Dicloberl

Dicloberl is a medication from the NSAID subgroup, a derivative of α-toluic acid.

The active ingredient of the therapeutic agent is diclofenac Na. The medicine has an intense anti-inflammatory effect, slowing down the processes of binding of PG components. At the same time, it has analgesic, antipyretic and anti-edematous (in case of tissue swelling during inflammation) activity. The medicine also weakens the adhesive activity of platelets under the influence of ADP with collagen.

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Indications Dicloberla

It is used to treat the following disorders:

• diseases of rheumatic origin (rheumatism, rheumatoid arthritis or osteoarthritis);
• Bechterew's disease;
• gout;
• joint lesions of a dystrophic nature;
• pain arising in case of injury to soft tissues or the musculoskeletal system;
• myalgia or neuralgia;
• primary dysmenorrhea.

Release form

The drug is released in the form of an injection liquid, inside ampoules with a capacity of 3 ml (corresponds to 75 mg). There are 5 such ampoules in a pack. In addition, it is released in the form of enteric-coated tablets with a volume of 50 mg. 50 or 100 pieces inside a cell package.

It is also produced in the form of capsules with prolonged activity (volume 0.1 g), 10, 20 or 50 pieces inside a blister plate. It is also sold in the form of rectal suppositories (volume 50 mg), 5 or 10 pieces inside a blister.

Pharmacokinetics

After an intramuscular injection of the drug, the plasma Cmax value is noted after 10-20 minutes. When the substance is taken orally, it is completely absorbed through the intestines; the Cmax values in the blood plasma are recorded after 1-16 hours (on average, after 2-3 hours).

After intestinal absorption, presystemic metabolic processes with the first intrahepatic passage develop. 35-70% of the active element participates in posthepatic circulation.

When the suppository is inserted into the rectum, the plasma level Cmax is noted after half an hour.

About 30% of the drug is involved in metabolic processes. Elimination of metabolic elements is realized through the intestine. Inactive metabolites formed during hepatocyte hydroxylation and conjugation are eliminated through the kidneys.

The half-life is 120 minutes and does not change in case of liver or kidney dysfunction. Synthesis with blood protein is 99%.

Dosing and administration

The substance should be administered parenterally by deep intramuscular injection into the buttock muscle area. One ampoule, equal to 75 mg of the drug, is usually used per day. In general, the daily dose of the drug should not exceed 0.15 g of the substance. If long-term therapy is required, rectal or oral forms of Dicloberl are used.

The tablets are taken orally, with food (to prevent irritating effects on the gastric mucosa), washed down with plain water. The tablets are not chewed. The daily dosage of 50-150 mg is divided into 2-3 doses. The duration of treatment should be selected by a doctor, individually.

The capsules are taken once a day (portion 0.1 g). If an increase in dosage is required, the tablet form of the drug is used.

Suppositories should be inserted deep into the rectum after defecation. The dosage is selected by the doctor individually, taking into account the severity of the disease. Often, the daily dosage varies in the range of 50-150 mg. This dosage should be administered in 2-3 applications.

Use Dicloberla during pregnancy

Dicloberl should not be used during breastfeeding or pregnancy.

Contraindications

Among the contraindications:

• severe allergy to diclofenac (or other substances from the NSAID subcategory);
• ulcer affecting the gastrointestinal tract;
• ulcer of a peptic nature;
• bleeding in the gastrointestinal tract;
• disorder of hematopoiesis;
• BA.

Side effects Dicloberla

Main side effects:

• lesions affecting the gastrointestinal tract: exacerbation of gastrointestinal pathologies, constipation, dyspepsia, nausea, diarrhea, loss of appetite, abdominal pain and vomiting. In addition, pancreatitis, glossitis, liver failure, esophagitis, mild bleeding in the gastrointestinal tract. People with gastrointestinal diseases may experience bleeding or perforation of an existing ulcer. Bloody diarrhea or vomiting, as well as melena, are observed sporadically;
• CNS dysfunction: severe fatigue, dizziness, taste changes, agitation, insomnia, headaches, convulsions and fear. In addition, there are disturbances of sensitivity or vision, changes in sound perception, nightmares, a feeling of disorientation, tremor, confusion, depression and stiffness of the occipital muscles (aseptic meningitis);
• allergy symptoms: bullous or epidermal rash, burning at the injection site, itching, TEN, sterile abscess or necrosis of the subcutaneous layers at the injection site, as well as SJS, bronchial spasm, swelling of the larynx, tongue or face, and anaphylaxis;
• disorders of hematopoiesis: leukopenia or thrombocytopenia, agranulocytosis or anemia;
• problems with the functioning of the cardiovascular system: palpitations, increased or decreased blood pressure and pain in the chest area;
• Others: in case of necrotizing fasciitis, a deterioration in the general condition may be observed; allergic vasculitis and pulmonitis may also occur.

Overdose

In case of overdose of the drug, symptomatic measures should be taken. Headaches, disorientation, loss of consciousness, dizziness and myoclonic seizures (in children) may occur; in addition, abdominal pain, vomiting, bleeding in the gastrointestinal tract, liver or kidney disorders and nausea may occur.

Interactions with other drugs

The use of the drug together with digoxin, phenytoin or lithium drugs increases the plasma values of the latter.

Combination with antihypertensive and diuretic substances leads to a weakening of their therapeutic effect.

Combination with potassium-sparing diuretics causes an increase in blood potassium levels.

Dicloberl, used together with ACE inhibitors, can lead to the development of renal dysfunction.

Use together with GCS and other NSAIDs leads to potentiation of the negative impact on the gastrointestinal tract.

Using the medication the day before or after taking methotrexate causes an increase in the latter's levels and potentiation of its toxicity.

Combination with antiplatelet agents requires medical monitoring of the blood coagulation system (although interactions have not yet been detected).

Use together with cyclosporine potentiates its toxicity.

Medicines containing probenecid inhibit the excretion of diclofenac.

There are isolated data on changes in serum sugar levels in diabetics, requiring changes in the dosage of hypoglycemic drugs and insulin.

Storage conditions

Dicloberl should be stored in a dark place, out of the reach of small children. Temperature – within 25°C.

Shelf life

Dicloberl can be used for a period of 36 months from the date of sale of the drug.

Application for children

It is prohibited to prescribe the medication to persons under 15 years of age.

Analogues

Analogues of the drug are Naklofen, Almiral, Diclac with Ibuprofen, and also Argett Rapid, Ortofen, Bioran, Rapten with Voltaren, Feloran, Diclofenac and Olfen with Diclobru, as well as Ketarolac.

Reviews

Dicloberl gets good reviews from patients – it helps to quickly and effectively eliminate moderate pain. But it should be taken into account that the drug in the form of injections is prohibited to use constantly. It is used only once, because it has an increased probability of developing negative symptoms (mainly gastric). The lack of effect is observed only occasionally, if the intensity of pain is assessed correctly. Allergies also occur quite rarely.