenesis of inflammation, pain and fever. The analgesic effect is due to two mechanisms. One of them is peripheral (by suppressing the synthesis of prostaglandins), and the other is central (through inhibition in the peripheral nervous system).
Proteoglycan synthesis is inhibited, usually in cartilage. In the presence of rheumatic diseases, joint pain at rest and during movement is reduced. In addition, morning stiffness with swelling of the joints is eliminated, which contributes to a significant increase in range of motion. Post-traumatic and postoperative pain, as well as inflammatory edema, are reduced.
According to the instructions for use "Diclofenac-ratiopharm" platelet aggregation is suppressed. With prolonged use, a desensitizing effect occurs. In the framework of local application in ophthalmology, edema and pain are reduced in the inflammatory process of non-infectious etiology.
Composition and dosage form: gel, tablets, capsules, patch
The main component of the drug Diclofenac-ratiopharm under consideration is a substance called diclofenac sodium. For ease of use, this medication has a large number of release forms:
- The described medicine is released in tablets.
- There is a form in the form of capsules, characterized by a prolonged action.
- Rectal capsules are also available.
- To achieve a quick effect from the drug, a solution for intramuscular and intravenous administration is issued.
- In addition, the drug is delivered to drugstores in the form of rectal suppositories “Diclofenac-ratiopharm”, as well as a gel and a patch.
Indications for use
The presented medicinal product “Diclofenac-ratiopharm” is used in the following cases:
- Against the background of inflammatory and degenerative diseases of the musculoskeletal system with rheumatoid, psoriatic, juvenile chronic arthritis.
- In the case of ankylosing spondylitis.
- In the presence of neuralgic amyotrophy.
- With osteoarthritis, rheumatism, gouty arthritis (it is worth noting that with acute attacks of gout, quick-acting forms of the drug are more preferable).
- Against the background of pain. For example, in the presence of headache or toothache, sciatica, neuralgia, myalgia, arthralgia, radiculitis, as well as with oncological pathologies.
- In the case of the development of post-traumatic and postoperative syndrome, accompanied by inflammation.
- In the presence of inflammatory processes in the pelvis, including adnexitis.
- Against the background of infectious and inflammatory diseases of the otolaryngological organs with the presence of severe pain (as part of a comprehensive treatment): with pharyngitis, tonsillitis, otitis media.
- In the case of febrile syndrome in infectious diseases.
Contraindications
There are a number of prohibitions when this drug can not be used:
- With hypersensitivity.
- In the case of a combination of bronchial asthma with recurrent nasal polyposis.
- Against the background of hematopoiesis disorders (with leukopenia, anemia).
- In the case of various disorders of blood coagulability. For example, with hemophilia, prolonged bleeding time and a tendency to such.
- In the presence of erosive and ulcerative lesions.
- Against the background of pregnancy, lactation or in childhood up to six years.
With caution, the medicine is used for anemia, bronchial asthma, decompensated heart failure, arterial hypertension, edema syndrome, alcoholism, diverticulitis, diabetes, in old age. It is better to refrain from using the medication in the postoperative period.
Diclofenac-ratiopharm capsules cannot be used against rectal bleeding, hemorrhoids, injuries or inflammations of the rectum.
Instructions and dosage forms: tablets, injections, capsules
In the form of tablets, "Diclofenac-ratiopharm" is taken orally, it is not chewed and used during or after meals. Adults are prescribed 50 milligrams three times a day. After achieving the optimal therapeutic effect, the dose is gradually reduced, and they switch to maintenance therapy in the amount of 50 mg per day or 100.
Diclofenac-ratiopharm has a maximum daily dose of 150 milligrams.
For children over six years of age and adolescents, only tablets with a standard duration of action of 25 milligrams are used. The daily dosage of Diclofenac-ratiopharm tablets is 2 milligrams per kilogram of the child’s weight. In the case of juvenile rheumatoid arthritis, the dosage can be increased to 3 milligrams per kilogram. Tablets should be taken on an empty stomach with a small amount of water.
"Diclofenac-ratiopharm" of prolonged exposure is prescribed 100 milligrams once (in the presence of dysmenorrhea and migraine attacks prescribe up to 200 mg). For intravenous use, the maximum dosage is also 150 milligrams. Immediately before administration, the contents of the ampoule should be diluted in 500 milliliters of a 0.9% solution of sodium chloride or dextrose with the addition of sodium bicarbonate. Depending on the nature of the severity of pain, the infusion is carried out within 30-180 minutes.
As indicated by the instructions for use with Diclofenac-ratiopharm injections, in order to prevent postoperative pain, an infusion is carried out with a shock dose of the drug (50 milligrams in sixty minutes). In the future, the infusion continues at a rate of 5 milligrams per hour (until the maximum daily dosage is reached). As part of the treatment of an acute condition or for the relief of exacerbations of chronic pathology, a single intramuscular injection is possible, and further therapy is continued with oral forms, taking into account the maximum permitted dose. It is worth noting that injections with injection solution are administered deeply for no more than two weeks.
Rectal capsules are used at 50 milligrams twice daily or 100 mg once. With a migraine attack, the same form of the drug is used in a dosage of 100 milligrams with the first symptoms of the attack. If necessary, taking the drug is repeated in the same amount.
The use of Diclofenac-ratiopharm gel
The medication is applied to the skin in the area of the painful area three times a day and is easily rubbed. The instruction for the Diclofenac-ratiopharm gel confirms this.
If there is a need to apply a bandage, it is used a few minutes after applying the medicinal composition to a dried surface.
