Ointments for sore muscles

Muscle pain can be caused by many reasons. For example, it can be various sports and household injuries, as well as some diseases of the musculoskeletal system. These diseases include myositis, myalgia, fibrositis, sciatica and lumbago.

Since pain in muscle tissue can be caused by different reasons, therapy must be selected based on the clinical picture of the problem.

Muscle pain ointment is a general name for restorative products for muscle problems. This group of drugs includes ointments, creams, and gels.

Traumatic prerequisites for muscle pain are accompanied by damage to small vessels, as well as tissue hypoxia and increased capillary permeability. All this leads to disruption of blood flow and tissue nutrition, as well as the process of their recovery. In these cases, sports ointments, gels and creams are good for use, which have an analgesic effect, reduce inflammation, accelerate resorption, relieve swelling and reduce the size of hematomas. In addition, such drugs help to establish microcirculation processes in tissues, as well as stimulate their regeneration. Sports ointments, as well as creams and gels are divided into products with a warming effect and preparations with a cooling effect.

Also, for muscle pain, conventional medications used in modern medicine and sold in regular pharmacies can be recommended.

Here is an incomplete list of medications that help cope with muscle pain. Ointment that relieves muscle pain is represented by the following names:

1. Apizartron.
2. Ben-Gay.
3. Bom-Bengue.
4. Butadion.
5. Bystrumgel.
6. Viprosal V.
7. Voltaren Emulgel.
8. Diclofenac.
9. Dolaren gel.
10. Dolobene gel.
11. Indomethacin.
12. Ketonal.
13. Finalgon.
14. Efkamon.

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Indications for use of ointment for muscle pain

• Apizartron.

It is used for unspecified arthrosis, joint pain, rheumatic polymyalgia, radiculopathy, sciatica, lumbago with sciatica, lower back pain, unspecified dorsalgia, unspecified lesions of the synovial membrane and tendons, unspecified myalgia, neuralgia and neuritis, other specified acquired deformities of the musculoskeletal system, unspecified pain, dislocations, sprains and injuries of the capsular-ligamentous apparatus of the joint of an unspecified area of the body, injuries of muscles and tendons in unspecified areas of the body.

• Ben-Gay.

Used for pain in muscles and joints caused by inflammation, stiffness in the joints and other problems. Indicated for pain in the lower back and sacrum caused by sprains. Also suitable after training and other sports activities with increased intensity.

• Bom-Bengue.

It is used to relieve pain in muscles and joints caused by sprains and bruises. It is also indicated for pain in the lower back and sacrum due to lumbago and sciatica.

• Butadion.

It is prescribed for post-traumatic inflammatory processes in soft tissues and joints, which are the result of stretching, overexertion or bruising of the above-mentioned tissues and organs. The drug is indicated for rheumatic diseases that affect soft tissues, namely, tendinitis, bursitis, lesions of periarticular tissues, as well as muscle pain of rheumatic and non-rheumatic origin. The drug is used for pain syndromes and swelling caused by problems with muscles and joints, namely rheumatoid arthritis, osteoarthrosis, radiculitis, lumbago, sciatica.

• Bystrumgel.

The drug is used for inflammations or injuries that affect joints and muscles, ligaments and tendons. These problems include arthritis and periarthritis, bursitis, tendinitis, tendosynovitis, bruises and ligament injuries, various dislocations, knee meniscus damage, torticollis and lumbago, phlebitis and periphlebitis.

• Viprosal V.

It is used for pain caused by arthritis of various origins, as well as myalgia, neuralgia, sciatica and radiculitis.

• Voltaren Emulgel.

The presence of back pain caused by inflammatory and degenerative processes in the spine, namely radiculitis, osteoarthrosis, lumbago, sciatica. Existing joint pain that affects the joints of the fingers, knee joints, etc., caused by rheumatoid arthritis and osteoarthrosis. The presence of muscle pain that was caused by sprains, bruises, injuries and overstrain of these tissues. The appearance of inflammatory processes and swelling in soft tissues and joints that are caused by injuries and rheumatic diseases, such as bursitis, tendovaginitis, wrist syndromes, damage to periarticular tissues.

• Diclofenac.

Used for inflammation of muscles, ligaments, tendons and joints caused by rheumatic prerequisites, which occur with sprains, heavy loads and bruises. Also used for the treatment of localized forms of soft tissue rheumatism with bursitis, tendovaginitis, periarthropathy. Used for localized rheumatic diseases, such as arthrosis of the joints.

• Dolaren gel.

Used for myositis, fibrositis, sciatica, muscle and tendon strains, musculoskeletal injuries. Indicated for pain in muscles and joints, especially when there are high physical loads. Used to treat inflammatory and degenerative phenomena in joints.

• Dolobene gel.

The drug is indicated for use in hematomas and inflammatory processes in soft tissues, muscles, tendons, tendon sheaths, ligaments in case of bruises, compressions, injuries. The medication is also used for neuralgia, scapulohumeral periarthritis, epidural arthritis of the shoulder, tendinitis, tendovaginitis, bursitis, arthritis, deforming osteoarthritis, superficial thrombophlebitis, thrombotic ulcers, which are caused by chronic venous insufficiency.

• Indomethacin.

It is used for inflammatory processes in tendons, ligaments, muscles and joints caused by injuries. It is also prescribed for the treatment of inflammation in soft tissues in tendovaginitis, tendinitis, bursitis. It is indicated for myalgia, lumbago and sciatica. It is used for inflammatory and degenerative processes in the musculoskeletal system, for example, in deforming osteoarthrosis, rheumatoid arthritis, ankylosing spondylitis, osteochondrosis, etc.

• Ketonal.

It is used for inflammatory diseases of a degenerative nature, which characterize the musculoskeletal system: rheumatoid arthritis, seronegative arthritis, Bechterew's disease, psoriatic arthritis, Reiter's syndrome, symptoms of gout, as well as pseudogout and osteoarthrosis. It is used for tendinitis, bursitis, myalgia, neuralgia, radiculitis, post-traumatic and postoperative pain syndromes, which are accompanied by inflammatory processes and an increase in body temperature.

• Finalgon.

The drug is indicated for the treatment of muscle and joint pain caused by overexertion, arthritis, lumbago, sciatica, neuritis, tendovaginitis, bursitis.

