Neurodiclovite

Neurodiclovit has antipyretic, anti-inflammatory and analgesic activity.

Indications Neurodiclovita

It is used for the following types of rheumatic pathologies:

• various neuralgias or neuritis;
• arthritis of pronounced gouty origin, which is acute in nature;
• chronic type of polyarthritis or arthrosis;
• spondyloarthritis or ankylosing spondylitis;
• rheumatism developing in the extra-articular area, affecting soft tissues.

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Release form

The component is released in capsules - 10 pieces inside a cellular package. A pack contains 3 or 5 such packages.

Pharmacodynamics

The drug has a non-selective inhibitory effect on COX-1 and COX-2, and in addition reduces the level of PG in the inflammation zone and prevents the development of arachidonic acid metabolism processes.

In case of rheumatic lesions, this drug reduces joint pain and swelling, as well as the intensity of stiffness in the morning. Thanks to this, the motor activity of the joints is significantly improved.

Pyridoxine hydrochloride stabilizes the function of the nervous system. It is a coenzyme of important enzymes located inside the nervous tissue. Along with this, the substance participates in the development of the biosynthesis of most neurotransmitters.

Thiamine hydrochloride after passing into the body is transformed into a component of cocarboxylase. This substance is a coenzyme of most enzymes and an important part of metabolic processes. It takes an active part in the processes of neuronal synaptic excitation.

Cyanocobalamin helps to normalize hematopoiesis, as well as the maturation of red blood cells; it is a participant in a large number of biochemical processes required for the stable functioning of the body. At the same time, the component has a positive effect on the processes occurring within the nervous system. Coenzyme forms of this element are required for cellular growth and renewal.

Pharmacokinetics

The combination of B-vitamins contained in the medication (cyanocobalamin with pyridoxine and thiamine) enhances the analgesic activity of diclofenac.

Diclofenac has a full absorption at high speed, but the use of food slows down this process for some time (1-4 hours), and at the same time reduces the Cmax of the active element by 40%. When taking capsules orally, the Cmax level is noted after 2-3 hours. This indicator has a linear dependence on the size of the dosage used.

The bioavailability values of the drug are 50%; the substance has a significant synthesis with blood protein. The half-life from synovium is approximately 4-5 hours. Cmax values inside synovium are recorded approximately 3 hours later than inside plasma.

Part of the active element (50%) undergoes intrahepatic cleavage. Metabolic processes develop after conjugation, as well as hydroxylation of the element with glucuronic acid. The enzyme structure P450 CYP2C9 participates in the processes of drug cleavage. 65% of the drug is excreted through the kidneys in the form of metabolic elements, and less than 1% of the substance is excreted unchanged. The remainder is excreted with bile (also in the form of metabolic components).

Total clearance values are 350 ml/minute. Plasma half-life is 2 hours. Diclofenac can be excreted in breast milk.

B-vitamins contained in Neurodiclovit are soluble in water. Thiamine and pyridoxine are absorbed in the upper part of the small intestine. This process mainly depends on the portion size. In the body, the substances undergo intrahepatic breakdown and are excreted mostly through the kidneys. Only approximately 9% of the drug is excreted unchanged. If the drug is taken in large portions, intestinal excretion of thiamine and pyridoxine increases.

The absorption of cyanocobalamin is largely determined by the presence of endogenous factors in the upper small intestine and stomach. The movement of this element is determined by the activity of transcobalamin. After intrahepatic breakdown, the component is excreted mainly with bile. Only about 6-30% of this vitamin is excreted by the liver.

Dosing and administration

The drug must be taken orally - the capsules are swallowed whole during meals, washing down the medicine with plain water. The sizes of dosage portions may vary depending on the severity of the pathology. The average portion is 1-3 capsules per day, which is equal to 0.1 g of diclofenac.

Adults usually start taking the medication by taking 2-3 capsules per day. The maximum daily dose should not exceed 3 capsules. The maintenance dose is 1 capsule taken 1-2 times per day.

The medication should be used with extreme caution in elderly people.

Teenagers over 14 years of age can use Neurodiclovit, but its maximum dose should be a maximum of 1 capsule 2 times a day.

The duration of the treatment cycle is determined by the healthcare professional.

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Use Neurodiclovita during pregnancy

It is prohibited to prescribe Neurodiclovit to pregnant women.

Contraindications

Main contraindications:

• severe intolerance associated with the components of the drug;
• bleeding affecting the gastrointestinal tract;
• bronchial asthma accompanied by polyposis of the nasal mucosa;
• hemostasis disorders;
• lactation period;
• disorders of hematopoiesis;
• bleeding that occurs inside the skull;
• lesions inside the gastrointestinal tract that have erosive and ulcerative etiology (especially during periods of exacerbation).

Caution is required when using in the following conditions:

• CHF of a congestive nature;
• IHD or anemia, as well as bronchial asthma;
• liver or kidney failure;
• diabetes mellitus;
• intestinal pathologies of inflammatory genesis;
• alcoholism;
• induced type of porphyria;
• edema syndrome;
• diverticulitis;
• elevated blood pressure;
• systemic disorders of connective tissue function;
• elderly people.

