Diclofenac is a popular drug. It has an analgesic, anti-inflammatory and antipyretic effect. Instructions for use for "Diclofenac" will be presented in this article. We will also consider analogues of the drug.
Dosage forms and composition of the drug
The drug is found in several dosage forms. There are:
- Pills are round, biconvex, enteric-coated. The color of the tablets is from orange to yellow-orange. They are produced 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, tablets are produced in dark glass jars of 30 pieces.
- Clear solution for intramuscular injections. The color of the solution is colorless to pale yellow. The solution has a slight characteristic odor of benzene alcohol. Produced in ampoules, 3 ml in each of 5 ampoules per pack, 2 packs in a carton pack. What other form of release of "Diclofenac" exists?
- Gel for external use. There is one and five percent, white (creamy or yellowish tint is allowed), with a characteristic odor. Produced in aluminum tubes, 30 and 50 g.
- Ointment for external use of white color with a slight specific odor. Sold in packs of one aluminum tube of 30 g of ointment.
- Candles "Diclofenac". Often used in gynecology. They have a torpedo shape, color - from white to white with a creamy tint. Sold in cardboard packs of 2 blister packs, each of which contains 5 suppositories.
- Eye drops 0.1%, which are a clear solution similar to an intramuscular solution. Produced in plastic dropper bottles of 5 ml. We examined the release forms of Diclofenac. They are selected according to the symptoms.
The main active ingredient of the drug is diclofenac sodium in various quantities. One tablet and one milliliter of solution for injection contains 25 mg of the 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" contains 100 mg of the active ingredient. As part of 1 ml of eye drops - 1 mg of diclofenac sodium.
Auxiliary components of the drug differ 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, tropeolin dye 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 performed by hydrochloric acid, polyethoxylated castor oil (macrogol glyceryl ricinoleate), trometamol, benzalkonium chloride, disodium dihydrate, purified water.
When is the drug used?
According to the instructions for use, "Diclofenac" is used only as a symptomatic therapy, since it does not have any effect on the course of the pathological process. The tool is perfect for stopping the inflammatory process and reducing pain. Specific indications for Diclofenac differ for different forms.
Pills and rectal suppositories can be used for diseases such as:
- Pain syndrome, which is pronounced in oncology.
- Teethaches and headaches, including those caused by migraines.
- Lumbago (acute pain in the lumbar region).
- Sciatica (pain caused by irritation of the sciatic nerve).
- Sciatica.
- Muscle pain (myalgia).
- Bone pain (ossalgia).
- Pain in the joints (arthralgia).
- Neuralgia (peripheral nerve damage).
- Pain syndrome that occurs after injuries or surgery and is accompanied by an inflammatory process.
- ODE diseases of inflammatory and degenerative nature.
- Pelvic inflammatory disease.
- 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" from pain in the joints helps very well and quickly. The result will not keep you waiting.
Intramuscularly, the agent is prescribed for the purpose of short-term therapy for pain syndrome of various genesis of moderate intensity. In fact, the indications are the same as for Diclofenac tablets and suppositories - various diseases of the musculoskeletal system, inflammation in the pelvic area, pain in muscles, joints, bones, peripheral nerves, postoperative and post-traumatic pain.
Gel and ointment are used externally to relieve muscle pain of rheumatic and non-rheumatic genesis, with soft tissue injuries of rheumatic and traumaticnature, ODA diseases, including osteoarthritis and various arthritis.
What other indications does Diclofenac have?
Eye drops are effective in the treatment of non-infectious inflammations, including corneal erosion, inflammation of the conjunctiva and cornea caused by trauma or surgery, conjunctivitis, keratoconjunctivitis and some other eye diseases.
Let's also consider the contraindications of Diclofenac.
Contraindications to the use of the remedy
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 should not be used for:
- Bronchial asthma and proliferation of mucous tissues of the nose and paranasal sinuses, combined with individual intolerance to NSAIDs, including acetylsalicylic acid.