• Efkamon.

The drug is prescribed for acute arthritis, polyarthritis, myalgia, neuralgia, lumbago, cervical myositis, rheumatism, lumbosacral radiculitis, migraines, bruises, deforming spondylitis, truncitis, ganglionitis in the cervicothoracic spine.

Release form

• Apizartron.

The medicine is an ointment of white or yellowish color. The drug is released in aluminum tubes of twenty or fifty grams, which are sealed with aluminum foil and closed with plastic caps. Each tube is placed in a cardboard package. One hundred grams of the medicine contains bee venom - three milligrams, methyl salicylate - ten grams, allyl isothiocyanate - one gram, sodium lauryl sulfate - seven hundred milligrams, white petroleum jelly - six grams, emulsified cetostearyl alcohol - fourteen grams, water - up to one hundred grams.

• Ben-Gay.

The drug is available in the form of a cream and a sports balm of creamy consistency. The cream and balm are packaged in aluminum tubes with thirty-five gams of the drug in each. The tubes are placed one by one in a cardboard package and supplied with a leaflet with instructions.

Each gram of cream contains active substances - one hundred and fifty milligrams of methyl salicylate and one hundred milligrams of menthol. Auxiliary components include a certain amount of stearic acid, glycerol monostearate, polysorbate 85, sorbitan tristearate, trolamine, purified water.

Each gram of sports balm includes active substances - methyl salicylate - two hundred eighty milligrams, menthol - one hundred milligrams. The auxiliary substances in the composition of the drug contain a certain amount of glycerol monostearate, lanolin, polysorbate 85, purified water, sorbitan tristearate, stearic acid, xanthan gum, potassium hydroxide.

• Bom-Bengue.

The medicine is produced in the form of an ointment, which has a white or white with a yellowish tint color, as well as a strong specific smell. The drug is packaged in aluminum tubes of twenty-five grams each and placed in a cardboard package along with an instruction leaflet. One gram of the medicine contains the active substances menthol - thirty-nine milligrams and methyl salicylate - two hundred and two milligrams, as well as auxiliary components in the form of paraffin and petroleum jelly.

• Butadion.

The drug is produced in the form of an ointment, which is white, has a uniform consistency and a specific smell. The medicine is packaged in aluminum tubes of twenty grams each and placed in a cardboard box along with a leaflet-instruction.

One gram of the drug contains fifty milligrams of the active substance - phenylbetazone, as well as a certain amount of auxiliary components, namely sodium carboxyethylcellulose, colloidal silicon dioxide, methyl parahydroxybenzoate, glycerin, polysorbate 60, liquid paraffin, propylene glycol, purified water.

• Bystrumgel.

The drug is available in the form of a gel, which is transparent and colorless and has a specific smell. The medicine is packaged in aluminum tubes of thirty or fifty grams each and placed in cardboard boxes of one tube. A leaflet with instructions is put into the box. One gram of the drug contains the active substance - ketoprofen - twenty-five milligrams. There is also a certain amount of auxiliary substances - ethyl alcohol, nipagin, carbomer, lavender oil, trometamol, neroli oil, purified water.

• Viprosal V.

The drug is available as an ointment, which is white or whitish with a yellow tint, and has a camphor or turpentine smell. The medicine is packaged in aluminum tubes of thirty or fifty grams each. The tube is placed in a cardboard box and supplied with a leaflet with instructions. One gram of the medicine contains fifty units of viper venom, ten milligrams of salicylic acid, thirty milligrams of camphor, thirty milligrams of gum turpentine. There is also a certain amount of auxiliary substances, namely, solid paraffins, medical vaseline, distilled glycerin, emulsifier, sodium chloride and purified water.

• Voltaren Emulgel.

The drug is a creamy gel, which is white or white with a yellowish tint. The medicine is packaged in laminated aluminum tubes with a shoulder and closed with a solid molded shaped membrane, as well as a plastic cap. Each tube weighs fifty or one hundred grams of the drug and is placed in a cardboard package supplied with an insert leaflet. One hundred grams of gel contains 2.32 grams of the active substance - diclofenac diethylamine, as well as auxiliary components, which include carbomers, cetostearo macrogol, cocoyl caprylocaprate, diethylamine, isopropanol, liquid paraffin, oleyl alcohol, eucalyptus flavoring, propylene glycol, butylhydroxytoluene, purified water.

• Diclofenac.

The drug is available in the form of an ointment, which is white or almost white in color, and also has a weak specific smell. The medicine is packed in aluminum tubes of thirty grams each. The tubes are placed in a cardboard package with an instruction leaflet. Each tube contains the active substance - sodium diclofenac - three hundred milligrams. The drug also contains a certain amount of excipients - dimethyl sulfoxide, propylene glycol, macrogol 1500, macrogol 400.

• Dolaren gel.

The drug is produced in the form of a yellowish gel, which has a specific smell. The medicine is packaged in aluminum tubes of thirty grams each. One hundred grams of gel contains 1.163 grams of diclofenac diethylamine, five grams of menthol, ten grams of methyl salicylate and three grams of linseed oil. Other components include benzyl alcohol, carbomer, diethanolamine, bronopol, sodium metabisulfite, propylene glycol, polysorbate 80, sandalwood oil, isopropyl alcohol, purified water.

• Dolobene gel.

The drug is a gel packaged in aluminum tubes of fifty or one hundred grams. Each tube is placed in a cardboard package and supplied with an instruction leaflet. One hundred grams of gel contains 15 grams of dimethyl sulfoxide, fifty thousand units of sodium heparin, two and a half grams of dexpanthenol and auxiliary substances.

• Indomethacin.

The medicine is produced in the form of a ten percent ointment, which is packaged in forty gram glass jars or aluminum tubes. Each jar or tube is placed in a cardboard package and supplied with an instruction leaflet. The ointment is a substance that has a light yellow or dark yellow color, as well as a specific menthol smell. One hundred grams of the drug contains ten grams of indomethacin, as well as a certain amount of excipients - dimexide, urea, polyethylene oxide 400, polyethylene oxide 1500, propylene glycol, menthol, nipagin, nipazole, purified water.

• Ketonal.

