Non-steroidal anti-inflammatory drugs (NSAIDs) are among the commonly prescribed drugs. They are used in the treatment of various diseases accompanied by pain or inflammation. Ointments based on diclofenac are one of the representatives of NSAIDs. They treat pain and inflammation locally, with little to no systemic absorption, reducing the chance of side effects.
What is diclofenac?
Diclofenac is a sodium s alt, a derivative of phenylacetic acid, a non-steroidal anti-inflammatory drug (NSAID or NSAID). Its special difference is that it inhibits COX-2 - inducible cyclooxygenases (working in inflammatory processes) with greater efficiency than COX-1 (functioning constantly).
Since the advent of the substance - 1973 - various drugs containing diclofenac have been developed in order to increasepharmacological efficacy, tolerability and ease of use. Initially, when developing, safety and convenience in dosing were taken into account to a greater extent. In new drugs, the emphasis is on rapid absorption. The appearance of gels, ointments based on diclofenac made it possible to treat pain and inflammation locally, with minimal systemic absorption of the active substance.
The pharmaceutical market offers a wide range of preparations of soft-plastic consistency, which include sodium s alt, a derivative of phenylacetic acid. The name of an ointment based on diclofenac does not always contain the name of the main active ingredient. The reference point should be the inscription under the trade name, it indicates the active substance of the drug.
Medicinal effect
Based on the instructions, diclofenac-based ointments have analgesic (pain-relieving), anti-inflammatory effects. They inhibit cyclooxygenase, as a result of which the synthesis of prostaglandins, a pain mediator, thromboxanes, and substances that increase blood pressure, is disrupted. Some ointments with prolonged use have an anti-allergic effect. Normalize the content of the connective tissue substance, which is a lubricant in the joints.
Diclofenac-based ointments relieve pain both during activity and at rest. They reduce stiffness in movement that occurs in the morning, relieve swelling of the joints, increase motor ability. In inflammation resulting from trauma or surgery, relieve spontaneous pain, reduce swelling at the sitewounds.
Ointments with diclofenac as an active substance are significantly superior in anti-inflammatory activity to drugs based on butadione, ibuprofen, acetylsalicylic acid. After application to the skin, the analgesic effect of 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 relief from pain 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 sciatica, lumbago, osteoarthritis, 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, overexertion, bruises.
- Sprains and tendons.
- Post-operative pain and inflammatory swelling due to dental and orthopedic surgery.
- Inflammation in tissues and joints with tendovaginitis, wrist syndrome, bursitis, lesions of tissues surrounding the joint.
- Swelling and inflammation in the joints and soft tissues resulting from injuries.
Contraindications
In some names of diclofenac-based ointments, the manufacturer indicates what other substance is present in the composition in high concentration. Experienced doctors and pharmacists immediately determine whoremedy is contraindicated. But the trade name can be bought by another manufacturer, who 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 of the stomach and duodenum.
- Asthma of allergic origin.
- Inflammation of the nasal mucosa (rhinitis).
- Last trimester of pregnancy.
- Abrasions, scratches, a wound in the intended area of application.
Age restrictions for different ointments are different. Use in childhood is best done as directed by a pediatrician.
There is no data on the penetration of the drug into breast milk, so it is better to refrain from using the ointment during lactation. If, nevertheless, there is an urgent need to use the drug, then it should be applied carefully, trying not to get on the mammary glands.
List of diclofenac 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 produced in the form of ointments and gels. The difference between the latter is that they have a more viscous consistency and have elasticity and plasticity. On themedicinal efficacy is not particularly affected by such characteristics.
Overview of diclofenac ointments:
- "Ortofen" - ointment 5% 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.
- "Diklak Lipogel". Gel composition: diclofenac, tocopherol, lecithin, carbomer. The product is approved for use from the age of 12.
- "Dicloran plus" - 1% gel produced in Russia and India. In addition to diclofenac, the composition of the product includes flax seed oil, levomycetin, methyl salicylate.
- "Diclogen" - gel with the smell of lavender. The composition of the product includes diclofenac diethylamine, sodium sulfite, propylene glycol, benzine alcohol, trolamine, lavender oil. It is excreted from the body by the kidneys, patients with porphyria should use the gel under medical supervision.
- "Voltaren Emulgel" - gel 2%. Approved for use from 12 years. In addition to diclofenac, the product contains carbomers, cetostearomacrogol, cocoylcaprylocaprate, diethylamine.