- Bleeding in the digestive tract.
- Inflammatory process in the intestines.
- Ulcer and erosion in the stomach or duodenum.
- Severe kidney and liver failure.
- Kidney and liver problems.
- Severe hyperkalemia.
- Acute and chronic heart failure.
- Children and adolescents (less than 6 years old for tablets, under 14 (sometimes 18) years old for rectal suppositories).
- Late pregnancy (third trimester).
- Lactation period.
- Increased individual sensitivity and intolerance to active or auxiliarycomponents 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, weakened immune systems, suffering from stomach or intestinal ulcers, 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 a number of infectious diseases and the simultaneous use of the drug with anticoagulants, glucocorticosteroids, antiplatelet agents, non-steroidal anti-inflammatory drugs.
All this is described in the instructions for use for Diclofenac.
Solution for intramuscular injection is not prescribed for:
- Erosive and ulcerative diseases of the digestive tract in acute form.
- Impaired hematopoiesis.
- Carrying and breastfeeding.
- Children and adolescents under 15 years of age.
- Individual hypersensitivity to the components of the drug.
As with the use of tablets and suppositories, care should be taken when using the solution"Diclofenac" for heart, liver and kidney failure, as well as in old 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 lactation, in children under 6 years of age, with intolerance and increased individual sensitivity to the components of the drug and NSAIDs.
These forms of "Diclofenac" for back pain and other types of pain are used with extreme caution in the same cases as the solution, tablets and suppositories, that is, with bronchial asthma, renal, hepatic or heart failure, dysfunction kidneys and liver, the elderly, as well as before the third trimester of pregnancy and with any pathologies of blood clotting.
The main contraindication for the use of eye drops is severe individual hypersensitivity to the components of the product.
Caution is needed when using eye drops in children, pregnant women, the elderly, patients with bronchial asthma, bleeding disorders.
Method of application and dosage of different forms of medication
Diclofenac tablets are taken orally, without crushing, with a sufficient amount of liquid (preferably clean water). For the best therapeutic effect, it is recommended to take the medicine half an hour before a meal, but it is allowed to take tablets before meals, during and after. For patients over 15 years of age, a single dose of the drugis 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 the patient's condition improves, 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 of age, 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 weighing 25-37 kg, take one tablet 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.
Diclofenac solution is injected deep intramuscularly. The dosage per dose for an adult patient is 75 mg. Repeated injection, if necessary, is allowed no earlier than twelve hours later. The duration of treatment with this form of the drug should not be more than two days. After that, you should switch to the oral form.
Suppositories for rectal administration are used at 100-150 mg per day, divided into 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 dailythe dosage of the drug is 50-100 mg, and if necessary, gradually, over several menstrual cycles, increases to 150 mg. With migraine symptoms, suppositories are used at 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 exceed 150 mg for several injections. Patients under 14 years of age are recommended to use 1 suppository of 50 mg maximum twice a day.
For topical application "Diclofenac" for osteochondrosis, for example, is applied to the skin, rubbing 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 of age. When used in children from 6 to 12 years old, it is not recommended to apply more than 2 g of the drug 2 times a day. The course of treatment with Diclofenac is determined by the doctor individually.
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 throughout the entire period of treatment. If the drug is used regardless of the operation, then, as a rule, 4-5 applications per day, 1 drop, are prescribed. 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. According to the doctor's prescription, therapy can be extended fora few weeks.
Is Diclofenac allowed while breastfeeding? More on that later.
Medication side effects
The drug in tablets causes a large number of different side effects:
- Nervous system - headache and dizziness, insomnia, nightmares, drowsiness, fatigue, irritability, depression, aseptic meningitis, convulsions, feelings of anxiety or fear, disorientation.