The drug is produced in the form of a homogeneous and transparent gel. The medicine is placed in aluminum tubes, which have a varnish coating on the inside. The tube is covered with a protective membrane and a screw-on polymer cap on top. The tube is placed in a cardboard box along with an instruction leaflet. Each tube contains fifty grams of the drug. One gram of gel contains twenty-five milligrams of the active substance - ketoprofen. Of the excipients, the manufacturers resorted to using carbomer, trolamine, lavender essential oil, ethyl alcohol 96% and purified water.

• Finalgon.

The drug is produced in the form of an ointment and is packaged in aluminum tubes of twenty grams of the drug each, equipped with plastic applicators. Each tube is packed in a cardboard box, which contains a leaflet with instructions. Each tube contains four grams of nonivamide, as well as twenty-five milligrams of nicoboxil.

• Efkamon.

The medicine is produced in the form of an ointment for external use and is packaged in aluminum tubes of twenty grams each. The composition of the medicine includes one gram of methyl salicylate, eighty milligrams of capsicum tincture, forty milligrams of camphor, one hundred milligrams of clove oil, thirty milligrams of mustard oil, seventy milligrams of eucalyptus oil, one hundred and forty milligrams of methol.

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Pharmacodynamics of ointment for muscle pain

• Apizartron.

The components of the drug have the following pharmacodynamic effects:

• Bee venom – promotes pain relief and anti-inflammatory effects by stabilizing lysosomal membranes; has an antibacterial effect by inhibiting gram-positive bacteria.
• Methyl salicylate is a non-steroidal anti-inflammatory drug and has strong anti-inflammatory efficacy by inhibiting the production of PG and suppressing COX.
• Allyl isothiocyanate is a purified standardized extract of mustard oil that promotes deep tissue heating, resulting in improved local blood flow and decreased muscle tonic contractility.

• Ben-Gay.

The drug has a distracting and analgesic effect. The drug is able to expand capillaries, as well as irritate sensitive skin receptors. The drug has the ability to cause a feeling of warmth due to the menthol it contains. The warming effect helps to reduce tension, spasmodic and painful sensations, leads to increased microcirculation, and also facilitates the removal of irritants from the body in the form of lactic acid. Due to this, the quality of movements improves, and therapeutic effects occur that concern joints, muscles, tendons, and certain internal organs. The action of methyl salicylate leads to the relief of pain.

• Bom-Bengue.

The drug has a combined effect. The active component - methyl salicylate - has anti-inflammatory, analgesic, irritant and distracting activity. This is expressed in increased capillary permeability, improved microcirculation processes, inhibition of the activity of mediators that cause inflammatory processes. Metol irritates nerve endings in tissues that have increased sensitivity and leads to the achievement of an analgesic effect.

• Butadion.

The drug is a non-steroidal anti-inflammatory drug that can relieve inflammation and pain. The active substances non-selectively inhibit the activity of cyclooxygenase 1 and 2, and also inhibit the production of prostaglandins. Phenylbutazone leads to inhibition of the production of ATP-dependent mucopolysaccharides.

The drug is prescribed to eliminate pain and swelling caused by inflammation. Local application of the drug eliminates pain in joints and muscles that are at rest and in motion.

• Bystrumgel.

It has anti-inflammatory and analgesic effects. It inhibits cyclooxygenase 1 and 2 and helps suppress prostaglandin production. It has an antibradykinin effect and stabilizes lysosomal membranes. It also reduces cytokine production and inhibits neutrophil activity. It is distinguished by its ability to reduce or eliminate pain at rest and during movement.

• Viprosal V.

The drug promotes the appearance of irritating and analgesic effects, which is expressed in the irritation of the skin and subcutaneous tissue receptors, which have high sensitivity. All this leads to the expansion of blood vessels and improvement of tissue trophism.

• Voltaren Emulgel.

The drug contains the active substance diclofenac, which is a non-steroidal anti-inflammatory drug. This component causes the analgesic, anti-inflammatory and antipyretic effect of the drug. The active component has the ability to non-selectively inhibit cyclooxygenase 1 and 2, as well as disrupt the metabolic processes of arachidonic acid. The drug is used to relieve pain syndromes and inflammation that affect joints, muscles and ligaments due to the traumatic or rheumatic nature of the problem. At the same time, the level of pain and swelling decreases, which helps to increase joint mobility.

• Diclofenac.

The drug is a non-steroidal anti-inflammatory agent, a derivative of phenylacetic acid. It has anti-inflammatory and analgesic effects. The drug leads to a decrease in the amount of prostaglandins in the inflammation focus, which is achieved by non-selective inhibition of cyclooxygenase 1 and cyclooxygenase 2, as well as disruption of arachidonic acid metabolism.

• Dolaren gel.

The drug is a fast-acting agent that is applied locally. It has analgesic and anti-inflammatory effects.

The drug causes hyperemia of the skin and enhances microcirculation in tissues, promotes analgesic, warming and anti-inflammatory effects. The drug has an activating effect on metabolic processes, and also leads to improved elasticity of muscles and tissues and reduces local muscle tone. The effectiveness of the drug is noticeable within a few minutes after application and becomes maximum within twenty or thirty minutes from the moment of its use.

The active component of the drug - sodium diclofenac is a non-steroidal anti-inflammatory drug, which is characterized by the ability to deeply penetrate into tissues and accumulate in them. The substance is capable of inhibiting cyclooxygenase, leading to a decrease in the production of prostaglandins.

Linseed oil and methyl salicylate have local irritating and distracting effects directed at nerve endings. In addition, the substances are noted for their vasodilatory action.

Menthol has the effect of dilating blood vessels in subcutaneous structures, relieves pain and brings a feeling of coolness.

• Dolobene gel.

The drug has anti-inflammatory, antiexudative, analgesic, antithrombotic properties; promotes tissue regeneration.

The effectiveness of the drug results from the properties of its active substances.

Dimethyl sulfoxide has anti-inflammatory, anti-exsdative and analgesic effects. It is able to penetrate biological membranes and skin well. At the same time, it enhances the penetration of other components into the body when used together.

Heparin is characterized by its ability to inactivate biogenic amines in tissue, which explains its anti-inflammatory effect, as well as the ability to improve microcirculation. It leads to inhibition of the effectiveness of hyaluronidase, which has a good effect on the regenerative qualities of tissues.

Dexpanthenol has anti-inflammatory and dermatoprotective effects, and also helps improve the processes of epithelialization and granulation of the skin, helps stimulate regenerative processes in tissues. After absorption, it is oxidized to pantothenic acid, which is part of coenzyme A, and therefore participates in many metabolic processes.

• Indomethacin.

The drug has strong anti-inflammatory and analgesic effects. The active substance is characterized by inhibition of the activity of cyclooxygenase 1 and 2, which leads to disruption of the production of eicosanoids and prostaglandins.

In rheumatic processes, it promotes the appearance of anti-inflammatory and analgesic effects. It can reduce pain both at rest and during physical activity.

The pain-relieving effect occurs from thirty minutes to one hour after using the ointment. The effect can be observed for six to nine hours. The maximum effectiveness of the drug is noted after two to three hours from the moment of its application to the affected area.

• Ketonal.

The active component of the drug - ketoprofen is a non-steroidal antirheumatic drug, which has anti-inflammatory and analgesic effects. The substance is considered one of the most powerful cyclooxygenase inhibitors. Lipoxygenase and bradykinin also reduce their activity under the influence of ketoprofen. The substance stabilizes liposomal membranes, which helps prevent the release of enzymes that are mediators of inflammatory processes.

• Finalgon.

The drug has a combined effect and is used locally.

Of the active substances, the action of nonivamide and nicoboxil is noticeable. Nonivamide is a synthetic derivative of capsaicin and is characterized by a local irritant effect that stimulates peripheral nerve endings. Nicoboxil has a direct vasodilatory effect. The active substances of the drug are able to potentiate each other.

The drug causes hyperemia of the skin, as well as pain relief and a long-lasting warming effect. It has an anti-inflammatory effect and promotes accelerated tissue regeneration. The effect of the drug is observed within three to six hours.

• Efkamon.

The drug has a local irritant and analgesic effect.

The active component of the drug - methyl salicylate - promotes anti-inflammatory and analgesic effects by suppressing the production of prostaglandins at the site of the inflammatory process.

Another active component of the medicine – tincture of capsicum – contains the substance capsaicin, which has a strong irritating effect on sensitive skin receptors. The same qualities are characteristic of the essential oils included in the composition of the drug – eucalyptus, mustard, cloves, as well as camphor and menthol.

The drug has a distracting, analgesic, warming, resolving and anti-inflammatory effect. Its effectiveness is based on stimulating the production of endorphins and enkephalins by the central nervous system, which suppress or reduce pain in problem areas by interacting with the central nervous system of impulses from diseased tissues and areas of drug application. The drug is distinguished by its ability to improve blood supply in areas of inflammation, which leads to increased permeability of blood vessels that drain pathological tissues better.

Pharmacokinetics of ointment for muscle pain

• Apizartron.

No data on the pharmacokinetic properties of the drug are provided.

• Ben-Gay.

There are no data on the pharmacokinetics of the drug.

• Bom-Bengue.

The active component of the drug is able to penetrate through intact skin and have a systemic effect, although the analgesic concentration of the substance does not accumulate in the systemic bloodstream.

• Butadion.

Systemic absorption with local use does not exceed five percent. Phenylbutazone can undergo metabolism in the liver and is excreted in the form of metabolites through the kidneys and only one quarter of the metabolites are excreted in the feces.

• Bystrumgel.

Local application of the gel results in a very slow absorption rate of the active substance, which helps to maintain therapeutic concentrations of ketoprofen in the required tissues for a long time. Ketoprofen is capable of good penetration into the synovial fluid, as well as into connective tissues. The concentration of ketoprofen in the systemic bloodstream is low, the level of bioavailability does not exceed five percent. It does not accumulate in the body.

• Viprosal V.

There is no information on the pharmacokinetics of the drug.

• Voltaren Emulgel.

The amount of the active substance, diclofenac, which is absorbed through the skin, is determined by the area of application of the drug, as well as its dose.

The concentration of the active substance in the blood plasma is one hundred times lower than after oral administration of a similar amount of the component. About one hundred percent of diclofenac is capable of binding to blood proteins, mainly albumins. The active substance has the ability to distribute and accumulate in those tissues that are subject to inflammatory processes.

Diclofenac is metabolized into several phenolic metabolites, some of which are transformed into glucuronide conjugates. The half-life of the substance and its metabolites is one to three hours. The largest amount of diclofenac and its metabolites is eliminated from the body through urine.

• Diclofenac.

The amount of drug absorbed through the skin is approximately six percent of the dose used. A ten-hour occlusion can result in a threefold increase in the concentration of the absorbed drug.

The maximum amount of the drug in the blood serum by skin application of the drug is one hundred times lower than with oral use of the drug. More than ninety-nine percent of the active substances are capable of binding to blood plasma proteins, most of all - to albumins. The half-life of the substance in the blood is an interval of one to two hours. The active component of the drug and its metabolites are excreted from the body to a greater extent through urine.

• Dolaren gel.

Local use of the drug results in five percent absorption of the applied amount. At the same time, the systemic effect of the active components on the body is minimal.

• Dolobene gel.

Dimethyl sulfoxide, when used locally, is characterized by its ability to quickly penetrate all biological membranes. The concentration level of the active substance in the skin, muscles and synovial membrane is ten to one hundred times higher than in the blood. About ninety percent of the substance is excreted through the kidneys, about six percent of the component - through the lungs. The half-life of the substance is from three to four hours.

Heparin is characterized by rapid penetration through the skin. Therefore, within sixty minutes after the start of the drug, the amount of heparin in the surrounding tissues corresponds to the intravenous administration of five thousand units of the substance.

Dexpanthenol is absorbed through the skin and quickly oxidizes to pantothenic acid. The component is not characterized by systemic absorption.

• Indomethacin.

The drug is quickly absorbed into the tissues, already five minutes after its application to the skin, its appearance in the subcutaneous tissues can be observed. The amount of the substance that can be absorbed through the skin depends on the time the ointment remains on the skin, as well as its quantity and the quality of absorption of the skin. The active substance is able to penetrate the synovial membrane and synovial fluid of the joints, where it can be observed for five to eight days.