- "Diklak - gel 5% with a peculiar smell.
- "Ortofer - ointment (2%). The water-alcohol base of the product has a local slightly anesthetic effect.
General recommendations for use
All diclofenac-based ointments (photos are presented in the article) are well absorbed through the pores of the skin within 3-5 minutes. Penetrate into the fluid that fills the cavity of the joints (synovium), where they are stored inconstant concentration for 4-6 hours. Therefore, it is enough to apply the ointment in a thin layer on the inflamed area no more than 3-4 times a day. The duration of self-therapy should not exceed 10 days. The feasibility and safety of longer-term use should be discussed with a physician.
Diclofenac by its chemical composition is an acid that irritates mucous membranes and delicate skin. If the focus of inflammation is, for example, on the face, the ointment should be applied carefully so as not to get into the eyes. Wash your hands after the procedure.
During therapy, you need to monitor the amount of ointment used, its daily dose should not exceed 8 g. Uncontrolled use may cause undesirable 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 a 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. At increased concentrations, diclofenac begins to have a toxic effect, which is expressed in the following manifestations:
- Skin. An erythematous (bright red) and urticarial (small papules) rash appears on the skin, a feeling of irritation, tingling. Less often there is local swelling of the mucous membrane, subcutaneous tissue, increased pain, generalized itching, eczema, increased sensitivity to ultraviolet radiation.
- Digestive system. Paroxysmalpain in the abdomen and pelvis, 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, fast and increased fatigue, sleep disturbance up to its loss, psychasthenia, taste disturbance.
- Sense organs. Visible double vision, reduced visual acuity, impaired peripheral vision, tinnitus.
- The urinary system. Damage to the glomerular apparatus of the kidneys, increased protein content in the urine.
- Circulatory system. Decrease in the level of platelets, hemoglobin, leukocytes in the blood.
- Cardiovascular system. Chest pain, increased blood pressure, palpitations.
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 contributes to an increase in the pharmacological activity of the drug and facilitates penetration into the extracellular space. The instructions for use of diclofenac-based ointments indicate that the parallel use of other NSAIDs enhances its therapeutic effect.
The combined use of potassium-sparing diuretics (Triamterin, Amiloride) and NSAIDs increases the risk of increasing the level of potassium in the blood.
Diclofenac ointments reduce the diuretic effect of loop diuretics (Furosemide, Britomar, Ethacrynic acid).
Simultaneous use of ointments and other dosage formspreparations containing diclofenac, increases the level of lithium and digoxin in the blood plasma. Concurrent use of diclofenac and anticoagulants (Coumarin, Indandion, Heparin) may cause bleeding.
Alternative
NSAIDs include a large number of different means. All of them have a common pharmacological action - anti-inflammatory, analgesic, antipyretic. Besides diclofenac, the most common are acetylsalicylic acid and ibuprofen. The latter has fewer side effects compared to other NSAIDs, it is even allowed to be taken by children under one year old and pregnant women.
Ibuprofen belongs to the group of propionic acid derivatives. He, like diclofenac, is listed in the list of important drugs. Ointments based on ibuprofen are widely used. 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.
Review of ibuprofen gels
Unfortunately, due to the large number of contraindications, it is not always possible to treat pain and inflammation with diclofenac-based ointments. Analogues in such situations can be means with ibuprofen. They also effectively and quickly relieve pain and eliminate inflammation and are about the same cost.
List of the most common ibuprofen-based ointments:
- "Ibuprofen gel" - gel for n / a 5%,available in tubes of 20, 30, 50 and 100 g. The composition of the product includes ibuprofen, propylene glycol, dimexide, triethanolamine, neroli and lavender oil. Apply the ointment to the 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 contributes to the rapid relief 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 tool is available in the form of a gel and cream. The latter, in addition to anesthetic and analgesic, also has a decongestant effect. The gel can be used from the age of 12, and the ointment from the age of 14.
Reviews
NSAIDs help relieve pain. Such drugs are the most popular. The only difficulty is too much choice, because of which it is difficult to decide. Our review of ointments based on diclofenac and analogues will help to understand the choice a little.
People with chronic diseases of the musculoskeletal system, as well as athletes, say that such drugs are always in their first aid kit. Modern ointments are quickly absorbed, practically do not leave marks on clothes and are always effective.
Mothers of schoolchildren claim that diclofenac products are a real find. Moreover, unlike others, they act equally well both with fresh bruises and sprains, and with old ones.
