Ointments for muscle pain

Pain in the muscles 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 prerequisites, respectively, and therapy should be selected, based on the clinical picture of the problem.

Ointment from pain in the muscles - this is the generalized name of the remedies for muscular problems. In this group of drugs are actually ointments, as well as creams and gels.

Traumatic prerequisites for muscle pain are accompanied by the defeat of small vessels, as well as tissue hypoxia and increased capillary permeability. All this leads to a violation of blood flow and nutrition of tissues, as well as the process of their recovery. In these cases, sports ointments, gels and creams that have analgesic effect, reduce inflammatory processes, accelerate resorption, remove puffiness and reduce the size of hematomas are good for use. 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 means with a warming effect and preparations with a cooling effect.

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

Here is an incomplete list of drugs that help cope with muscle pain. Ointment relieving pain in the muscles, is represented by the following names:

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

[1], [2]

Indications for the use of ointments for muscle pain

• Apizartron.

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

• Ben-Gay.

Used for pain in the muscles and joints, which are caused by inflammation, joint stiffness and other problems. It is indicated in the presence of pain in the lower back and sacrum, which are caused by stretching. Also suitable after training and other sports activities with increased intensity.

• Bom-Bengu.

It is used to alleviate pain in the muscles and joints that were caused by sprains and bruises. Also shown if there are pains in the loin and sacrum in lumbago and sciatica.

• Butadione.

It is prescribed for posttraumatic inflammatory processes in soft tissues and joints, which resulted from stretching, overstrain or injury of the above tissues and organs. The drug is indicated for rheumatic diseases that affect soft tissues, namely, tendinitis, bursitis, lesions of periarticular tissues, as well as pain in muscles that have a rheumatic and non-rheumatic nature. The medication is used for pain syndromes and swelling, which are caused by problems with muscles and joints, namely with rheumatoid arthritis, osteoarthrosis, radiculitis, lumbago, sciatica.

• Bystrumgel.

The drug is used for inflammation or trauma, which affects joints and muscles, ligaments and tendons. These problems include arthritis and periarthritis, bursitis, tendinitis, tendosynovitis, bruises and ligament damage, various dislocations, knee meniscus damage, the presence of torticollis and lumbago, phlebitis and periphlebitis.

• Viprosal V.

It is used for pain sensations that cause arthritis of a different nature, as well as myalgia, neuralgia, sciatica and radiculitis.

• Voltaren Emulgel.

The presence of pain in the back caused by inflammatory and degenerative processes in the spine, namely radiculitis, osteoarthrosis, lumbago, sciatica. There are joint pains that touch the joints of the fingers, knee joints, and so on, due to rheumatoid arthritis and osteoarthritis. The presence of pain in the muscles, which were caused by stretches, bruises, injuries and overexertion of these tissues. The appearance of inflammatory processes and swelling in soft tissues and joints, which are caused by trauma and rheumatic diseases, such as bursitis, tendovaginitis, wrinkles, lesions of periarticular tissues.

• Diclofenac.

Used for rheumatic conditions caused by inflammation of muscles, ligaments, tendons and joints that occur with stretching, heavy loads and bruises. It is also used for the therapy of localized forms of soft tissue rheumatism in bursitis, tendovaginitis, periarterripathy. Used for localized rheumatic diseases, for example, with joint arthrosis.

• Dolaren gel.

Used for myositis, fibrositis, sciatica, muscle and tendon stretches, injuries of the musculoskeletal system. It is indicated for pain in the muscles and joints, especially when there are high physical exertion. It is used for the treatment of inflammatory and degenerative phenomena in the joints.

• Dolobien gel.

The drug is indicated for use in hematomas and inflammatory processes in soft tissues, muscles, tendons, tendon sheaths, ligaments with bruises, squeezing, injuries. Also, the medication is used for neuralgia, humeroscapular periarthritis, epineondylitis of the shoulder, tendinitis, tendovaginitis, bursitis, arthritis, deforming osteoarthritis, superficial thrombophlebitis, thrombotic ulcers, which causes chronic venous insufficiency.

• Indomethacin.

It is used for inflammatory processes in tendons, ligaments, muscles and joints, which were caused by trauma. It is also prescribed for the treatment of inflammation in soft tissues with tendovaginitis, tendinitis, bursitis. It is indicated for myalgia, lumbago and sciatica. Used for inflammatory and degenerative processes in the musculoskeletal system, for example, with deforming osteoarthritis, rheumatoid arthritis, ankylosing spondylitis, osteochondrosis and so on.

• Ketonal.

It is used for inflammatory diseases with a degenerative character characterized by the musculoskeletal system: rheumatoid arthritis, seronegative arthritis, Bechterew's disease, psoriatic arthritis, Reiter's syndrome, gout symptoms, and pseudogout and osteoarthrosis. 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 pain in the muscles and joints, which are caused by overexertion, arthritis, lumbago, sciatica, neuritis, tendovaginitis, bursitis.

