Dexalgin - instructions for use, analogs, testimonials and release forms (tablets 25 mg, injections in ampoules for injection in solution) for the treatment of pain in arthrosis, arthritis in adults, children and pregnancy. Composition

In this article, you can read the instructions for using the drug Dexalgin. Comments of visitors of the site - consumers of this medication, as well as opinions of doctors of specialists on the use of Dexalgin in their practice are presented. 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 Dexalgin with existing structural analogues.Use for the treatment of pain in arthrosis, arthritis, osteochondrosis in adults, children, as well as during pregnancy and lactation. Composition of the preparation.

Dexalgin non-steroidal anti-inflammatory drug (NSAID). Has analgesic, anti-inflammatory and antipyretic effect. The mechanism of action is associated with inhibition of prostaglandin synthesis at the level of COX-1 and COX-2.

The analgesic effect occurs 30 minutes after parenteral administration. The duration of the analgesic effect after administration in a dose of 50 mg is 4-8 hours.

With combined therapy with opioid analgesics, Dexalgin significantly (up to 30-45%) reduces the need for opioids.

Composition

Dexketoprofenum trometamol + auxiliary substances.

Pharmacokinetics

For dexketoprofen, trometamol is characterized by a high level of binding to plasma proteins (99%). The main way of eliminating dexketoprofen is its conjugation with glucuronic acid followed by excretion by the kidneys.

Indications

• relief of pain syndrome of various genesis (including postoperative pain, pain in bone metastases, posttraumatic pain, pain in renal colic, algodismenorea, sciatica, radiculitis, neuralgia, toothache);
• symptomatic treatment of acute and chronic inflammatory, inflammatory-degenerative and metabolic diseases of the musculoskeletal system (including rheumatoid arthritis, spondylitis, arthrosis, osteochondrosis).

Forms of release

The tablets covered with a cover of 25 mg.

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

Other dosage forms, whether it be ointment, gel or cream, do not exist.

Instructions for use and dosing regimen

Pills

Install individually.

The average recommended single dose is 12.5 mg (1/2 tablet) 1 to 6 times a day every 4 to 6 hours as needed or 25 mg (1 tablet) 1 to 3 times per day every 8 hours.

The maximum daily dose is 75 mg (3 tablets).

In patients with impaired liver or kidney function, in elderly people, the drug should be taken at lower doses - not more than 50 mg per day.

The drug is not intended for long-term use: the duration of administration should not exceed 3-5 days.

Ampoules

Dexalgin is intended for intravenous and intramuscular administration.

Recommended adult dose: 50 mg every 8-12 hours.If necessary, repeated administration of the drug with a 6-hour interval is possible. The daily dose is 150 mg.

In elderly patients and patients with impaired liver and / or kidney function, the drug Dexalgin should be started with lower doses; the daily dose is 50 mg.

Dexalgin is intended for short-term (no more than 2 days) application in the period of acute pain syndrome. In the future, the patient can be transferred to analgesics for oral administration.

Rules for the preparation and administration of solutions

The contents of one ampoule (2 ml) are slowly injected deeply intramuscularly.

The contents of one ampoule (2 ml) is administered by slow intravenous injection lasting at least 15 seconds.

The contents of one ampoule (2 ml) are diluted in 30-100 ml of physiological solution, glucose solution or Ringer's solution (lactate). The solution should be prepared under aseptic conditions and always protected from daylight. The diluted solution (should be transparent) is administered by slow intravenous infusion with a duration of 10-30 minutes.

Side effect

• anemia, neutropenia, thrombocytopenia;
• headache;
• dizziness;
• insomnia;
• drowsiness;
• blurred vision;
• noise in ears;
• arterial hypotension;
• feeling of heat;
• hyperemia of the skin;
• extrasystole;
• tachycardia;
• arterial hypertension;
• peripheral edema;
• superficial thrombophlebitis;
• bronchospasm;
• nausea, vomiting;
• dyspepsia;
• diarrhea;
• constipation;
• dry mouth;
• erosive and ulcerative lesions of the digestive tract, including bleeding and perforation;
• anorexia;
• jaundice;
• polyuria;
• renal colic;
• nephritis or nephrotic syndrome;
• violation of the menstrual cycle;
• violation of the function of the prostate;
• muscular spasm;
• difficulty in movement in the joints;
• dermatitis;
• rash;
• sweating;
• acne;
• photosensitization;
• hives;
• severe skin reactions (Stevens-Johnson syndrome, Lyell's syndrome);
• angioedema;
• allergic dermatitis;
• ketonuria;
• proteinuria;
• pain at the injection site;
• inflammatory reaction, hematoma, hemorrhages at the injection site;
• feeling of heat;
• chills;
• fatigue;
• backache;
• fainting;
• fever;
• anaphylactic shock;
• swelling of the face;
• aseptic meningitis, which occurs predominantly in patients with systemic lupus erythematosus or mixed connective tissue diseases;
• hematological disorders (purpura, aplastic and hemolytic anemia, rarely - agranulocytosis and bone marrow hypoplasia).

