Diclofenac (Atc Code S01BC03)

When ATH:
S01BC03

Characteristic.

Crystalline powder of yellowish-white to light beige. It is soluble in methanol, soluble in ethanol, practically insoluble in chloroform, Potassium salt is soluble in water.

Pharmacological action.
Anti-inflammatory, analgesic, pyretic, antirheumatic, antiagregatine.

Application.

Inflammatory joint disease (rheumatoid arthritis, rheumatism, ankiloziruyushtiy spondylitis, chronic gouty arthritis), degenerative diseases (deforming osteoarthritis, osteochondrosis), lyumbago, sciatica, neuralgia, myalgia, extra-articular tissues diseases (tendinitis, ʙursit, rheumatic soft tissue), posttraumatic pain syndromes, accompanied by inflammation, post-operative pain, acute attack of gout, Primary disalgomenoreya, adnexitis, migraine attacks, počečnaâ and how pečenočnaâ, infection of upper respiratory tract, residual effects of pneumonia. Locally - Tendon injury, ligaments, muscles and joints (for the relief of pain and inflammation in sprains, dislocation, uşiʙax), localized forms of soft tissue rheumatism (elimination of pain and inflammation). In ophthalmology - A non-infectious conjunctivitis, Post-traumatic inflammation after penetrating and non-penetrating wounds of the eyeball, pain in applying excimer laser, during implantation and removal operations of the lens (to- and prevention of post-operative miosis, cystoid edema of the optic nerve).

Contraindications.

Hypersensitivity (incl. to other NSAIDs), hemodyscrasia unspecified etiology, peptic ulcer, destructive and inflammatory bowel disease in the acute phase, "Aspirin" asthma, childhood (to 6 years), the last trimester of pregnancy.

Restrictions apply.

Violation of the liver and kidneys, heart failure, porphyria, Job, requires more attention, pregnancy, lactation.

Side effects.

Gastrointestinal disorders (nausea, vomiting, anorexia, flatulence, constipation, diarrhea), NSAID-gastropathy (defeat antral mucosa in the form of erythema, hemorrhage, erosions and ulcers), Acute medical erosions and ulcers, etc.. GI, gastrointestinal bleeding, abnormal liver function, elevated transaminase levels in the serum, drug-induced hepatitis, pancreatitis, interstitial nephritis (seldom-nephrotic syndrome, papillary necrosis, acute renal failure), headache, staggering when walking, dizziness, excitation, insomnia, irritability, fatiguability, swelling, aseptic meningitis, eosinophilic pneumonia, Local allergic reactions (rash, erosion, эritema, eczema, izayazvlenie), erythema multiforme, Syndrome Stevens - Johnson, Lyell's syndrome, erythroderma, bronchospasm, systemic anaphylactic reactions (including shock), hair loss, photosensitivity, purpura, violation of hematopoiesis (anemia-hemolytic and aplastic, leykopeniya vploty to agranulocytosis, thrombocytopenia), cardiovascular disorders (increased blood pressure), sensory disturbances and vision, convulsions.

When the/m introduction-burning, Education infiltration, abscess, necrosis of adipose tissue.

When applying the candles — local irritation, mucus mixed with blood, pain during bowel movements.

When applied topically is itching, эritema, rashes, burning, also may develop systemic side effects.

Cooperation.

It increases blood concentration of lithium, digoksina, anticoagulants, oral antidiabetic drugs (possible both hypo-, and hyperglycemia), quinolone derivatives. It increases the toxicity of methotrexate, cyclosporine, the likelihood of side effects of glucocorticoids (gastrointestinal bleeding), the risk of hyperkalemia on the background of potassium-sparing diuretics, reduces the effect of diuretics. The plasma concentration is reduced by application of acetylsalicylic acid.

Overdose.

Symptoms: dizziness, headache, hyperventilation, dizziness, children — mioclauniceskie convulsions, gastrointestinal disorders (nausea, vomiting, abdominal pain, bleeding), disorders of the liver and kidneys.

Treatment: gastric lavage, administration of activated charcoal, simptomaticheskaya therapy, aimed at addressing the increasing blood pressure, renal dysfunction, seizures, irritation of the gastrointestinal tract, respiratory depression. Forced diuresis, hemodialysis maloeffyektivny.

Dosing and Administration.

The mode set individually, taking into account the indications and severity of the condition. Inside, / m, I /, rectally, locally (fur gloves, instillation in the conjunctival sac). The maximum single dose 100 mg.

Inside: adults-to 75-150 mg/day in a few receptions; retard form — 1 once a day (if necessary - up 200 mg / day). Upon reaching the clinical effect a dose reduce to the minimum maintenance. For children 6 years and older and adolescents appoint only tablets normal duration of calculation 2 mg / kg / day.

As initial therapy (e.g. postoperatively, in acute conditions) / m or I /. / M - 75 mg / day (in severe cases, 75 mg 2 twice a day with a break of a few hours) for 1-5 days. Later moving to pills or suppositories.

Rectal: by 50 mg 1-2 times a day.

Fur gloves: gently rubbing the skin 2-4 g of gel or ointment 2-4 times a day; after application is necessary to wash your hands.

Instillyatsionno: instilled into the conjunctival sac 1 drop 5 times during 3 hours before the operation, immediately after the operation is on 1 drop 3 times, then - 1 drop 3-5 times per day for the time required for treatment; other testimony 1 drop 4-5 times a day.

Precautions.

Prolonged treatment is necessary to periodically study blood counts and liver function, fecal occult blood test. First 6 months of pregnancy should be used under strict indications and in the smallest dosage. Because of a possible reduction in the rate of reaction is not recommended driving and using machinery. Do not apply to damaged or exposed skin, in conjunction with occlusive dressing; You can not avoid contact with eyes and mucous.

Cooperation