• Efkamon.

The drug is prescribed for acute arthritis, polyarthritis, myalgia, neuralgia, lumbago, cervical myositis, rheumatism, sciatica, migraines, bruises, deforming spondyloarthritis, trunkita, ganglionitis in the cervico-thoracic spine.

Form of issue

• Apizartron.

The drug is an ointment with a white or yellowish color. The drug is produced 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 box. In a hundred grams of medicine contains bee venom - three milligram, methyl salicylate - ten grams, allyl isothiocyanate - one gram, sodium lauryl sulfate - seven hundred milligrams, white petrolatum - six grams, emulsified cetostearyl alcohol - fourteen grams, water - up to one hundred grams.

• Ben-Gay.

The drug is available in the form of cream and sports balm creamy consistency. Cream and balm are packaged in aluminum tubes for thirty-five gammas of medicament in each. Tubes one by one are placed in a cardboard box 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. The auxiliary components include some stearic acid, glycerin monostearate, polysorbate 85, sorbitan tristearate, trolamine, purified water.

Each gram of sports balsam includes active substances-tartalsalicylate - two hundred and eighty milligrams, menthol - one hundred milligrams. Of the excipients in the preparation contains a certain amount of glycerin monostearate, lanolin, polysorbate 85, purified water, sorbitan tristearate, stearic acid, xanthan gum, potassium hydroxide.

• Bom-Bengu.

The drug is produced in the form of an ointment that is white or white with a yellowish tinge, and a strong specific odor. The drug is packaged in aluminum tubes of twenty-five grams each and placed in cardboard packaging together with a leaflet-instruction. One gram of the drug 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 petrolatum.

• Butadione.

The drug is available in the form of an ointment that has a white color, a uniform consistency and a specific odor. The medication is packaged in aluminum tubes of twenty grams each and placed in a cardboard box along with a littcomst 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, glycerol, polysorbate 60, liquid paraffin, propylene glycol, purified water.

• Bystrumgel.

The drug is available in the form of a gel that is clear and colorless and has a specific odor. The medication is packaged in aluminum tubes of thirty or fifty grams each and placed in cardboard boxes along one tube. A sheet with instructions is put into the box. In one gram of the drug contains the active substance - ketoprofen - twenty five milligrams. There is also a certain amount of excipients - ethyl alcohol, nipagin, carbomer, lavender oil, trometamol, neroli oil, purified water.

• Viprosal V.

The preparation is available in the form of an ointment that has a white or whitish color with a yellow tinge, as well as camphor or turpentine smell. The drug is packaged on aluminum tubes of thirty or fifty grams each. The tube is placed in a cardboard box and is supplied with a leaflet with instructions. In one gram of the drug there are fifty viper venom units, ten milligrams of salicylic acid, thirty milligrams of camphor, thirty milligrams of turpentine turpentine. There is also a certain amount of auxiliary substances, namely, paraffins of solid, vaseline medical, distilled glycerin, emulsifier, sodium chloride and purified water.

• Voltaren Emulgel.

The drug is a gel with a creamy consistency, which is white or white with a yellowish hue. The drug is packaged in laminated aluminum tubes that have a shoulder and are closed using a solidified shaped membrane as well as a plastic cover. Each tube has a weight of fifty or one hundred grams of the drug and is placed in a cardboard box provided with a leaflet. A hundred grammes of the gel contains 2.32 grams of active ingredient, diclofenac diethamine, as well as auxiliary components, including carbomer, cetostearmacrogol, cocoyl prilocaprate, diethylamine, isopropanol, liquid paraffin, oleyl alcohol, eucalyptus flavor, propylene glycol, butylhydroxytoluene, purified water.

• Diclofenac.

The drug is available in the form of an ointment that is white or almost white in color, as well as a weak specific odor. The medicine is packed in aluminum tubes of thirty grams each. Tubes are placed in a cardboard box with an insert instruction. Each tube contains an active substance - diclofenac sodium - three hundred milligrams. Also, the preparation contains a certain amount of auxiliary substances - dimethylsulfoxide, propylene glycol, macrogol 1500, macrogol 400.

• Dolaren gel.

The drug is available in the form of a yellowish gel that differs in a specific odor. The drug is packaged in aluminum tubes of thirty grams each. In a hundred grammes of gel there are 1,163 grams of diclofenac diethylamine, five grams of menthol, ten grams of methyl salicylate and three grams of linseed oil. Of the other components, there is a content of benzyl alcohol, carbomer, diethanolamine, bronopol, sodium metabisulphite, propylene glycol, polysorbate 80, sandalwood oil, isopropyl alcohol, purified water.

• Dolobien gel.

The drug is a gel, packaged in aluminum tubes of fifty or one hundred grams. Each tube is placed in a cardboard box and is supplied with an insert instruction. In a hundred grammes of gel there are 15 grams of dimethylsulfoxide, fifty thousand units of sodium heparin, two and a half grams of dexpanthenol and auxiliary substances.

