Neurodiclavitis - instructions for use, analogs, reviews and release forms (capsules or tablets) drugs for the treatment of arthritis, arthrosis, sciatica, lumbago in adults, children and pregnancy. Composition and alcohol

In this article, you can read the instructions for using the drug Neurodictivitis. There are reviews of visitors to the site - consumers of this medication, as well as opinions of doctors of specialists on the use of Neurodiclovitis 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 Neurodiclovitis in the presence of existing structural analogues. Use for the treatment of pain and inflammation in arthritis, arthrosis, sciatica,lumbago in adults, children, as well as during pregnancy and lactation. Composition and interaction of the drug with alcohol.

Neurodictivitis - non-steroidal anti-inflammatory drug (NSAID) in combination with Vitamins of group B. Diclofenac has anti-inflammatory, analgesic, antiplatelet and antipyretic effect. By indiscriminately inhibiting COX-1 and COX-2, it breaks the metabolism of arachidonic acid, reduces the number of prostaglandins in the inflammatory focus. In rheumatic diseases, the anti-inflammatory and analgesic effect of diclofenac significantly reduces the severity of pain, morning stiffness, swelling of the joints, which improves the functional state of the joint. In injuries, in the postoperative period, diclofenac reduces pain and inflammatory edema.

Thiamine (vitamin B1) in the human body as a result of phosphorylation processes is converted into cocarboxylase, which is the coenzyme of many enzyme reactions. Vitamin B1 plays an important role in carbohydrate, protein and fat metabolism. Actively involved in the processes of conduction of nervous excitation in the synapses.

Pyridoxine (vitamin B6) is necessary for the normal functioning of the central and peripheral nervous system. In phosphorylated form it is a coenzyme in the metabolism of amino acids (decarboxylation, reamination). Acts as a coenzyme of the most important enzymes that act in the nerve tissues. Participates in the biosynthesis of many neurotransmitters - such as dopamine, serotonin, noradrenaline, epinephrine, histamine and GABA.

Cyanocobalamin (vitamin B12) is necessary for normal hematopoiesis and ripening of red blood cells, and also participates in a number of biochemical reactions that ensure the vital activity of the organism - in the transfer of methyl groups, in the synthesis of nucleic acids, protein, in the exchange of amino acids, carbohydrates, lipids. Has a beneficial effect on the processes in the nervous system (the synthesis of nucleic acids and the lipid composition of cerebrosides and phospholipids). Coenzyme forms of cyanocobalamin - methylcobalamin and adenosylcobalamin are necessary for replication and cell growth.

The combination of B vitamins potentiates the analgesic effect of diclofenac.

Composition

Diclofenac sodium + Thiamine hydrochloride (vitamin B1) + Pyridoxine hydrochloride (vitamin B6) + Cyanocobalamin(vitamin B12) + excipients.

Pharmacokinetics

Diclofenac

Absorption of diclofenac is fast and complete. Food slows the absorption rate by 1-4 hours and reduces Cmax by 40%. The concentration in the plasma is linear depending on the amount of the dose taken. Bioavailability - 50%. Changes in the pharmacokinetics of diclofenac against the background of repeated administration are not noted, do not accumulate. Binding to plasma proteins is more than 99% (most of it is associated with albumins). Penetrates into the synovial fluid. Diclofenac is excreted in breast milk. 50% of the active substance is metabolized during the "first pass" through the liver. Metabolism occurs as a result of multiple or one-time hydroxylation and conjugation with glucuronic acid. The isozyme CYP2C9 is involved in the metabolism of the drug. The pharmacological activity of metabolites is lower than that of diclofenac. The concentration of diclofenac in the synovial fluid 4-6 hours after taking the drug is greater than in the plasma, and remains above the plasma values ​​for another 12 hours. The relationship between the concentration of the drug in the synovial fluid and the clinical efficacy of the drug has not been elucidated.65% of the administered dose is excreted as metabolites by the kidneys, less than 1% is excreted unchanged, the rest of the dose is excreted as metabolites with bile.

Vitamins B1, B6, B12

The vitamins that make up Neurodiclovitis are water-soluble, which excludes the possibility of their cumulation in the body.

Thiamin and pyridoxine are absorbed in the upper part of the small intestine, metabolized in the liver and excreted by the kidneys (about 8-10% - unchanged). The degree of absorption depends on the dose, overdose significantly increases the excretion of thiamine and pyridoxine through the intestine.

The absorption of cyanocobalamin depends to a large extent on the presence in the body of the internal factor (in the stomach and upper part of the small intestine), in the future, the delivery of the vitamin in the tissue is determined by the transport protein transcobalamin. After metabolism in the liver, cyanocobalamin is excreted mainly with bile, the degree of excretion by the kidneys is variable - from 6 to 30%.