Almost one hundred percent of the active substance binds to blood proteins, which is reversible. Indomethacin is metabolized in the liver by forming metabolites, which are inactive. The half-life is from four to nine hours. A third of the metabolites are excreted with feces, seventy percent of the metabolites are eliminated from the body through urine. Thirty percent of the substance remains unchanged, which is also eliminated from the body.

• Ketonal.

The active component of the drug is quickly absorbed through the skin. Therapeutic concentrations are achieved in two hours. The percentage of bioavailability of the drug reaches ninety percent. Ketoprofen is ninety-nine percent capable of binding to serum proteins. The substance is characterized by the ability to penetrate into the synovial fluid and can reach therapeutic concentrations in it. Metabolism of ketoprofen occurs in the liver, while conjugates are formed, which are excreted from the body through urine. There is no connection between the metabolism of the active substance depending on the age characteristics of the patient. Severe renal failure of the patient or a history of liver cirrhosis also does not affect its metabolism. The rate of excretion of ketoprofen through urine is slow.

• Finalgon.

There are no data on the pharmacokinetics of the drug.

• Efkamon.

There is no information on the pharmacokinetics of the drug.

Method of administration and dosage

Apizartron.

• The medicine is used externally. The ointment is applied to the skin in the form of a strip, which is three to five centimeters long. After that, the product is distributed over the desired area of the skin with a thickness of up to one millimeter until redness and a feeling of warmth appear (approximately, for two to three minutes). Then the drug must be rubbed into the skin with great intensity and at a slow pace. It is recommended to wrap the affected area with a cloth in order to increase the effectiveness of the drug by maintaining heat on the treated area of the skin. The drug is used two to three times a day for ten days.

Ben-Gay.

• The cream is used locally in a small amount, which is applied to the desired area of the skin. Thus, it is necessary to do three or four times a day.
• Sports balm is applied by rubbing into muscles three or four times a day.

Bom-Bengue.

• The medication is used externally by rubbing into the necessary areas of the body two or three times a day. The course of treatment is determined by a specialist, which depends on the patient's problems.

Bystrumgel.

• The drug is used locally. Three to five centimeters of the medicine is applied to the required area of the skin and spread in a thin layer, rubbed in carefully until the drug is absorbed into the skin. It is used twice a day.

Viprosal V.

• The medication is intended for external use. Five or ten grams of the drug are applied to the painful area and thoroughly rubbed into the skin until the pain disappears completely. This procedure should be done one to two times a day. The course of therapy with the drug depends on the patient's problems and the nature of his illness.

Voltaren Emulgel.

• The drug is used externally. Two to four grams of gel is applied to the desired area of skin, with light rubbing movements. This procedure should be done twice a day, twelve hours each. After which hands should be washed thoroughly. The course of treatment is up to fourteen days.

Diclofenac.

• The ointment is used externally. Two to four grams of the drug is applied in a thin layer to the desired area of the skin and rubbed in with light movements. The procedure should be repeated two to three times a day. The maximum amount of the drug per day is up to eight grams. After using the medicine, you must wash your hands. The course of treatment is selected individually, but not more than two weeks.

Dolaren gel.

• The medicine is intended for external use. The gel is applied in a thin layer to the selected area of skin in an amount of two to four grams and lightly rubbed in until the drug is absorbed. The procedure is repeated three to four times a day. Painful symptoms are reduced or disappear in the first days after the start of treatment.

Dolobene gel.

• The drug is applied locally. A thin strip of gel is applied to the required area of skin and lightly rubbed in. This procedure should be carried out two to four times a day. It is possible to use the gel and physiotherapeutic procedures - iontophoresis and phonophoresis.

Indomethacin.

• The drug is used externally. A small amount of ointment is applied to the affected areas with rubbing movements. This should be done three or four times a day. To fix the drug in the right place, it is worth resorting to the use of an occlusive dressing. The largest daily dose of ointment for adult patients should not exceed fifteen centimeters squeezed out of the tube. For pediatric patients, the amount of ointment is halved. The course of treatment can be thirty days, although the duration of therapy should be determined by a specialist.

Ketonal.

• The drug is used once or twice a day. Five to ten centimeters of gel is applied to the required area of skin with gentle rubbing movements. There is no need to apply a bandage. The gel can be used together with other Ketonal drugs, which are capsules, tablets, suppositories. The total daily amount of the drug should not exceed two hundred milligrams. The course of treatment with the drug is determined by the attending physician.

Finalgon.

• The medicine is used externally. Treatment with the drug should be started with a small dosage. In this case, the amount of medicine up to half a centimeter long should be applied to the skin surface, which is equal to the area of the palm of the hand. The drug is applied to the skin with an applicator and rubbed in without using force. After this, it is important to wash your hands, which will protect the patient from getting the medicine on other areas of the skin.
• To enhance the therapeutic effect of the drug, it is necessary to cover the treated area with woolen fabric. The drug should be used two to three times a day. The course of treatment with the drug is determined by the nature of the disease.

Efkamon.

• The drug is used externally. Two to three grams of the product are rubbed into the required area of skin. This procedure should be done two or three times a day. After rubbing, a dry and warming bandage is applied to the treated area. The course of treatment depends on the patient's problems and is determined by a specialist.

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Using Ointment for Muscle Pain During Pregnancy

• Apizartron.

Use of the drug during pregnancy is contraindicated. It is necessary to use the drug with caution during the lactation period.

• Ben-Gay.

It is prohibited to use the drug during pregnancy and breastfeeding.

• Bom-Bengue.

The use of the medication during pregnancy and lactation is contraindicated.

• Butadion.

The medicine should not be used during pregnancy and breastfeeding.

• Bystrumgel.

The drug is prohibited for use during pregnancy and lactation.

• Viprosal V.

The drug should not be used during pregnancy and breastfeeding.

• Voltaren Emulgel.

There is no information on the use of the drug during pregnancy. Due to this fact, the drug can be used in the first and second trimesters of pregnancy only on the recommendation of a doctor, when the benefit to the mother will outweigh the risk to the fetus. The use of the gel in the third trimester of pregnancy is prohibited, since this drug can provoke the appearance of uterine tone or premature closure of the arterial duct of the fetus.

During the lactation period, the medication should not be used due to the lack of data on the penetration of the active components of the drug into breast milk.

• Diclofenac.