Contraindications

• peptic ulcer of the stomach and duodenum;
• gastrointestinal hemorrhages in anamnesis, other active bleeding (including suspicion of intracranial bleeding), anticoagulant therapy;
• gastrointestinal diseases (Crohn's disease, ulcerative colitis);
• severe violations of the liver (10-15 points on the scale Child-Pugh);
• severe renal dysfunction (CK <50 mL / min);
• bronchial asthma (including in the anamnesis);
• severe heart failure;
• treatment of pain syndrome in aortocoronary shunting;
• hemorrhagic diathesis or other coagulation disorders;
• childhood;
• hypersensitivity to dexketoprofen or other NSAIDs or to any of the excipients that make up the drug;
• contraindicated for epidural, intrathecal or intraluminal administration due to the ethanol included in the formulation.

Application in pregnancy and lactation

The use of the drug Dexalgin during pregnancy and during lactation is contraindicated.

Use in children

Contraindication: children's age.

special instructions

In patients with disorders of the digestive system or gastrointestinal diseases in a history, continuous monitoring is necessary. In the event of gastrointestinal bleeding or ulcerative lesions, Dexalgin should be discontinued.

Because all non-steroidal anti-inflammatory drugs (NSAIDs) can inhibit platelet aggregation and increase bleeding time due to a delay in the synthesis of prostaglandins. In controlled clinical trials, the simultaneous administration of dexketoprofen trometamol and low-molecular-weight Heparin preparations in prophylactic doses in the postoperative period was studied. No effect on coagulation parameters was observed. Nevertheless, with the simultaneous appointment of the drug Dexalgin with other drugs that affect blood clotting, careful medical control is necessary.

Like other NSAIDs, Dexalgin may lead to an increase in the level of creatinine and Nitrogen in the blood plasma. Like other inhibitors of prostaglandin synthesis,Dexalgin may have a side effect on the urinary system, which can lead to the development of glomerulonephritis, interstitial nephritis, papillary necrosis, nephrotic syndrome and acute renal failure.

Against the background of therapy with Dexalgin, as with other NSAIDs, there may be a slight transient increase in some hepatic parameters, as well as a significant increase in the level of AST and ALT in the blood serum. At the same time, control of liver and kidney functions is necessary in elderly patients. In the case of a significant increase in the corresponding indicators, Dexalgin should be abolished.

Like other NSAIDs, dexketoprofen trometamol can mask the symptoms of infectious diseases. In case of symptoms of bacterial infection or worsening of well-being on the background of therapy with Dexalgin, the patient should inform the doctor about it.

In each ampoule of the drug Dexalgin contains 200 mg of ethanol (alcohol).

Impact on the ability to drive vehicles and manage mechanisms

In connection with the possible dizziness and drowsiness on the background of treatment with the drug Dexalgin, a decrease in the ability to concentrate and speed of psychomotor reactions is possible.

Drug Interactions

The following drug interaction is characteristic of all non-steroidal anti-inflammatory drugs (NSAIDs), including Dexalgin.

Unwanted combinations

Simultaneous administration of several NSAIDs, including salicylates in high doses (more than 3 g per day) increases the risk of gastrointestinal bleeding and ulcers due to synergistic action.

With simultaneous use with oral anticoagulants, heparin at doses exceeding preventive, and ticlopidine increases the risk of bleeding due to inhibition of platelet aggregation and damage to the gastrointestinal mucosa.

NSAIDs increase the concentration of lithium in the blood plasma, down to toxic, and therefore this indicator should be monitored when appointing, changing the dose and after the abolition of NSAIDs.

When used with Methotrexate in high doses (15 mg per week or more), the hematological toxicity of methotrexate is increased due to a decrease in its renal clearance against the background of therapy with NSAIDs.

At simultaneous application with hydantoins and Sulfanilamide preparations there is a risk of intensifying the toxic effect of these drugs.

Combinations that require caution

If simultaneous use with diuretics, ACE inhibitors is necessary, it should be taken into account that NSAID therapy is associated with the risk of acute renal failure in patients with dehydration (reduced glomerular filtration due to oppression of prostaglandin synthesis). NSAIDs can reduce the hypotensive effect of certain drugs. With simultaneous appointment with diuretics, it is necessary to make sure that the patient's water balance is adequate, and to monitor the kidney function before prescribing NSAIDs.

