Diklak - instructions for use, reviews, analogs and formulations (tablets 75 mg and 150 mg, 5% gel and 1% lipogel or ointment, rectal 50 mg and 100 mg, injections in ampoules) for the treatment of arthritis in adults, children and in pregnancy

In this article, you can read the instructions for using the drug Diklak. There are reviews of visitors to the site - consumers of this medication, as well as opinions of doctors of specialists on the use of Diklak in their practice. A big request is to actively add their feedback on the drug: the medicine helped or did not help get rid of the disease, which were observed complications and side effects, possibly not declared by the manufacturer in the annotation. Analogues of Diklak in the presence of existing structural analogs. Use for the treatment of arthritis, arthrosis and other inflammatory phenomena in joints in adults, children, as well as during pregnancy and lactation. Composition of the preparation.

Diklak - non-steroidal anti-inflammatory drug (NSAID), a derivative of phenylacetic acid. Has a pronounced anti-inflammatory, analgesic and moderate antipyretic effect. The mechanism of action is associated with oppression of the activity of COX, the main enzyme of arachidonic acid metabolism, which is the precursor of prostaglandins, which play a major role in the pathogenesis of inflammation, pain and fever. The analgesic effect is due to two mechanisms: peripheral (indirectly, through suppression of prostaglandin synthesis) and central (by inhibiting the synthesis of prostaglandins in the central and peripheral nervous system).

Inhibits the synthesis of proteoglycan in the cartilage.

When rheumatic diseases reduces pain in joints at rest and during movement, as well as morning stiffness and swelling of the joints, contributes to an increase in the volume of movements. Reduces post-traumatic and post-operative pain, as well as inflammatory edema.

Suppresses the aggregation of platelets. With long-term use has a desensitizing effect.

With topical application in ophthalmology reduces edema and pain in inflammatory processes of non-infectiousetiology.

Composition

Diclofenac sodium + auxiliary substances.

Pharmacokinetics

After oral administration, it is absorbed from the digestive tract. The intake of food slows the rate of absorption, the degree of absorption does not change. About 50% of the active substance is metabolized by the "first pass" through the liver. With rectal administration, absorption is slower. The concentration of the active substance in the plasma is in linear dependence on the amount of the applied dose. Do not cumulate. Binding to plasma proteins is 99.7% (mainly with albumin). Penetrates into the synovial fluid. It is metabolized to a great extent with the formation of several metabolites, among which two are pharmacologically active, but to a lesser extent than diclofenac. Approximately 60% of the dose is excreted as metabolites kidneys, less than 1% is excreted in the urine in an unmodified form, the remaining part is output as metabolites in the bile.

Indications

• diseases of the musculoskeletal system (rheumatoid arthritis, psoriatic, juvenile chronic arthritis, ankylosing spondylitis, gouty arthritis, rheumatic soft tissue, osteoarthritis peripheral joints and spine, including with radicular syndrome, tenosynovitis, bursitis);
• pain syndrome of mild or moderate intensity: neuralgia, myalgia, lumboschialgia, posttraumatic pain syndrome accompanied by inflammation, postoperative pain, headache, migraine, algodismenorea, adnexitis, proctitis, toothache;
• in the complex therapy of infectious and inflammatory diseases of the ear, throat, nose with severe pain syndrome (pharyngitis, tonsillitis, otitis);
• febrile syndrome.

For topical application

• inhibition of miosis during surgery for cataracts
• prevention of cystoid macular edema associated with removal and implantation of the lens
• inflammatory processes of the eye of non-infectious nature
• posttraumatic inflammatory process with penetrating and non-penetrating injuries of the eyeball.

Forms of release

Gel for external use 5% (sometimes mistakenly called ointment or cream).

Gel for external use 1% Lipogel.

Long-acting tablets 75 mg and 150 mg.

Candles for rectal use 50 mg and 100 mg.

Solution for intramuscular injection (injections in ampoules for injection).

Instructions for use and dosage

Pills

The drug is used inside, not liquid, squeezed with a small amount of water, usually during or after a meal.

Assign 75 mg (1 tablet) 1-2 times a day or 150 mg (1 tablet) 1 time per day. The maximum daily dose of the drug is 150 mg.

Gel

For oral administration for adults, a single dose is 25-50 mg 2-3 times a day. Frequency depends on the dosage form used, the severity of the disease and is 1-3 times a day, rectally - once a day.

For children over 6 years and adolescents, the daily dose is 2 mg / kg.

External apply in a dose of 2-4 g (depending on the area of ​​the painful area) to the affected area 3-4 times a day.

When used in ophthalmology, the frequency and duration of administration are determined individually.

Ampoules

Driving intramuscularly deep. Single dose - 75 mg (1 ampoule). If necessary, repeated administration, but not earlier than 12 hours. Duration of application - no more than 2 days. If it is necessary to continue therapy, Diclofenac is used rectally in the form of suppositories or in a dosage form for oral administration.

Rectal Candles

Before using the suppository it is recommended to empty the intestine.

Suppositories 50 mg: adults and adolescents aged 15 years are prescribed 1 suppository 2-3 times a day.

Suppositories 100 mg: adults are prescribed 1 suppository once a day.

The maximum daily dose is 150 mg. When rectal administration simultaneously with diclofenac for oral administration, it is more rational to use suppositories once for 50-100 mg per night (in this case, the evening intake of oral forms of diclofenac is excluded).

Duration of application - no more than 7 days.