- Digestive tract - diarrhea, constipation, nausea, vomiting, pain, abdominal cramps and bloating, flatulence, ulcerative bleeding of the gastrointestinal tract, peptic ulcer, esophageal lesions, jaundice, blood in the stool, hepatitis, cholecystopancreatitis, dry mucous membranes, appetite disorders, necrosis, liver cirrhosis, colitis, pancreatitis.
- Respiratory organs - bronchospasm, laryngeal edema, cough, pneumonitis.
- Heart and blood vessels - chest pain, arterial hypertension, heart failure.
- Urinary system - manifestations of urinary retention, oliguria, nephrotic syndrome, interstitial nephritis, hematuria, acute renal failure, papillary necrosis.
- Skin - skin rashes and itching, urticaria, toxic dermatitis, epidermal necrosis, alopecia, eczema, increased photosensitivity.
- Sense organs - signs of diplopia, blurred vision, tinnitus, taste distortion, hearing loss (including irreversible).
- Hematopoietic organs and the immune system - variousforms of anemia, leukopenia, thrombocytopenia, eosinophelia, 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.
Solution for intramuscular injection and rectal suppositories can cause similar side effects. In the area of intramuscular injection, local reactions are possible, for example, burning, aseptic necrosis, necrosis of adipose tissue. The use of suppositories rarely leads to edema.
Ointment and gel almost never cause adverse reactions, however, local manifestations in the form of itching, burning, redness and rash are possible.
Diclofenac suppositories in gynecology can cause unwanted local manifestations.
Eye drops cause adverse reactions from various organ systems, among which vomiting, nausea, local allergic reactions, blurred vision, burning eyes, clouding of the cornea, swelling of the face, skin rashes, fever, chills.
Drug Interactions
Before using any form of "Diclofenac" with other drugs, you should consult a specialist to avoid possible unwanted effects.
The use of "Diclofenac" during pregnancy and lactation
Any dosage forms during the period of expectation of a child and breastfeeding can be used only as directed by a doctor and only if the expectedthe benefit to the mother outweighs the risk to the unborn child.
It is not recommended to use the remedy for women during pregnancy planning or problems with fertilization.
In addition to the fact that Diclofenac cannot be used during pregnancy, there are other restrictions.
Alcohol Compatibility
"Diclofenac", like any NSAIDs, can not be combined with alcoholic beverages. If this recommendation is not followed, liver dysfunction, a decrease in the therapeutic effect of the drug, an increase in the side effect of the drug, and serious complications from the central nervous system are possible.
Below, consider the best analogues of Diclofenac.
Drug analogues
The drug has many analogues in various dosage forms. For example, tablets and solution can be replaced with Bioran, Diklak, Voltaren, Adolor, Diclogen. An action similar to the effect of Diclofenac ointment and gel is possessed by Nise, Febrofid, Fastum Gel, Ketoprofen, Finalgel, Finalgon, Bystrumgel, Voltaren Emulgel. Analogues of eye drops are Voltaren Ofta, Uniklofen, Akyular LS, Broksinak, Diclofenaklong, Diclo-F, Nevanak.
The best analogues of "Diclofenac" will be able to pick up a doctor.
Without a doctor's prescription, only dosage forms intended for external use can be purchased.
Conclusions on the article
"Diclofenac" is an effective drug that has analgesic, antipyretic andanti-inflammatory action. The agent enters the pharmacological market in various dosage forms: solution for intramuscular injections, eye drops, tablets, rectal suppositories, gel and ointment. The active ingredient is diclofenac sodium, the content of which depends on the dosage form.
The tool has a wide spectrum of action. Diclofenac treatment is effective for severe pain caused by oncological diseases, headaches and toothaches, pain in muscles, joints, bones, various problems of ODS, neuralgia, post-traumatic and postoperative pain syndrome.
At the same time, the drug has a number of serious contraindications and adverse reactions, which significantly limit the scope of the drug. It is not recommended to use Diclofenac in any form without first consulting a doctor.