• Indomethacin.

The drug is released in the form of a ten percent ointment, which is packaged in forty grams in glass jars or aluminum tubes. Each bank or tube is placed in a cardboard box and is supplied with a leaf-instruction. Ointment is a substance that has a light yellow or dark yellow color, as well as a specific menthol odor. One hundred grams of the drug contains ten grams of indomethacin, as well as a certain amount of auxiliary substances - dimexide, carbamide, polyethylene oxide 400, polyethylene oxide 1500, propylene glycol, menthol, nipagin, nipase, purified water.

• Ketonal.

The drug is available in the form of a homogeneous and transparent gel. The drug is placed in aluminum tubes, which inside have a varnish coating. On top of the tube is covered with a protective membrane and a screwed polymer cover. Tuba is placed in a cardboard box along with the insert instruction. Each tuba contains fifty grams of the drug. In one gram of gel there are twenty five milligrams of active substance - ketoprofen. Of the auxiliary substances, manufacturers resorted to the use of carbomer, trolamine, ethereal lavender oil, ethyl alcohol 96% and purified water.

• Finalgon.

The drug is available as an ointment and is packaged in aluminum tubes of twenty grams of the drug in each, equipped with plastic applicators. Each tube is packed in a cardboard box, where there is a leaflet with instructions. Each tuba contains four grams of nonivamide, and twenty five milligrams of nicoboxyl.

• Efkamon.

The drug is produced as an ointment for external use and is packaged in aluminum tubes of twenty grams each. The composition of the drug includes one gram of methyl salicylate, eighty milligrams of tincture of paprika, 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 metol.

[3],

Pharmacodynamics of ointments for muscle pain

• Apizartron.

The components of the drug have the following pharmacodynamic effects:

• Bee venom - promotes anesthesia and anti-inflammatory effect by stabilizing lysosomal membranes; has an antibacterial effect by inhibiting gram-positive bacteria.
• Methylsalicylate is a non-steroidal anti-inflammatory drug and has a strong anti-inflammatory effect by inhibiting the production of GHG and oppression of COX.
• Allyl isothiocyanate is a purified standardized mustard oil extract that promotes deep tissue warming, which improves local blood flow and reduces tonic muscle contractility.

• Ben-Gay.

The drug is distracting and analgesic. The medication is able to expand the capillaries, as well as irritate the sensitive skin receptors. The drug has the ability to cause sensations of heat due to the content of menthol in it. The warming effect helps to reduce tension, spasmodic and pain sensations, leads to increased microcirculation, and also facilitates the removal of irritating substances in the form of lactic acid from the body. Due to this, the quality of movements increases, and also therapeutic effects arise that relate to the joints, muscles, tendons, and also certain internal organs. The action of methyl salicylate leads to a reduction of pain.

• Bom-Bengu.

The drug has a combined effect. Active component - methyl salicylate - is distinguished by anti-inflammatory, analgesic, irritant and distracting activity. This is expressed in increasing capillary permeability, improving microcirculation processes, inhibiting the activity of mediators, causing inflammatory processes. Methol irritates the nerve endings in the tissues, which have increased sensitivity and leads to the achievement of the effect of anesthesia.

• Butadione.

The drug refers to non-steroidal anti-inflammatory drugs that can relieve inflammation and anesthetize. The active substances indiscriminately inhibit the activity of cyclooxygenase 1 and 2, and 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, which are caused by inflammation. Local application of the drug causes the elimination of pain in the joints and muscles, which are in a state of rest and movement.

• Bystrumgel.

Has anti-inflammatory and analgesic effects. It leads to inhibition of cyclooxygenase 1 and 2, and also promotes oppression of prostaglandin production. It is characterized by anti-bradykinin effect and leads to stabilization of lysosomal membranes. There is also a decrease in cytokine production and inhibition of neutrophil activity. It has the ability to reduce or eliminate pain in a state of rest and motion.

• Viprosal V.

The drug contributes to the appearance of irritating and analgesic effects, which is expressed in irritation of the skin receptors and subcutaneous tissue, which are highly sensitive. All this leads to an expansion of the vessels and an improvement in the trophism of the tissues.

• Voltaren Emulgel.

The drug has an active substance - diclofenac, which is a nonsteroidal anti-inflammatory drug. This component determines the analgesic, anti-inflammatory and antipyretic effect of the drug. The active component has the ability to indiscriminately inhibit cyclooxygenase 1 and 2, as well as disrupt the metabolic processes of arachidonic acid. The drug is used to stop pain syndromes and inflammations that affect the joints, muscles and ligaments due to the traumatic or rheumatic nature of the problem. This reduces the level of pain and swelling, which increases the mobility of joints.

• Diclofenac.