There are no data on clinical studies of the drug in a group of pregnant women and nursing mothers. Therefore, in these periods of life, women are advised to refrain from using the drug. It is prohibited to use the drug in the third trimester of pregnancy due to the risk of closure of the Botallov duct, which can weaken contractions during labor. There is no data on the penetration of active substances into breast milk.

• Dolaren gel.

It is prohibited to use the drug during pregnancy and breastfeeding.

• Dolobene gel.

The use of the drug during this period is prohibited, since there is no data on its safety during this period. Experimental studies have revealed the teratogenic effect of dimethyl sulfoxide.

The use of the drug during lactation is prohibited due to the fact that its active components are found in breast milk.

• Indomethacin.

The drug should not be used during pregnancy and lactation.

• Ketonal.

It is prohibited to use the drug in the third month of pregnancy because the active component of the drug can prolong the gestational period, prematurely close the Botallo duct and cause pulmonary hypertension in the newborn. In the first and second trimesters of pregnancy, the drug is used only based on strict indications and under the supervision of specialists.

It is not recommended to use the gel during lactation.

• Finalgon.

There is not enough information about the possibility of using the drug during pregnancy. Therefore, this medication is prohibited for use in these categories of women. There is no data on the penetration of the components of the drug into breast milk, so the drug cannot be used during the lactation period.

• Efkamon.

The use of the drug during pregnancy and lactation should be decided on an individual basis in each specific case of the need for therapy with the drug.

Contraindications to the use of ointment for muscle pain

Apizartron.

• Hypersensitivity to the components of the drug.
• Pediatric patients under twelve years of age.
• Women during menstrual bleeding.
• Presence of acute infectious diseases.
• The onset of sepsis.
• Acute inflammatory processes in the body, which are accompanied by the formation of pus.
• Tuberculosis.
• Hepatitis, nephritis, pancreatitis, diabetes.
• Presence of widespread osteoporosis.
• Tumor processes in the body.
• History of organic diseases of the central nervous system, as well as psychosis.
• Hemorrhagic diathesis.
• The appearance of coagulopathy, thrombocytopathy, anemia.
• The occurrence of circulatory failure in the second or third stage.
• The appearance of chronic renal failure, cachexia, adrenal insufficiency.
• The period before surgery.
• Exacerbations may occur in patients with gallstone and kidney stone diseases.

Ben-Gay.

• The presence of hypersensitivity to the components of the drug.
• Existing open wounds at the site of application of the medication.
• Presence of skin irritation.
• The patient's age is under twelve years.

Bom-Bengue.

• Existing hypersensitivity to the drug substance.
• The patient's age is under eighteen years.
• The presence of high sensitivity to acetylsalicylic acid, as well as non-steroidal anti-inflammatory drugs.
• History of bronchial asthma.
• Damaged skin.
• Presence of skin diseases.

Butadion.

• The presence of hypersensitivity to the components of the drug.
• The presence of trophic lesions of the skin with ulcers.
• The appearance of eczema.

Bystrumgel.

• Presence of hypersensitivity to ketoprofen and other substances of the drug.
• Presence of eczema, dermatoses, infected abrasions and wounds.|
• The patient's age is under fourteen years.

Viprosal V.

• The presence of hypersensitivity to the substances of the drug.
• Violation of the integrity of the skin.
• Presence of pulmonary tuberculosis.
• History of problems with cerebral and coronary circulation.
• Possibility of occurrence of angiospasms.
• Severe forms of liver and kidney dysfunction.

Voltaren Emulgel.

• Presence of hypersensitivity to the active or excipients.
• The possibility of developing bronchial asthma, as well as skin rashes, acute rhinitis, as a consequence of allergic reactions to acetylsalicylic acid and other non-steroidal anti-inflammatory drugs.
• Existing violations of the integrity of the skin in the desired area of application of the drug.
• The patient's age is under twelve years.
• The gel should be used with caution in cases of hepatic porphyria, erosive and ulcerative lesions of the gastrointestinal tract, severe liver and kidney dysfunction, problems with blood clotting, symptoms of chronic heart failure, bronchial asthma, and in old age.

Diclofenac.

• The presence of hypersensitivity to the ingredients of the drug. The same warning applies to acetylsalicylic acid and nonsteroidal anti-inflammatory drugs.
• The patient has a history of aspirin-induced asthma.
• The age of patients is up to twelve years.
• Existing violations of the integrity of the skin.

Dolaren gel.

• History of hypersensitivity to diclofenac sodium or other components of the gel.
• Presence of bronchial asthma.
• Signs of gastric ulcer or duodenal ulcer that indicate an exacerbation of the disease.
• Children under twelve years of age.

Dolobene gel.

• Existing hypersensitivity to the active components of the drug or its excipients.
• History of bronchial asthma.
• Existing symptoms of renal and hepatic failure.
• The presence of severe disorders of the cardiovascular system, namely angina pectoris, myocardial infarction, stroke, severe general atherosclerosis.
• The patient's age is under five years.

Indomethacin.

• The presence of high sensitivity to the substances included in the drug.
• Existing gastric ulcer or duodenal ulcer in the acute stage.
• Hypocoagulation phenomena.
• Chronic kidney disease.
• Damaged skin.
• The patient's age is under fourteen years.

Ketonal.

• The presence of high sensitivity to ketoprofen, as well as to other components of the drug.
• The presence of hypersensitivity to medications from the salicylate group, as well as non-steroidal anti-inflammatory drugs.
• The patient's age is up to fifteen years.
• The patient has a history of allergic reactions to salicylates.
• Having a predisposition to certain diseases, such as bronchial asthma or allergic diseases.
• It is prohibited to apply the drug to damaged skin surfaces - eczema, weeping dermatitis, open or infected wounds.

Finalgon.

• Increased skin sensitivity.
• The presence of hypersensitivity to the components of the drug.
• The presence of open wounds, irritations and damaged areas of the skin at the site of application of the drug. The drug should not be used on mucous membranes.
• Do not use if you have skin diseases.
• Do not use in pediatric patients under twelve years of age.

Efkamon.

• The presence of hypersensitivity to the components contained in the medication.

[ 4 ], [ 5 ], [ 6 ], [ 7 ], [ 8 ], [ 9 ]

Side effects of muscle pain ointment

Apizartron.

• Local reactions – skin irritation, redness, itching, pain, hyperemia, swelling.
• The occurrence of malaise, agitation, headaches, nausea, vomiting, tachycardia, chills, hives throughout the body.
• Sleep disturbances are observed.
• An increase in overall body temperature is possible.
• Sometimes there is pain in the lumbar region and joints, as well as cramps.

Ben-Gay.

• The appearance of skin irritation.
• The occurrence of allergic reactions in the form of urticaria and erythema.

Bom-Bengue.

• The occurrence of allergic reactions in the form of swelling of the skin, rashes, as well as itching and burning sensations.
• There is a possibility of allergic reactions: swelling of the face, lips, tongue and larynx, difficulty breathing. In this case, it is necessary to seek emergency medical care.

Butadion.

• Local reactions may include eczema, photosensitization, contact dermatitis accompanied by itching, redness, swelling, the appearance of papules and vesicles, and peeling.
• Allergic reactions include urticaria, angioedema, bronchospasm, and generalized skin rash.

Bystrumgel.

• Sometimes, in very rare cases, allergic reactions and photosensitivity symptoms may occur.

Viprosal V.

• Allergic reactions may occur in the form of itching and burning of the skin, as well as swelling and urticaria of the skin.

Voltaren Emulgel.

• Local allergic reactions – the appearance of erythema, dermatitis, including contact dermatitis, which is characterized by the presence of eczema, itching, swelling, rash, papules, vesicles, peeling. In rare cases, bullous dermatitis may appear, as well as photosensitivity.
• Immune system – the appearance of generalized skin rash and some allergic manifestations – urticaria, hypersensitivity, angioedema.
• Respiratory system – asthma attacks and bronchospastic reactions may occur.
• Of parasitic and infectious diseases, in rare cases, pustular rashes may appear.

Diclofenac.

• Allergic reactions – the appearance of eczema, photosensitivity, contact dermatitis accompanied by itching, hyperemia, swelling, papular-vesicular rashes, peeling of the skin; the occurrence of burning of the skin, erythematous skin rash, urticaria.
• Angioedema may occur, as well as systemic anaphylactic reactions, including anaphylactic shock.

Dolaren gel.

• The drug is well tolerated by patients.
• In rare cases, redness of the skin, itching or burning sensation may occur.

Dolobene gel.

• The appearance of bad breath.
• Changes in taste sensations that disappear within a few minutes.
• Allergic manifestations in the form of itching, urticaria, Quincke's edema.

Indomethacin.

• The appearance of allergic reactions in the form of itching and burning, hyperemia of the skin, rash, dry skin.
• The occurrence of systemic side effects: nausea, vomiting, heartburn, headache, dizziness, taste disturbances, blurred vision, proteinuria, interstitial nephritis, gastropathy).

Ketonal.

• Common manifestations include the appearance of skin hypersensitivity, namely the occurrence of itching, redness and transient inflammation of the skin, mild contact dermatitis.
• In rare cases, severe skin inflammatory reactions may occur in the form of contact dermatitis; severe contact prolonged photosensitization reactions, which subsequently spread to all skin surfaces; skin exanthemas; symptoms of purpura; impaired renal function in the presence of a history of renal failure; the appearance of intestinal nephritis and asthmatic reactions.

Finalgon.

• Allergic manifestations – the appearance of skin rashes and hives, the occurrence of facial swelling.
• Local reactions – some hyperemia in the area where the drug was applied, itching and burning.

Efkamon.

• Local allergic reactions – the appearance of unpleasant sensations in the form of itching and burning of the skin, as well as its peeling.

Overdose

Apizartron.

• Signs of skin irritation appear, which are expressed in reddening of the skin and the appearance of itching.
• If the above symptoms occur, you should stop using the medicine.

Ben-Gay.

• The drug is a medicine in which overdose is practically impossible.
• If the conditions for using the ointment are violated, then overdose symptoms may occur. In this case, it is recommended to stop using the medication and seek qualified medical help.
• Signs of a menthol overdose include the occurrence of central nervous system depression in the form of loss of consciousness and impaired reactions to external stimuli. Signs of vomiting, diarrhea and nausea, depressed breathing, increased blood flow to the face, and signs of drowsiness may also be observed.
• Signs of an overdose of methyl salicylate include the appearance of severe excitability, impaired breathing, and the appearance of hyperthermia in a malignant form.

Bom-Bengue.

• An overdose may develop only when using a large amount of the drug applied to large areas of the skin, as well as when the ointment comes into contact with damaged areas of the skin and when taken orally.
• Signs of methyl salicylate overdose include agitation, increased depth of breathing, and symptoms of hyperpyrexia.
• Symptoms of a menthol overdose include nausea and vomiting, abdominal pain, facial flushing, dizziness, unsteady gait, drowsiness, respiratory distress, and coma.
• In these cases, the use of symptomatic therapy is indicated.

Butadion.

• The low degree of absorption of the drug does not lead to overdose when used externally.
• If the medication was accidentally swallowed in large quantities, over twenty grams, the symptoms observed with an overdose of non-steroidal anti-inflammatory drugs will appear.
• In this case, you need to flush your stomach and take activated charcoal.

Bystrumgel.

• Low bioavailability of the drug makes overdose impossible.
• Theoretically, bleeding is expected to occur as a symptom of overdose.

Viprosal V.

• The appearance of allergic reactions is observed, which are expressed in the presence of itching and burning of the skin, as well as the appearance of dermatitis and skin peeling.
• In this case, it is recommended to stop using the drug and wash off any medication remaining on the skin with water.

Voltaren Emulgel.

• The drug is characterized by low systemic absorption, so overdose is considered unlikely. If the drug accidentally gets inside the patient, it can cause adverse reactions. In this case, it is necessary to wash the stomach, induce vomiting, prescribe activated carbon, and prescribe symptomatic therapy.

Diclofenac.

• There are no cases of drug overdose due to the low level of systemic absorption.

Dolaren gel.

• There are no cases where overdose was detected during the course of the drug.

Dolobene gel.

• Overdose is considered unlikely because systemic absorption of the active substances is considered very low.

Indomethacin.

• Low systemic absorption of the ointment makes it virtually impossible to overdose on the drug.
• If the drug was taken orally, it may cause overdose symptoms. Its signs are headache, dizziness, nausea, vomiting, memory impairment, disorientation in space, sometimes a feeling of numbness in the limbs, signs of paresthesia and convulsions.
• In this case, it is recommended to wash the stomach and also use symptomatic treatment. There is no specific antidote. Forced diuresis and hemodialysis procedures have shown their ineffectiveness.

Ketonal.

• Signs of skin irritation and itching, as well as erythema, may occur. In this case, it is necessary to wash the skin under running water for a long time.

Finalgon.

• Using more of the product than indicated in the instructions may cause the following symptoms: itching or burning symptoms, skin hyperemia. In order to reduce the unpleasant sensations, you should resort to using one of the nourishing creams.

Efkamon.

• There are no known cases of drug overdose.

Interactions of muscle pain ointment with other drugs

• Apizartron.

Bee venom and glucocorticoids, salicylates, antihistamines are a permitted combination in therapy. The use of methyl salicylate leads to increased effectiveness of anticoagulants and methotrexate.

• Ben-Gay.

There is no data on the interaction of the drug with other drugs.

• Bom-Bengue.

Patients using medication and anticoagulants for treatment require specialist supervision.

• Butadion.

There is no data on clinically important interactions of the drug and other medications. The drug should not be used with other non-steroidal anti-inflammatory drugs, as well as with medications that provoke photosensitivity.

• Bystrumgel.

No interactions of the drug with other medications were identified.

• Viprosal V.

There are no known interactions of the drug with other drugs.

• Voltaren Emulgel.

The medicinal product enhances the effectiveness of drugs that can cause a photosensitivity reaction. There are no descriptions of significant interactions with other drugs.

• Diclofenac.

It helps to enhance the effectiveness of drugs that cause photosensitivity reactions. It should be used with caution in combination with other medications that are characterized by hepatotoxicity. These include antibacterial agents, antiepileptic drugs. No clinically significant interaction with other medications is observed due to the presence of low systemic absorption.

• Dolaren gel.

No systemic interactions of the drug with other drugs have been identified.

• Dolobene gel.

With the help of dimethyl sulfoxide, the resorption of many substances that are characterized by poor penetration through the skin is increased. Peripheral neuropathies may occur due to the simultaneous use of drugs that contain sulindac.

• Indomethacin.

The ointment is characterized by low systemic absorption, so virtually no interactions with other drugs have been recorded. If other nonsteroidal anti-inflammatory drugs are used together, their systemic action may be enhanced, as well as the gastrotoxic effect.

Heparin enhances the analgesic and anti-inflammatory effect of the drug if it is used simultaneously and locally. The anticoagulant effect of heparin is also enhanced.

Menthol, as well as medications containing capsaicin and various essential oils, when applied simultaneously to the skin, help enhance the analgesic effect.

Dimethyl sulfoxide, which is used simultaneously with the drug, leads to increased systemic absorption and allows for an increase in the penetration distance of the ointment into tissues.

• Ketonal.

Ketoprofen, when used simultaneously with acetylsalicylic acid, is characterized by a decrease in the degree of its binding to blood plasma proteins. The action of probenecid can lead to a decrease in the clearance of ketoprofen and the degree of its binding to blood serum proteins. The active substance of the drug helps to reduce the elimination of methotrexate and increases the toxicity of the latter. Other drug interactions are not clinically significant.

• Finalgon.

There is no data on the nature of the interaction between the drug and other drugs.

• Efkamon.

There are no drug interactions described between the medication and other drugs.

Storage conditions for ointment for muscle pain

Each medical product requires certain conditions for its storage. The storage conditions for muscle pain ointment are as follows:

• Apizartron - in a place that is inaccessible to children and at a temperature that does not exceed twenty-five degrees Celsius.
• Ben-Gay - in a place inaccessible to children at an ambient temperature not exceeding twenty-five degrees Celsius.
• Bom-Bengue - in a place that is inaccessible to children, with the room temperature not exceeding twenty degrees Celsius.
• Butadion - in a room where children have no access at a temperature of eight to fifteen degrees Celsius.
• Bystrumgel - in a dry place, protected from children and sunlight, at a temperature of fifteen to twenty degrees Celsius.
• Viprosal B - at a temperature of up to twenty-five degrees Celsius and do not freeze, in a place inaccessible to children.
• Voltaren Emulgel - in a place inaccessible to children, at an ambient temperature not exceeding thirty degrees Celsius.
• Diclofenac - placed in a dry place, out of reach of children, at a temperature no higher than twenty-five degrees Celsius.
• Dolaren gel - in a dry place protected from direct sunlight, out of reach of children at temperatures up to twenty-five degrees Celsius.
• Dolobene gel - at an ambient temperature not exceeding twenty-five degrees Celsius and in a place inaccessible to children.
• Indomethacin - in a place protected from light and children, at a temperature of up to fifteen degrees Celsius.
• Ketonal is kept in a room that is inaccessible to children, at an ambient temperature not exceeding twenty-five degrees Celsius.
• Finalgon - must be kept at room temperature out of the reach of children.
• Efkamon - stored in a dry and cool place, out of reach of children.

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Best before date

Each medical drug has a certain shelf life, beyond which it cannot be used for medicinal purposes. The shelf life of drugs that help cope with muscle pain is as follows:

• Apizartron – thirty-six months from the date of manufacture.
• Ben-Gay - two years from the date of release.
• Bom-Bengue - twenty-four months from date of manufacture.
• Butadion – five years from the date of manufacture.
• Bystrumgel – twenty-four months from the date of manufacture.
• Viprosal B – three years from date of manufacture.
• Voltaren Emulgel – thirty-six months from the date of manufacture.
• Diclofenac – two years from date of manufacture.
• Dolaren gel – three years from the date of manufacture.
• Dolobene gel – two years from date of manufacture.
• Indomethacin – thirty-six months from date of manufacture.
• Ketonal – five years from date of manufacture.
• Finalgon - four years since release.
• Efkamon - three and a half years since release.

Ointment for muscle pain is a modern group of drugs that will help effectively cope with muscle pain and other disorders of the musculoskeletal system. Therefore, if any problems and pain occur, it is necessary to resort to the use of the drugs presented above, which will help relieve unpleasant symptoms and improve the patient's condition.