Indications

• pain syndrome with inflammation of non-rheumatic nature (after injuries, operative and dental interventions, with gynecological diseases - primary algodismenorea, adnexitis, in inflammatory diseases of ENT organs - pharyngitis, tonsillitis, otitis);
• inflammatory and degenerative diseases of the joints and spine (chronic polyarthritis, rheumatic and rheumatoid arthritis, ankylosing spondylitis, osteoarthritis, spondylarthrosis);
• neuritis and neuralgia (cervical syndrome, lumbago, sciatica);
• acute gouty arthritis;
• rheumatic soft tissue damage.

Forms of release

Capsules with modified retard release (sometimes mistakenly called pills).

Other dosage forms, whether injected in ampoules, ointment, cream or gel, at the time of publication of the drug in the Directory did not exist.

Instructions for use and dosage

Capsules should be taken orally while eating, without chewing and drinking with a lot of liquid.

Usually appoint 1 capsule 1-3 times a day.

Adults Neurodiclavitis appoint 1 capsule: at the beginning of treatment - 3 times a day, as a maintenance dose - 1-2 times a day. The duration of therapy depends on the nature and severity of the disease.

Side effect

• epigastric pain;
• sensation of bloating;
• diarrhea, constipation;
• nausea, vomiting;
• flatulence;
• increased levels of hepatic enzymes;
• peptic ulcer with possible complications (bleeding, perforation);
• gastrointestinal bleeding;
• jaundice;
• melena;
• the appearance of blood in the feces;
• defeat of the esophagus;
• aphthous stomatitis;
• dryness of mucous membranes (including the mouth);
• hepatitis (possibly lightning fast);
• 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 systemic lupus erythematosus and other systemic diseases of connective tissue);
• convulsions;
• general weakness;
• disorientation;
• nightmarish dreams;
• a sense of fear;
• noise in ears;
• blurred vision;
• a taste disorder;
• reversible or irreversible hearing loss;
• itching;
• skin rash;
• alopecia (baldness);
• hives;
• eczema;
• toxic dermatitis;
• multi-form exudative erythema (including Stevens-Johnson syndrome);
• toxic epidermal necrolysis (Lyell's syndrome);
• increased photosensitivity;
• small-point hemorrhages;
• bullous eruptions;
• fluid retention;
• nephrotic syndrome;
• proteinuria;
• oliguria;
• hematuria (blood in the urine);
• interstitial nephritis;
• papillary necrosis;
• acute renal insufficiency;
• azotemia;
• anemia (including hemolytic and aplastic anemia), leukopenia, thrombocytopenia, eosinophilia, agranulocytosis;
• thrombocytopenic purpura;
• cough;
• bronchospasm;
• laryngeal edema;
• pneumonia;
• increased blood pressure;
• congestive heart failure;
• extrasystole;
• pain in the chest;
• myocardial infarction;
• anaphylactoid reactions;
• anaphylactic shock (usually develops rapidly);
• swelling of the lips and tongue;
• allergic vasculitis;
• deterioration of the course of infectious processes (including the development of necrotizing fasciitis).

Contraindications

• erosive and ulcerative lesions of the gastrointestinal tract (in the phase of exacerbation);
• gastrointestinal bleeding;
• intracranial hemorrhages;
• complete or partial combination of asthma, recurrent nasal polyposis mucosa and the paranasal sinuses and intolerance to acetylsalicylic acid or other NSAIDs (including history);
• disorders of hematopoiesis;
• violations of hemostasis (including hemophilia);
• inflammatory bowel disease;
• severe hepatic impairment;
• active liver disease;
• renal failure of severe degree (QC less than 30 ml / min);
• progressive kidney disease;
• severe heart failure;
• period after aortocoronary shunting;
• confirmed hyperkalemia;
• pregnancy;
• lactation period (breastfeeding);
• childhood;
• hypersensitivity to the components of the drug;
• hypersensitivity to other NSAIDs or vitamins.

Precautions: gastric ulcer and duodenal ulcer, ulcerative colitis, Crohn's disease, a history of liver disease, hepatic porphyria, chronic liver failure, chronic heart failure, arterial hypertension, a significant reduction in the bcc (including after extensive surgery), elderly patients (including receiving diuretics and debilitated patients with low body weight), bronchial asthma, simultaneous glucocorticosteroids (GCS) (including prednisone), anticoagulant yantov (including warfarin), antiplatelet agents (including acetylsalicylic acid, clopidogrel), selective serotonin reuptake inhibitors (including citalopram, fluoxetine, paroxetine, sertraline), ischemic heart disease, cerebrovascular disease, dyslipidemia / hyperlipidemia, diabetes mellitus, peripheral arterial disease,chronic renal failure (KK 30-60 ml / min), the presence of Helicobacter pylori infection, prolonged use of NSAIDs, alcoholism, severe physical illnesses, smoking.