The drug is a non-steroidal anti-inflammatory agent, a derivative of phenylacetic acid. Has anti-inflammatory and analgesic effects. The drug leads to a reduction in the amount of prostaglandins in the inflammatory focus, which is achieved by indiscriminate inhibition of cyclooxygenase 1 and cyclooxygenase 2, as well as a violation of the metabolism of arachidonic acid.

• Dolaren gel.

The drug is a quick-acting agent that is applied topically. It differs in analgesic and anti-inflammatory effects.

The drug leads to skin hyperemia and enhances microcirculation in tissues, promotes anesthetizing, warming and anti-inflammatory actions. The drug has an activating effect on metabolic processes, and also leads to an improvement in the elasticity of muscles and tissues and reduces the local tone in the muscles. The effectiveness of the drug is noticed 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, diclofenac sodium, is a non-steroidal anti-inflammatory drug that is characterized by the ability to penetrate deeply into the tissues and accumulate in them. The substance is capable of inhibiting cyclooxygenase, leading to a decrease in prostaglandin production.

Flaxseed oil and methyl salicylate are distinguished by local irritating and distracting effects directed at the nerve endings. In addition, substances are noted in the vasodilating action.

Menthol has the effect of expanding the vessels in the subcutaneous structures, anesthetizing and bringing a sense of coolness.

• Dolobien gel.

The drug has anti-inflammatory, antiexudative, analgesic, antithrombotic properties; promotes the regeneration of tissues.

The effectiveness of the drug is derived from the characteristics of its active substances.

Dimethyl sulfoxide has anti-inflammatory, anti-exsessive and analgesic effects. It is able to penetrate well through biological membranes, as well as skin. This increases the penetration into the body of other components when used together.

Heparin is distinguished by the ability to inactivate biogenic amines in the tissue, which declares its anti-inflammatory effect, as well as the possibility of improving microcirculation. It leads to inhibition of the effectiveness of hyaluronidase, which is good for the regenerative qualities of tissues.

Dexpanthenol has anti-inflammatory and dermatoprotective effects, and also improves the processes of epithelialization and granulation of the skin, promotes the stimulation of restorative processes in tissues. After absorption, it is oxidized to pantothenic acid, which is a part of coenzyme A, and therefore participates in many metabolic processes.

• Indomethacin.

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

When rheumatic processes contribute to the emergence of anti-inflammatory and analgesic effects. It can ease the pain in both the calm state and the motor activity.

Anesthetic effect comes from thirty minutes to one hour after using the ointment. The preservation of the effect can be observed for six to nine hours. The maximum effectiveness of the drug is seen after two to three hours from the time it was applied to the affected area.

• Ketonal.

The active component of the drug, ketoprofen, is a non-steroidal antirheumatic drug that has anti-inflammatory and analgesic effects. The substance is considered one of the most potent inhibitors of cyclooxygenase. Lipooxygenase and bradykinin also reduce their activity under the influence of ketoprofen. The substance stabilizes the liposome membranes, which helps to prevent the release of enzymes that mediate inflammation.

• Finalgon.

The drug has a combined effect, it is used topically.

Of active substances, the action of nonivamide and nicoboxyl is noticeable. Nonivamide is a synthetic derivative of capsaicin and has a local irritant effect that stimulates peripheral nerve endings. Nikoboxil differs in its direct vasodilating effect. The active substances of the drug are able to potentiate each other.

The drug leads to hyperemia of the skin, as well as to anesthesia and a prolonged warming effect. It has an anti-inflammatory effect and promotes the acceleration of tissue regeneration. The effect of the drug is noted for 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.

In another active ingredient of the medicine - tincture of capsicum pepper contains substance capsaicin, which has a pronounced irritant effect on sensitive skin receptors. The same qualities characterize the essential oils that make up the product - eucalyptus, mustard, cloves, as well as camphor and menthol.

The drug has a distracting, analgesic, warming, resorptive and anti-inflammatory effects. Its productivity is based on stimulating the production of the central nervous system of endorphins and enkephalins, which suppress or alleviate pain in problematic areas by interacting with the central nervous system of impulses from diseased tissues and areas of application of the drug. The drug is characterized by the ability to improve blood supply in the areas of inflammation, which leads to an increase in the permeability of vessels that drain the pathological tissues better.

Pharmacokinetics of ointments for muscle pain

• Apizartron.

Data on the pharmacokinetic properties of the drug are not provided.

• Ben-Gay.

There is no data on the pharmacokinetics of the drug.

• Bom-Bengu.

The active component of the drug is able to penetrate through intact skin and provide a systemic effect, although the analgesic concentration of the substance in the systemic circulation is not accumulated.

• Butadione.

Systemic absorption in local use does not exceed five percent. Phenylbutazone is able to be metabolized in the liver and in the form of metabolites is excreted by the kidneys and only one quarter of metabolites are excreted with feces.

• Bystrumgel.

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

• Viprosal V.

Information on the pharmacokinetics of the drug is not available.

• Voltaren Emulgel.