It is worth noting that the Diclofenac-ratiopharm therapeutic gel should never be used under airtight dressings. Its maximum daily dosage is 9 grams (or 90 milligrams of diclofenac sodium). The duration of therapy is two weeks.
Using patch
It is necessary to incise a bag with Diclofenac-ratiopharm patches, which contain a biologically active substance. An incision is made along the marking. They take out the product and carefully close the bag, pressing on the locking system. Remove the protective film from the surface. Stick a patch on the sore spot. If necessary, it can be fixed with a mesh dressing. It is forbidden to use this form of medicine with an occlusive dressing.
Side effects
The following adverse reactions may occur during treatment with Diclofenac-ratiopharm dosage forms:
- The digestive organs respond to medication with abdominal pain or cramping, bloating, diarrhea, dyspepsia, nausea, constipation, flatulence, increased transaminase activity, peptic ulcer. Possible complications in the form of perforation, bleeding. Jaundice develops less often along with melena, the appearance of blood in the feces, damage to the esophagus, aphthous stomatitis, dry mucous membranes, hepatitis, hepatonecrosis, cirrhosis, hepatorenal syndrome and a change in appetite.
- Very rarely, sleep disturbance occurs along with drowsiness, depression, diplopia, anxiety, irritability, aseptic meningitis, convulsions, weakness.
- Tinnitus is possible in combination with blurred visual perception, taste impairment, hearing loss, scotoma.
- The skin can react with a rash, itching. Alopecia occurs less frequently along with urticaria, eczema, toxic dermatitis, erythema multiforme exudative, toxic epidermal necrolysis and photosensitivity.
- From the activity of the genitourinary system, fluid retention is likely.
- Sometimes nephrotic syndrome is formed in combination with proteinuria, oliguria, interstitial nephritis, papillary necrosis, acute renal failure and azotemia.
- The occurrence of anemia, leukopenia, thrombocytopenia, eosinophilia, agranulocytosis, thrombocytopenic purpura is not ruled out.
- The respiratory system is able to respond with cough, bronchial spasms, laryngeal edema. Less commonly, blood pressure rises and congestive heart failure is noted.
- Allergic reactions are likely. Lip swelling, anaphylactoid manifestations, anaphylactic shock are possible (as a rule, it develops rapidly).
Overdose
Symptoms of an overdose manifest in the form of dizziness, headache, hyperventilation of the lungs, clouding of consciousness. In children, myoclonic seizures can be fixed in combination with nausea, vomiting, abdominal pain, bleeding, impaired liver and kidney function.
As part of the treatment, the stomach is washed, activated charcoal is given, and symptomatic therapy is carried out aimed at eliminating the increase in pressure, seizures, digestive system irritation and respiratory depression. It is worth noting that forced diuresis with hemodialysis is ineffective.
special instructions
In order to quickly achieve the desired therapeutic effect, the medicine is taken half an hour before meals. In other situations, take the remedy before, after or during meals in unsweetened form, washed down with water.
Caution should be exercised when prescribing this drug to patients with heart and kidney failure, as well as in the treatment of elderly patients who take diuretics, and patients with a decrease in BCC. If this medicine is prescribed in such situations, it is recommended as a precaution to monitor renal function.
In patients with insufficiency of this organ with CC less than 10 milliliters per minute, the Css metabolites in the blood plasma should theoretically be higher than in patients with normal renal function, however, this is not really observed, since in such a situation the excretion of metabolites with bile is enhanced.
In patients with liver failure (in chronic hepatitis, compensated cirrhosis) metabolism and kinetics do not differ from the same process in people with normal functions of this organ. During long-term treatment, it is necessary to monitor liver function along with a picture of peripheral blood and fecal analysis.
During the treatment period, a decrease in the overall speed of mental and motor reactions is possible, therefore, it is required to refrain from driving motor vehicles and engaging in other potentially dangerous types of activities that require an increased concentration of attention.
Interaction
What else does the instruction for Diclofenac-ratiopharm tell us?
It should be borne in mind that the described drug increases the concentration in the blood plasma of methotrexate, digoxin, lithium and cyclosporin preparations. But it lowers the effect of diuretics. Against the background of the simultaneous use of potassium-sparing diuretics, the risks of developing hyperkalemia are increased. When combined with anticoagulants, antiplatelet agents, and thrombolytic agents (streptokinase, alteplase, urokinase), the risk of bleeding increases (most often in the digestive system).
This drug reduces the effect of sleeping pills and antihypertensive drugs. It increases the likelihood of side effects of other NSAIDs and corticosteroids. Concomitant use with paracetamol increases the risks of developing a nephrotoxic effect. "Diclofenac-ratiopharm" reduces the effect of hypoglycemic drugs.
With “Cefamandol”, “Cefoperazone”, “Cefotetan”, valproic acid and “Plikamycin”, the incidence of hypoprothrombinemia increases. Cyclosporin increases the effect of the described drug on the synthesis of Pg in the kidneys, which is manifested by an increase in nephrotoxicity.
The simultaneous administration of the drug in question with ethanol, Corticotropin and Colchicine increases the risks of bleeding in the digestive system. Photosensitizing medications increase the sensitizing effect of this drug on ultraviolet radiation. By drugs blocking tubular secretion, the plasma concentration of Diclofenac-ratiopharm increases, thereby increasing its effectiveness and toxicity.
Reviews
In the reviews, patients write that the drug “Diclofenac-ratiopharm” is very effective when it is necessary to cope with pain and discomfort. Consumers like a large selection of dosage forms of this product. But people are unhappy that this drug causes various adverse reactions and is extremely negative for the state of the digestive system.
We reviewed the instructions for use with the Diclofenac-ratiopharm gel, tablets, capsules and injections.