Application in pregnancy and lactation

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

In connection with the negative effect on fertility, it is not recommended to prescribe a drug for women planning to become pregnant.

In patients with infertility (including those undergoing examination) it is recommended to cancel the drug.

Use in children

Contraindicated in childhood.

Application in elderly patients

Caution should be given to elderly patients.

special instructions

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

To reduce the risk of developing adverse events from the gastrointestinal tract, Neurodiclavitis should be applied at the lowest effective dose with the minimum possible short course.

In order to quickly achieve the desired therapeutic effect, the tablets are taken 30 minutes before meals.In other cases, take before, during or after eating, without chewing, squeezed with enough water.

Because of the important role of prostaglandins in maintaining renal blood flow, caution should be exercised in appointing patients with cardiac or renal insufficiency, as well as in the treatment of elderly patients receiving diuretics and patients who for any reason have a decrease in BCC after extensive surgery. If in such cases diclofenac is prescribed, then as a precautionary measure it is recommended to monitor the kidney function.

If the increase in hepatic transaminase activity persists or increases during the administration of the drug, if clinical signs of hepatotoxicity (including nausea, fatigue, drowsiness, diarrhea, pruritus, jaundice) are noted, treatment should be discontinued.

Diclofenac (like other NSAIDs) can cause hyperkalemia.

During the reception of the drug is not recommended the use of multivitamin complexes, which include vitamins of group B.

Impact on the ability to drive vehicles and manage mechanisms

During the treatment period, it is possible to reduce the speed of mental and motor reactions, so patients should refrain from driving transport and practicing other potentially dangerous activities that require increased concentration and speed of psychomotor reactions.

Drug Interactions

With the simultaneous use of Neurodiclavitis increases the concentration in the plasma digoxin, methotrexate, lithium and cyclosporine.

With the simultaneous use of Neurodiclavitis reduces the effect of diuretics, against the background of potassium-sparing diuretics, the risk of hyperkalemia increases.

With the simultaneous use of Neurodiclavitis and anticoagulants, thrombolytic agents (alteplase, streptokinase, urokinase), the risk of bleeding increases (more often gastrointestinal bleeding).

With the simultaneous use of Neurodiclavitis reduces the effects of hypotensive and hypnotics.

With the simultaneous use of Neurodiclavitis increases the likelihood of side effects of other NSAIDs and GCS (gastrointestinal bleeding), toxicity of Methotrexate and nephrotoxicity of cyclosporine.

Acetylsalicylic acid (Aspirin) reduces the concentration of diclofenac in the blood.

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

With the simultaneous use of Neurodiclavitis reduces the effect of hypoglycemic agents.

When used simultaneously with Neurodiclovitis, cefamandol, cefoperazone, cefotetan, valproic acid and plikamycin increase the incidence of hypoprothrombinemia.

Cyclosporine and gold preparations increase the effect of diclofenac on the synthesis of prostaglandins in the kidneys, which increases the risk of developing nephrotoxicity.

Simultaneous appointment of Neurodiclovitis with ethanol (alcohol), colchicine, corticotropin, serotonin reuptake inhibitors and St. John's wort increases the risk of developing gastrointestinal bleeding.

Diclofenac 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.

Neurodiclavitis reduces the antiparkinsonian efficacy of levodopa.

Ethanol (alcohol) dramatically reduces the absorption of thiamine (blood levels may drop by 30%).

Long-term treatment with anticonvulsant drugs can lead to a thiamine deficiency.

The use of colchicine and biguanides reduces the absorption of cyanocobalamin.

Analogues of the drug Neurodiclavitis

Structural analogues of the active substance drug Neurodiclavitis has not. The combination of active ingredients in the preparation is unique and has no analogues.

Analogues on the curative effect (means for treating sciatica):

• Alvipsal;
• Apizarthron;
• Acylpyrine;
• Bengay;
• Betalgon;
• Bralangin;
• Brufen;
• Voltaren;
• Voltaren Emulgel;
• Dexalgin;
• Diklobene;
• Diqlovit;
• Dicloran;
• Diclofenac;
• Diprospan;
• Dolgit;
• Indomethacin;
• Adhesive plaster medical Nanoplast forte;
• Maxigan;
• Nyz;
• Neuromultivitis;
• Nimesulide;
• Niflugel;
• Pliwalgin;
• Rapten Duo;
• Revalgine;
• Sanaprox;
• Spasgan;
• Spazmalgon;
• Surgham;
• The Texman;
• Tenoktil;
• Fastum gel;
• Finalgon;
• Flamadex;
• Flamax;
• Fleksen;
• Cefexon;
• Efkamon;
• Yunispaz.

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