The amount of 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 active substance in the blood plasma is a hundred times lower than after oral intake of a similar amount of the component. About one hundred percent of diclofenac is able to bind to blood proteins, mainly albumins. The active substance has the characteristic of being distributed and accumulated in those tissues that undergo inflammatory processes.

Diclofenac by metabolism is converted into several phenolic metabolites, some of which are transformed into colluconide conjugates. The half-life of the substance and its metabolites is from one to three hours. The greatest amount of diclofenac and its metabolites is removed from the body by means of urine.

• Diclofenac.

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

The maximum amount of medicament in the blood serum with the help of skin application of the drug is a hundred times lower than with the oral use of the drug. More than ninety-nine percent of active substances are able to bind to blood plasma proteins, most of all - with albumins. The half-life of the substance from the blood is a period of one to two hours. The active component of the drug and its metabolites are excreted from the body more by means of urine.

• Dolaren gel.

Local use of the drug causes a five percent suction from the amount applied. In this case, the systemic effect of active components on the body is minimal.

• Dolobien gel.

Dimethyl sulfoxide in the case of methanol is characterized by the ability to rapidly penetrate all biological membranes. The level of active substance concentration in the skin, muscles and synovium is higher than in blood, ten to one hundred times. About ninety percent of the substance is excreted by the kidneys, a dose of six percent of the component is 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 beginning of the use 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 rapidly oxidized to pantothenic acid. The component is not characterized by systemic absorption.

• Indomethacin.

The drug is rapidly absorbed into the tissue, just five minutes after it is applied to the skin, it can be observed in subcutaneous tissues. The amount of substance that can be absorbed through the skin depends on the time that the ointment resides on the skin, as well as its quantity and quality of absorbing the skin. The active substance is able to penetrate into the synovial membrane and the synovial fluid of the joints, where it can be observed for five to eight days.

Virtually one hundred percent of the active substance binds to blood proteins, which is reversible. The metabolism of indomethacin is carried out in the liver by the formation of metabolites, which are inactive. The half-life is between four and nine hours. A third of the metabolites is excreted along with the calves, seventy percent of the metabolites are removed from the body through urine. Thirty percent of the substance remains unchanged, which is also removed from the body.

• Ketonal.

The active component of the drug is rapidly absorbed through the skin. Achieving therapeutic concentrations is observed after two hours. The percentage of bioavailability of the drug reaches ninety percent. Ketoprofen by ninety-nine percent is able to bind to serum proteins. The substance is characterized by the ability to penetrate into the synovial fluid and can achieve therapeutic concentrations therein. Metabolization of ketoprofen occurs in the liver, with the formation of conjugates, which are excreted from the body with the help of urine. There is no correlation of the metabolism of the active substance depending on the age characteristics of the patient. Heavy renal failure of the patient or history of liver cirrhosis also does not affect his metabolism. The rate of excretion of ketoprofen by urine is slow.

• Finalgon.

Data on the pharmacokinetics of the drug is not available.

• Efkamon.

There is no information on the pharmacokinetics of the drug.

Dosing and Administration

Apizartron.

• The drug is used externally. The ointment is applied to the skin in the form of a strip, which has a length of three to five centimeters. After that, the product is distributed to the desired area of skin with a thickness of up to one millimeter, until there is redness and a feeling of heat (approximately, for two to three minutes). Then the drug must be rubbed into the skin with a high intensity and at a slow pace. It is recommended to wrap the affected area with a cloth in order to strengthen the effectiveness of the preparation 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 topically in a small amount, which is applied to the desired area of the skin. So you have to do it three or four times a day.
• Sports balm is used for rubbing into muscles three or four times a day.

Bom-Bengu.

• The drug is used externally by rubbing it into 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 topically. From three to five centimeters of the medicine is applied to the required area of the skin and distributed in a thin layer, rubbed with caution until the drug is absorbed into the skin. It is used twice a day.

Viprosal V.

• The medication is for external use only. Five or ten grams of the drug is applied to the area with pain and carefully rubbed into the skin until the pain disappears completely. This procedure should be done from 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. From two to four grams of gel is applied to the required area of the skin, with light rubbing movements. This procedure should be done twice a day, after twelve hours each. After that, you need to wash your hands thoroughly. The course of treatment is up to fourteen days.

Diclofenac.

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

Dolaren gel.

• The drug is intended for external use. The gel is applied in a thin layer on the selected area of the skin in amounts of two to four grams and is rubbed lightly until the preparation is absorbed. The procedure is repeated three to four times a day. Painful symptoms decrease or disappear in the first days after the beginning of treatment.

Dolobien gel.

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

Indomethacin.