In addition, it is necessary to carefully monitor the patient's condition in cases where the medication is used after extensive surgery.

Side effects Neurodiclovita

Side effects of medicinal capsules include:

• liver or gastrointestinal tract damage: increased levels of liver enzymes, diarrhea, abdominal pain, flatulence, constipation, nausea, bleeding inside the gastrointestinal tract and peptic ulcers (complications may occur);
• dysfunction of the sense organs: tinnitus;
• disorders of the urogenital system: nephrotic syndrome or oliguria with azotemia, development of fluid retention, proteinuria, as well as tubulointerstitial nephritis, hematuria, acute renal failure and necrotic papillitis;
• problems with the functioning of the nervous system: headaches or severe dizziness;
• epidermal lesions: itching or rash;
• disorders in the functioning of the hematopoietic organs and immune function: leukopenia or thrombocytopenia, eosinophilia, agranulocytosis, and in addition, anemia, thrombocytopenic purpura and worsening of the existing infection.

Along with this, the following disorders occasionally occur in the liver or gastrointestinal tract: liver necrosis, pancreatitis, jaundice with colitis, hepatitis and aphthous stomatitis with cirrhosis, cholecystopancreatitis and hepatorenal syndrome. In addition, melena, dry mucous membranes, vomiting and damage to the esophagus are observed.

Rarely, CNS dysfunctions occur: depression, general weakness, sleep disorders, irritability, severe anxiety or drowsiness, as well as nightmares, disorientation and convulsions. The epidermis may also be affected - eczema, urticaria, MEE, severe photosensitivity, alopecia, TEN, toxic dermatitis and pinpoint hemorrhages.

Symptoms such as blurred vision, swelling in the larynx, increased blood pressure, scotoma, taste disturbance, hearing loss, bronchial spasm, diplopia, pneumonitis and cough appear occasionally. In addition, congestive heart failure, extrasystole, chest pain, myocardial infarction, anaphylaxis, swelling affecting the tongue and lips, some anaphylactoid symptoms and vasculitis of allergic origin develop.

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Overdose

After using too large doses of the drug, the following symptoms may occur: headaches, dyspnea, vomiting, as well as dizziness and clouding of consciousness. In children, myoclonic seizures, nausea, abdominal pain, bleeding, and kidney or liver dysfunction may occur.

To eliminate the disorders, gastric lavage and forced diuresis are performed, and activated carbon is also prescribed. Symptomatic measures are also taken. Hemodialysis has almost no effect.

Interactions with other drugs

When using Neurodiclovit, an increase in:

• lithium indices when combined with lithium agents;
• intensity of negative symptoms in case of combination with other NSAIDs;
• the risk of developing bleeding within the gastrointestinal tract when administered together with GCS;
• therapeutic activity of potassium-sparing diuretics, as well as drugs that slow down platelet aggregation;
• toxicity and methotrexate levels.

The effect of the drug is weakened in case of combination with hypotensive substances and loop diuretics. The indicators of the active component (diclofenac) are also reduced when combined with aspirin. The absorption of cyanocobalamin is reduced in case of administration of the drug together with neomycin, colchicine, and also with hypoglycemic drugs (for example, biguanidine) and PAS.

It is forbidden to combine the drug with levodopa, because it can weaken the intensity of its antiparkinsonian effect. At the same time, it can reduce the hypotensive properties of diuretic drugs and antihypertensive drugs, which is why such a combination is used with caution. During therapy, it is necessary to monitor blood pressure indicators. In addition, it is necessary to drink a lot of fluids, and at the initial stage of the treatment cycle and after its completion, it is necessary to monitor renal function, because nephrotoxicity can develop.

When used in combination with SSRIs, the risk of developing gastrointestinal bleeding increases.

Portion sizes of hypoglycemic agents should be carefully monitored when combined with Neurodiclovit.

Administration together with colestyramine or colestipol reduces the intensity of diclofenac absorption by approximately 30-60%. Therefore, several hours must be observed between drug administrations. Also, diclofenac indicators can be reduced by certain drugs that stimulate enzyme activity (phenytoin with St. John's wort, as well as rifampicin with carbamazepine).

It is also necessary to take into account that under the influence of 5-fluorouracil the effect of thiamine is inactivated, and antacids reduce its absorption rates. Loop diuretics are capable of slowing down the reabsorption of thiamine by the tubules, and with prolonged therapy they reduce its rates.

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Storage conditions

Neurodiclovit should be stored in a dark, dry place out of the reach of small children. The optimal temperature is no higher than 25°C.

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Shelf life

Neurodiclovit can be used within a 36-month period from the date of manufacture of the therapeutic substance.

Application for children

This drug should not be used in pediatrics.

Analogues

Analogues of the drug are Blokium B12, Fanigan, Dolex with Bol-Ran, Cinepar, Diclocaine, Maxigesic with Diclofenac, as well as Olfen-75 and Diclofenac C Paracetamol with Flamidez.