Dicloran

Dicloran contains an active element, diclofenac, the activity of which determines the therapeutic effect of the drug.

The diclofenac component is included in the subgroup of NSAID drugs, and its drug 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 GHG elements). By reducing the number of PG elements (inflammatory hormones), the drug demonstrates a strong analgesic, anti-inflammatory, and, in addition, antipyretic effect. [1]

Indications Dicloran

It is used for the following disorders:

• rheumatology and orthopedics: treatment of joint lesions that are degenerative or inflammatory in nature - arthritis (post-traumatic or rheumatoid, and in addition to gouty or psoriatic type), bursitis with osteoarthritis, myositis, ankylosing spondylitis and tendinitis;
• neurology: radiculitis, neuralgic type ambiotrophy and neuralgia (including cervicalgia, lumboischealgia with thoracalgia and lumbago);
• otolaryngology: combined treatment of tonsillitis with otitis media, pharyngitis and laryngitis;
• gynecology-obstetrics: combination therapy for salpingitis, adnexitis or metritis;
• toothache, headache, post-traumatic or postoperative pain.

Release form

The release of the therapeutic element is made in enteric tablets with a volume of 50 mg; inside the box - 10, 20 or 100 pieces.

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 to slow down platelet aggregation. Its analgesic effect is associated with a weakening of the sensitivity of neural endings to irritating factors. This is done 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 decreases absorption rate, but does not decrease absorption rate. Blood indicators Cmax are recorded after 0.5-1 hour from the moment of administration. After 2 hours, the Cmax of the drug is observed inside the synovium. [3]

The term for the half-life of an active element and metabolic components with therapeutic activity is 2-4 hours.

Dosing and administration

A maximum of 0.15 g of medication is allowed per day. It is required to divide this dosage into 2-4 uses (in a portion of 25-50 mg). The tablets are taken after meals or with it; they do not need to be chewed - they are taken by swallowing and washed down with plain water. When the therapeutic effect is obtained, the portion of the drug is reduced to a maintenance one, which is 50 mg per day. The therapy lasts 1-1.5 months.

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

For intravenous infusions, 75 mg of drugs (1 ampoule) are dissolved in isotonic liquid (0.1-0.5 l), after which they are used through the system for intravenous injections; the procedure lasts 0.5-3 hours. To relieve acute pain, the infusion can be accelerated during the first 15 minutes of administration. Further, the speed of the procedure is slowed down. When the acute pains disappear, the patient is transferred to Dicloran tablets.

It is allowed to inject the drug by intramuscular method for a period of maximum 2 weeks. The injections are performed deep inside the muscle of the buttock. The daily portion 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 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.

Very carefully, the medication is used in diabetics and the elderly, and in addition, for alcoholism, asthma, chronic renal failure or chronic liver failure.

Side effects Dicloran

The main side symptoms:

• lesions associated with the function of the gastrointestinal tract: peritoneal spasms, pain, dyspepsia, flatulence, stool disorders, bleeding inside the gastrointestinal tract (of a non-ulcer nature), and besides this, a peptic ulcer (proceeding with perforation or bleeding). Stomatitis, hepatitis, pancreatitis, jaundice, esophagitis and colitis with cirrhosis may occur, and in addition, vomiting, decreased appetite and blood in the feces;
• problems with the activity of the NS: 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, and at the same time thrombocytopenic purpura;
• disorders of the urogenital system: signs of weakening of the secretory activity of the kidneys. Perhaps the development of oliguria, acute renal failure, proteinuria, nephritis, nephrotic syndrome, or necrosis of the papillary layer;
• lesions associated with blood and hematopoietic organs: leuko- or thrombocytopenia, and with these agranulocytosis, anemia and eosinophilia;
• problems with the respiratory organs: swelling of the larynx, bronchial spasm and cough;
• disturbances in the work of the CVS: heart failure or hypertensive crisis;
• development of anaphylactic symptoms.

Overdose

In case of poisoning, excitement is first noted, and later suppression of consciousness, and in addition, dizziness with severe headaches, the appearance of vomiting, seizures, bleeding, pain in the abdomen and kidney / liver failure.

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

Interactions with other drugs

You can not combine the medication with other NSAIDs (pyrazolones or salicylates), since this may lead to a weakening of the drug activity and an increase in the toxicity of drugs.

Administration along with indirect / direct anticoagulants increases the likelihood of bleeding.

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

By the 2-3rd day, when administered together with digoxin, the blood glycoside index increases. To stabilize the blood values of digoxin after stopping the administration of Dicloran, at least 2 days are required.

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

Use in combination with cyclosporins 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 - in order to prevent increased toxicity.

Storage conditions

Dicloran must be kept out of the reach of 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.

Analogs

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