Side effect

• abdominal pain;
• sensation of bloating;
• diarrhea, constipation;
• nausea, vomiting;
• flatulence;
• peptic ulcer with possible complications (bleeding, perforation);
• gastrointestinal bleeding;
• jaundice;
• the appearance of blood in the feces;
• defeat of the esophagus;
• aphthous stomatitis;
• dry mouth and mucous membranes;
• hepatitis (possibly fulminant flow);
• necrosis of the liver;
• cirrhosis;
• hepatorenal syndrome;
• change in appetite;
• pancreatitis;
• cholecystopancreatitis;
• colitis;
• headache;
• dizziness;
• sleep disturbance;
• drowsiness;
• depression;
• irritability;
• aseptic meningitis (more often in patients with SLE and other systemic diseases of connective tissue);
• convulsions;
• weakness;
• disorientation;
• nightmarish dreams;
• a sense of fear;
• noise in ears;
• diplopia;
• a taste disorder;
• reversible or irreversible hearing loss;
• itching;
• skin rash;
• alopecia;
• hives;
• eczema;
• toxic dermatitis;
• photosensitization;
• small-point hemorrhages;
• fluid retention;
• nephrotic syndrome;
• proteinuria, oliguria, hematuria;
• interstitial nephritis;
• papillary necrosis;
• acute renal insufficiency;
• anemia (including hemolytic and aplastic anemia), leukopenia, thrombocytopenia, eosinophilia, agranulocytosis;
• cough;
• bronchospasm;
• laryngeal edema;
• increased blood pressure;
• congestive heart failure;
• extrasystole;
• pain in the chest;
• anaphylactoid reactions;
• anaphylactic shock (usually develops rapidly);
• swelling of the lips and tongue;
• allergic vasculitis;
• multi-form exudative erythema, incl. Stevens-Johnson syndrome;
• toxic epidermal necrolysis (Lyell's syndrome);
• deterioration of the course of infectious processes (development of necrotizing fasciitis).

Contraindications

• erosive and ulcerative lesions of the gastrointestinal tract (in the phase of exacerbation);
• bleeding from the digestive tract;
• "aspirin" asthma;
• disorders of hematopoiesis;
• violations of hemostasis (including hemophilia);
• children and adolescents under 18 years (tablets, injections);
• children under 6 years (gel Lipogel);
• pregnancy;
• lactation period (breastfeeding);
• hypersensitivity to the components of the drug;
• hypersensitivity to other NSAIDs.

Application in pregnancy and lactation

The drug Diklak is contraindicated in pregnancy and lactation (breastfeeding).

Use in children

Gel Lipogel is not recommended for use in children under the age of 6 years.

Tablets, injections and candles are contraindicated for children and adolescents under the age of 18 years.

Application in elderly patients

With caution should be used in elderly patients.

special instructions

During the period of treatment should be a systematic control of the picture of peripheral blood, liver function, kidneys, examination of feces for the presence of blood.

With special care apply for diseases of the liver, kidneys, gastrointestinal tract in history, dyspeptic phenomena, bronchial asthma, arterial hypertension, heart failure, immediately after serious surgical interventions, as well as in elderly patients.

When taking the drug should be excluded from drinking alcohol.

Impact on the ability to drive vehicles and manage mechanisms

Patients taking the drug should refrain from activities that require increased concentration of attention and rapid psychomotor reactions.

Drug Interactions

Increases the concentration in the plasma digoxin, methotrexate, lithium and cyclosporine.

Reduces the effect of diuretics, against the background of potassium-sparing diuretics increases the risk of hyperkalemia; against the background of anticoagulants, thrombolytic agents (alteplase, streptokinase, urokinase) - the risk of bleeding (more often from the gastrointestinal tract).

Reduces the effects of hypotensive and hypnotics.

Increases the likelihood of side effects of other NSAIDs and glucocorticosteroids (GCS) (bleeding from the gastrointestinal tract), toxicity of Methotrexate and nephrotoxicity of cyclosporine.

Acetylsalicylic acid or Aspirin reduces the concentration of diclofenac in the blood.

Simultaneous use with Paracetamol increases the risk of developing nephrotoxic effects of diclofenac.

Reduces the effectiveness of hypoglycemic agents.

Cefamandol, cefoperazone, cefotetan, valproic acid and plikamycin increase the incidence of hypoprothrombinemia.

Cyclosporine and gold preparations strengthen Dicklac's influence on the synthesis of prostaglandins in the kidneys, which increases nephrotoxicity.

Simultaneous administration with ethanol (alcohol), colchicine, corticotropin and preparations of St. John's wort increases the risk of bleeding from the digestive tract.

Diklak enhances the effect of drugs that cause photosensitivity.

Drugs that block tubular secretion, increase the concentration in the plasma of diclofenac, thereby increasing its toxicity.

Analogues of the drug Diklak

Structural analogs for the active substance:

• Artrex;
• Beliefed;
• Voltaren;
• Voltaren Emulgel;
• Diklak Lipogel;
• Diklo F;
• Diklobene;
• Dicluberl;
• Diqlovit;
• Diklogen;
• Diclomax;
• Diclomelan;
• Diclonac;
• Diclonat P;
• Dicloran;
• Diclorium;
• Diclofen;
• Diclofenac;
• Diclofenac sodium;
• Diclofenaclong;
• Diclofenacol;
• Diphene;
• Dorosan;
• Naklof;
• Naklofen;
• Orthophene;
• Orthofer;
• Orthoflex;
• Rapent;
• Revmavek;
• Redwood retard;
• Remetan;
• Sanfinak;
• SwissSet;
• Feloran;
• Feloran retard;
• Flotac.

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