• The drug is applied externally. A small amount of ointment is applied to the affected areas by rubbing movements. It is necessary to do this three or four times a day. To fix the drug in the right place, it is necessary to resort to the use of an occlusive dressing. The largest daily dose of ointment for adult patients should not exceed fifteen centimeters, which are squeezed out of the tuba. For patients of childhood, the amount of ointment is reduced by half. 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. From five to ten centimeters of the gel is applied to the desired area of the skin with soft rubbing movements. There is no need to apply a bandage. The gel can be used in conjunction with other Ketonal drugs, which are capsules, tablets, suppositories. The total daily amount of the drug should not be more than two hundred milligrams. The course of treatment with a medication is determined by the attending physician.

Finalgon.

• The medicine is used externally. Treatment with the drug should start with a small dosage. In this case, the amount of medicament up to half a centimeter should be applied to the surface of the skin, which is equal to the area of the palm of the hand. The drug is applied to the skin with the help of an applicator and rubbed without the use of force. After that, it is important to wash your hands, which will save the patient from getting medication on other skin areas.
• To enhance the therapeutic effect of the drug, you need to cover the treated area with a woolen cloth. The use of the drug per day should be from two to three times. The course of treatment with a drug is determined by the nature of the disease.

Efkamon.

• The drug is used externally. Two or three grams of the drug is rubbed into the necessary area of the 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.

[10], [11], [12], [13],

The use of ointment from pain in the muscles during pregnancy

• Apizartron.

Use of the drug during pregnancy is contraindicated. Care must be taken during the lactation period.

• Ben-Gay.

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

• Bom-Bengu.

Contraindicated use of medication during pregnancy and lactation.

• Butadione.

Do not use the drug 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 the period of breastfeeding.

• Voltaren Emulgel.

There is no information on the use of the drug during pregnancy. Due to this fact, the use of the drug in the first and second trimesters of pregnancy is possible only on the recommendation of the doctor, when the benefit to the mother will exceed the risk to the fetus. It is forbidden to use the gel in the third trimester of pregnancy, since this agent can provoke the appearance of the uterine tone or the 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 trials of the drug in the group of pregnant women and nursing mothers. Therefore, during these periods of life, women are advised to refrain from using the drug. It is forbidden to use the drug in the third trimester of pregnancy because of the threat of closure of the Botallus duct, which can ease contractions during childbirth. There is no data on the penetration of active substances into breast milk.

• Dolaren gel.

It is forbidden to use the drug during pregnancy and while breastfeeding.

• Dolobien gel.

The use of the drug during this period is prohibited, since there are no data on its safety in a given period of time. Experimental studies have revealed a teratogenic effect of dimethylsulfoxide.

The use of the drug during lactation is prohibited in the villa that its active ingredients are found in breast milk.

• Indomethacin.

Do not use the drug during pregnancy and lactation period.

• Ketonal.

It is forbidden to use the drug in the third month of pregnancy because the active component of the drug may prolong the gestational period, prematurely close the Botallov duct and cause pulmonary hypertension in the newborn. In the first and second trimesters of pregnancy, the medication is used only on the basis of their strict indications and under the supervision of specialists.

It is not recommended to apply the gel during the lactation period.

• Finalgon.

There is insufficient information about the possibility of using the drug during pregnancy. Therefore, this drug is prohibited for women in these categories. There is no data on the penetration of the components of the drug in breast milk, so you can not use the drug in the lactation period.

• Efkamon.

The use of the drug during pregnancy and lactation should be decided on a case-by-case basis in each case by the need for therapy with the help of a medication.

Contraindications to the use of ointments for muscle pain

Apizartron.

• Hypersensitivity to the components of the drug.
• Patients of childhood up to twelve.
• Women during menstrual bleeding.
• The presence of acute infectious diseases.
• The appearance of sepsis.
• Acute inflammatory processes in the body, which are accompanied by the formation of pus.
• Tuberculosis.
• Hepatitis, nephritis, pancreatitis, diabetes mellitus.
• The presence of widespread osteoporosis.
• Tumor processes in the body.
• Presence in the anamnesis of organic diseases of the central nervous system, and also psychoses.
• Hemorrhagic diathesis.
• The appearance of coagulopathy, thrombocytopathy, anemia.
• Occurrence of circulatory failure in the second or third stage.
• The appearance of chronic renal failure, cachexia, adrenal insufficiency.
• Period before surgery.
• Perhaps the emergence of exacerbations in patients with cholelithiasis and nephrolithiasis.

Ben-Gay.

• Presence of hypersensitivity to the components of the drug.
• There are open wounds at the site of application of the drug.
• Presence of skin irritations.
• The patient's age is up to twelve years.

Bom-Bengu.

• Existing susceptibility to the substance of the drug.
• The patient's age is up to eighteen years.
• The presence of high sensitivity to acetylsalicylic acid, as well as non-steroidal anti-inflammatory drugs.
• There is a history of bronchial asthma.
• Disturbed skin.
• Presence of skin diseases.

Butadione.

• Presence of hypersensitivity to the components of the drug.
• Presence of trophic lesions of skin with ulcers.
• Appearance of a copy.