When used simultaneously with methotrexate in low doses (less than 15 mg per week), it is possible to increase the hematological toxicity of methotrexate due to a decrease in its renal clearance against the background of therapy with NSAIDs. It is necessary to monitor the number of blood cells weekly in the first weeks of simultaneous therapy. In the presence of a violation of kidney function, even in an easy degree, as well as in the elderly, careful medical supervision is necessary.

With simultaneous use with pentoksifillinom increases the risk of bleeding. It requires intensive clinical monitoring and frequent monitoring of bleeding time (blood clotting time).

With simultaneous use with zidovudine, there is a risk of increasing the toxic effect on red blood cells caused by exposure to reticulocytes, with the development of severe anemia a week after the appointment of NSAIDs. It is necessary to control all blood cells and reticulocytes 1-2 weeks after the initiation of therapy with NSAIDs.

It is possible to increase the hypoglycemic effect of sulfonylurea derivatives due to its displacement from the binding sites to plasma proteins under the influence of NSAIDs.

With the simultaneous use of low-molecular weight heparin with drugs, the risk of bleeding increases.

Combinations that need to be taken into account

NSAIDs can reduce the hypotensive effect of beta-blockers, which is due to inhibition of the synthesis of prostaglandins.

When used simultaneously with cyclosporine and tacrolimus, NSAIDs can enhance nephrotoxicity, which is mediated by the action of renal prostaglandins. During the combination therapy it is necessary to monitor the kidney function.

With concomitant administration with thrombolytics, the risk of bleeding increases.

With simultaneous application with probenecid, an increase in plasma NSAID concentrations is possible, which may be due to inhibition of renal secretion and / or conjugation with glucuronic acid. This requires correction of the dose of NSAIDs.

NSAIDs can cause an increase in the concentration of cardiac glycosides in blood plasma.

In connection with the theoretical risk of changing the effectiveness of Mifepristone under the influence of inhibitors of prostaglandin synthesis, NSAIDs should not be prescribed earlier than 8-12 days after the withdrawal of mifepristone.

The data obtained in experimental studies on animals indicate a high risk of convulsions in the appointment of NSAIDs with Ciprofloxacin in high doses.

Pharmaceutical interaction

Dexalgin should not be mixed in the same syringe with a solution of dopamine, promethazine, pentazocine, pethidine or hydroxysin (a precipitate is formed).

Dexalgin can be mixed in a single syringe with a solution of heparin, lidocaine, morphine and theophylline.

Diluted solution of the drug Dexalgin for infusion should not be mixed with promethazine or pentazocine.

The diluted solution of the drug Dexalgin for infusion is compatible with the following solutions for injection: dopamine, heparin, hydroxyzine, lidocaine, morphine, pethidine and theophylline.

When diluted solutions of Dexalgin are stored for infusions in plastic containers or when infusion systems made of ethyl vinyl acetate, cellulose propionate, low density polyethylene or polyvinyl chloride are used, no absorption of the active ingredient by the listed materials occurs.

Analogues of the drug Dexalgin

Dexalgin does not have structural analogs for the active substance.

Analogues for the pharmacological group (non-steroidal anti-inflammatory drugs - derivatives of propionic acid):

• Advance;
• Ultrazir Ultra;
• Apranaks;
• Arthrosylen;
• Artrum;
• Bonifen;
• Brufen;
• Brufen retard;
• Burana;
• Bystrumgel;
• Bystrumcaps;
• Deblock;
• Children's Motrin;
• Dolgit;
• Ibuprom;
• Ibuprom Max;
• Ibuprom Sprint Caps;
• Ibuprofen;
• Ibusan;
• Ibutop gel;
• Ibufen;
• Iprene;
• Ketonal;
• Ketonal Duo;
• Ketoprofen;
• Ketosphere;
• MIG 200;
• MIG 400;
• Nalgezin;
• Nalgezin forte;
• Nalfon;
• Naprios;
• Naprobeene;
• Naproxen;
• Nurofen;
• Nurofen for children;
• Nurofen fort;
• Nurofen Express;
• Oruvel;
• Pedee;
• Pronaxen;
• Profenide;
• Rakstan Sanovel;
• Sanaprox;
• Solpaflex;
• Strepsils Intensive;
• Surgham;
• Faspik;
• Fastum;
• Fastum gel;
• Febrofide;
• Flamax forte;
• Flamax;
• Fleksen;
• Flugalin.

Similar medicines:

Other medicines: