Dicloran

Dicloran contains the active ingredient diclofenac, the activity of which determines the therapeutic effect of the medication.

The component diclofenac is included in the subgroup of NSAIDs, and its medicinal effect develops due to the ability to slow down the activity of prostaglandin synthetase (this is a biocatalyst that is a participant in the binding of PG elements). By reducing the number of PG elements (inflammatory hormones), the drug demonstrates a strong analgesic, anti-inflammatory, and also antipyretic effect. [ 1 ]

Indications Dicloran

It is used for the following disorders:

• rheumatology and orthopedics: treatment of joint lesions of a degenerative or inflammatory nature - arthritis (post-traumatic or rheumatoid, as well as gouty or psoriatic type), bursitis with osteoarthritis, myositis, ankylosing spondylitis and tendinitis;
• neurology: radiculitis, neuralgic ambitrophy and neuralgia (including cervicalgia, lumboschialgia with thoracic pain and lumbago);
• otolaryngology: combined treatment of tonsillitis with otitis, pharyngitis and laryngitis;
• gynecology-obstetrics: combination therapy for salpingitis, adnexitis or metritis;
• dental, headache, post-traumatic or post-operative pain.

Release form

The therapeutic element is released in enteric-coated tablets with a volume of 50 mg; there are 10, 20 or 100 pieces in a box.

In addition, it is sold in the form of an injection liquid - inside ampoules with a capacity of 75 ml; in a pack - 5 or 25 ampoules.

Pharmacodynamics

Diclofenac helps slow down platelet aggregation. Its analgesic effect is associated with a weakening of the sensitivity of neuronal endings to irritating factors. This is accomplished by reducing the number of inflammatory mediators that activate these factors. [ 2 ]

Pharmacokinetics

Dicloran is absorbed almost completely and at high speed after oral administration. Food reduces the rate of absorption, but does not reduce its extent. Blood Cmax values are recorded after 0.5-1 hour from the moment of administration. After 2 hours, Cmax of the drug is observed inside the synovium. [ 3 ]

The half-life of the active ingredient and metabolic components with therapeutic activity is 2-4 hours.

Dosing and administration

A maximum of 0.15 g of the drug is allowed per day. This dosage should be divided into 2-4 doses (25-50 mg per serving). The tablets are taken after or with meals; they do not need to be chewed – they are taken by swallowing and washing down with plain water. When the therapeutic effect is achieved, the dose of the drug is reduced to a maintenance dose, which is equal to 50 mg per day. The therapy lasts 1-1.5 months.

For a child over 6 years of age, daily dosages are selected in the proportion of 2 mg/kg.

For intravenous infusions, 75 mg of the drug (1 ampoule) is dissolved in isotonic fluid (0.1-0.5 l), after which it is administered through a system for intravenous injections; the procedure lasts 0.5-3 hours. To eliminate acute pain, the infusion can be accelerated during the first 15 minutes of administration. Then the procedure speed is slowed down. When acute pain disappears, the patient is transferred to taking Dicloran tablets.

The drug may be administered intramuscularly for a maximum of 2 weeks. Injections are given deep into the gluteal muscle. The daily dose should not exceed 0.15 g.

• Application for children

Dicloran is not prescribed to persons under 6 years of age.

Use Dicloran during pregnancy

Pregnant women are prohibited from using the medication.

Contraindications

Among the contraindications:

• "aspirin" asthma;
• personal hypersensitivity to diclofenac and other NSAIDs;
• leukopenia or anemia;
• coagulopathy;
• ulcers affecting the gastrointestinal tract;
• breast-feeding.

The medication should be used with great caution in diabetics and the elderly, as well as in cases of alcoholism, bronchial asthma, chronic renal failure or chronic liver failure.

Side effects Dicloran

Main side effects:

• lesions associated with the function of the gastrointestinal tract: abdominal spasms, pain, dyspepsia, flatulence, bowel disorders, bleeding inside the gastrointestinal tract (of a non-ulcer nature), and also peptic ulcer (occurring with perforation or bleeding). Stomatitis, hepatitis, pancreatitis, jaundice, esophagitis and colitis with cirrhosis may be observed, as well as vomiting, loss of appetite and blood in the feces;
• problems with the functioning of the nervous system: headaches or dizziness. Anxiety, weakness, diplopia, sleep disorders, irritation, meningeal signs and disorders of taste, sound or auditory receptors may appear;
• disorders in the epidermis: urticaria, photosensitivity, itching, eczema (also exudative form), TEN and dermatitis, as well as thrombocytopenic purpura;
• disorders of the urogenital system: signs of weakening of the secretory activity of the kidneys. Development of oliguria, acute renal failure, proteinuria, nephritis, nephrotic syndrome or necrosis of the papillary layer is possible;
• lesions associated with the blood and hematopoietic organs: leukopenia or thrombocytopenia, and along with these agranulocytosis, anemia and eosinophilia;
• problems with the respiratory organs: swelling of the larynx, bronchial spasm and cough;
• disorders in the functioning of the cardiovascular system: heart failure or hypertensive crisis;
• development of anaphylactic symptoms.

Overdose

In case of poisoning, agitation is initially observed, and later suppression of consciousness, and in addition, dizziness with severe headaches, vomiting, convulsions, bleeding, pain in the abdominal area and kidney/liver failure.

In case of oral intoxication, gastric lavage and oral administration of sorbents are performed; symptomatic actions are also performed. Forced diuresis with hemodialysis have low efficiency. There is no antidote.

Interactions with other drugs

The drug should not be combined with other NSAIDs (pyrazolones or salicylates), as this may weaken the medicinal activity and increase the toxicity of the drug.

Administration together with indirect/direct anticoagulants increases the risk of bleeding.

The drug increases the volume of lithium ions in the blood plasma when combined with metal salts.

By the 2nd-3rd day, when administered together with digoxin, the blood level of the glycoside increases. At least 2 days are required to stabilize the blood levels of digoxin after stopping the administration of Dicloran.

The drug retains water and sodium in the body, weakening the medicinal effect of antihypertensive and diuretic substances.

Use in combination with cyclosporines leads to potentiation of nephrotoxic activity.

The toxic properties of the drug are potentiated when used together with GCS.

It is necessary to observe a 1-day break between the administration of methotrexate and the drug to prevent increased toxicity.

Storage conditions

Dicloran must be stored in a place closed to small children. Temperature values are within 25 °C.

Shelf life

Dicloran can be used for a period of 36 months from the date of manufacture of the therapeutic product.

Analogues

The analogs of the drug are Dicloreum, Diclogen with sodium diclofenac, Dicloberl and Diclofenac, as well as Diclonac with Naklofen.