Bystrumgel.

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

Viprosal V.

• Presence of hypersensitivity to drug substances.
• Violations of the integrity of the skin.
• Presence of pulmonary tuberculosis.
• There are problems in the anamnesis with cerebral and coronary circulation.
• The possibility of angiospasm.
• Heavy forms of hepatic and renal dysfunction.

Voltaren Emulgel.

• Presence of hypersensitivity to active or auxiliary substances.
• The possibility of the appearance of bronchial asthma, as well as rashes on the skin, acute rhinitis, as a consequence of allergic reactions to acetylsalicylic acid and other non-steroidal anti-inflammatory drugs.
• Existing breaches of the integrity of the skin at the right place of application.
• The patient's age is up to twelve years.
• Caution should be used gel for hepatic porphyria, erosive and ulcerative lesions of the gastrointestinal tract, severe disorders of liver and kidney functions, problems with blood coagulability, symptoms of chronic heart failure, bronchial asthma, and also in old age.

Diclofenac.

• Presence of hypersensitivity to the ingredients of the drug. The same warning applies to acetylsalicylic acid and non-steroidal anti-inflammatory drugs.
• Presence in the patient's anamnesis of "aspirin" asthma.
• The age of patients is up to twelve.
• Existing breaches of the integrity of the skin.

Dolaren gel.

• A history of hypersensitivity to diclofenac sodium or other components of the gel.
• The presence of bronchial asthma.
• Signs of peptic ulcer of the stomach or duodenum, which indicate an exacerbation of diseases.
• Child age is up to twelve.

Dolobien gel.

• Existing hypersensitivity to the active components of the drug or its excipients.
• Presence in an anamnesis of a bronchial asthma.
• There are symptoms of renal and hepatic insufficiency.
• The presence of severe cardiovascular disorders, namely angina pectoris, myocardial infarction, stroke, expressed general atherosclerosis.
• The patient's age is up to five years.

Indomethacin.

• Presence of high sensitivity to the substances included in the preparation.
• There is an ulcerative disease of the stomach or duodenum in the stage of exacerbation.
• The phenomena of hypocoagulation.
• Chronic kidney diseases.
• Violated in the integrity of the skin.
• The patient's age is up to fourteen years.

Ketonal.

• The presence of high sensitivity to ketoprofen, as well as to other components of the drug.
• The presence of hypersensitivity to drugs from the group of salicylates, as well as non-steroidal anti-inflammatory drugs.
• The patient's age is up to fifteen years.
• Allergic reactions to salicylates in the patient's medical history.
• Presence of predisposition to certain diseases, such as bronchial asthma or allergic diseases.
• It is forbidden to apply the drug on damaged skin surfaces - with eczema, dandruff, open or infected wounds.

Finalgon.

• Increased skin sensitivity.
• The presence of hypersensitivity to the components of the drug.
• Presence of open wounds, irritations and damaged skin at the site of application. Do not use medicinal product on mucous membranes.
• Do not use if skin conditions are present.
• Do not use children under 12 years of age.

Efkamon.

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

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

Side effects of ointments for muscle pain

Apizartron.

• Local reactions - skin irritation, the appearance of redness, itching, pain, hyperemia, swelling.
• The emergence of ailments, excitement, the appearance of headaches, nausea, vomiting, tachycardia, chills, hives throughout the body.
• There are sleep disorders.
• It is possible to increase the overall body temperature.
• Sometimes there are pains 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-Bengu.

• The occurrence of allergic manifestations in the form of edema of the skin, the appearance of rashes, as well as sensations of itching and burning.
• There is the possibility of allergic reactions: edema of the face, lips, tongue and larynx, shortness of breath. In this case, you need to resort to emergency medical care.

Butadione.

• From local reactions, the appearance of a specimen, photosensitivity, contact dermatitis accompanied by itching, reddening of the swelling, the appearance of papules and vesicles, as well as peeling may occur.
• Of allergic reactions, there is the appearance of urticaria, angioedema and bronchospasm, as well as generalized skin rash.

Bystrumgel.

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

Viprosal V.

• Perhaps the emergence of allergic reactions in the form of itching and burning of the skin, as well as edemas and urticaria of the skin.

Voltaren Emulgel.

• Local reactions of an allergic nature - the appearance of erythema, dermatitis, including contact dermatitis, which are characterized by the presence of eczema, itching, swelling, rashes, papules, vesicles, and peeling. In rare cases, the appearance of bullous dermatitis, as well as the emergence of photosensitization.
• The immune system is the appearance of a generalized skin rash and some allergic manifestations - hives, hypersensitivity, angioedema.
• Respiratory system - there may be attacks of suffocation, as well as bronchospastic reactions.
• From parasitic and infectious diseases - in rare cases, the appearance of pustular eruptions.

Diclofenac.

• Allergic reactions - the appearance of eczema, photosensitivity, contact dermatitis, accompanied by itching, flushing, swelling, papular-vesicular rashes, skin peeling; the occurrence of burning skin, erythematous skin rash, urticaria.
• Perhaps the appearance of angioedema, as well as systemic anaphylactic reactions, reaching anaphylactic shock.

Dolaren gel.

• The drug is well tolerated by patients.
• In rare cases, redness of the skin, itching or burning sensations can be observed.

Dolobien gel.

• Occurrence of a smell from a mouth.
• Change in taste that pass within a few minutes.
• Allergic manifestations in the form of itching, urticaria, edema Quincke.

Indomethacin.

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

Ketonal.

• Frequent manifestations include the appearance of skin hypersensitivity, namely the occurrence of itching, redness and transient inflammation of the skin, contact dermatitis of mild degree.
• In rare cases, severe skin inflammatory reactions may occur in the form of contact dermatitis; heavy contact long-term photosensitivity reactions, which subsequently spread to all skin surfaces; skin exanthema; symptoms of purpura; impaired renal function in the presence of a history of kidney failure; the appearance of intestinal nephritis and asthmatic reactions.

Finalgon.

• Allergic manifestations - the appearance of rashes on the skin and hives, the emergence of facial swelling.
• Local reactions - some hyperemia in the area where the drug was applied, the appearance of 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.

• There are signs of irritation of the skin, which is expressed in the redness of the skin and the appearance of itching.
• If these symptoms appear, stop using the medication.

Ben-Gay.

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

Bom-Bengu.

• It is possible to develop an overdose only when using a large amount of the drug applied to large surfaces of the skin, as well as when the ointment hits the damaged areas of the skin and when taken orally.
• Signs of an overdose of methyl salicylate include the appearance of excitation, increased depth of breathing, as well as symptoms of hyperpyrexia.
• Symptoms of an overdose of menthol include the presence of nausea and vomiting, abdominal pain, the appearance of face redness, dizziness, unsteady gait, drowsiness, respiratory distress and coma.
• In these cases, the use of symptomatic therapy is indicated.

Butadione.

• Low degree of absorption of the drug does not lead to an overdose in external use.
• If the medicine was accidentally swallowed and in large quantities, over twenty grams, there is a symptomatic appearance that occurs when an overdose of non-steroidal anti-inflammatory drugs occurs.
• In this case, you need to rinse the stomach and take activated charcoal.

Bystrumgel.

• Low bioavailability of the drug makes an overdose impossible.
• Theoretically, the occurrence of bleeding as a symptom of an overdose is assumed.

Viprosal V.

• There are allergic reactions, which are expressed in the presence of itching and burning of the skin, as well as in the appearance of dermatitis and skin peeling.
• In this case, it is recommended to stop using the drug and apply the remaining medicament to rinsing with water.

Voltaren Emulgel.

• The drug characterizes a low systemic absorption, so an overdose is considered unlikely. If the medication accidentally gets inside the patient, it can cause the occurrence of adverse reactions. In this case, it is necessary to rinse the stomach, induce vomiting, prescribe reception of activated charcoal, and prescribe symptomatic therapy.

Diclofenac.

• Cases of drug overdose are absent due to a low level of systemic absorption.

Dolaren gel.

• There are no cases when an overdose was detected during the drug.

Dolobien gel.

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

Indomethacin.

• Low systemic absorption of the ointment leads to a practical impossibility of drug overdose.
• If the drug has been taken orally, it can trigger symptoms of an overdose. Its signs - the appearance of headache, dizziness, nausea, vomiting, memory impairment, disorientation in space, sometimes - a feeling of numbness in the limbs, signs of paresthesia and seizures.
• In this case it is shown to wash the stomach, and also to use symptomatic treatment. There is no specific antidote. It shows its ineffectiveness of the procedure of forced diuresis and hemodialysis.

Ketonal.

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

Finalgon.

• Use of a larger amount of the drug than indicated in the instructions can cause the following symptoms: symptoms of itching or burning, skin flushing. In order to reduce discomfort, you should resort to using one of the nutritious creams.

Efkamon.

• There is no information on known cases of drug overdose.

Interactions of ointments from muscle pain with other drugs

• Apizartron.

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

• Ben-Gay.

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

• Bom-Bengu.

Patients who use medications and anticoagulants for treatment need to be monitored by a specialist.

• Butadione.

There is no evidence of clinically important drug interactions and other medications. Do not use the drug with other non-steroidal anti-inflammatory drugs, as well as with drugs that trigger photosensitivity.

• Bystrumgel.

There were no interactions of the drug with other medicines.

• Viprosal V.

There is no known interaction of the drug with other drugs.

• Voltaren Emulgel.

The drug enhances the effectiveness of drugs that can cause a photosensitization reaction. There is no description of significant interactions with other drugs.

• Diclofenac.

Helps enhance the effectiveness of drugs that cause a photosensitization reaction. Caution should be used in conjunction with other medicines that characterize hepatotoxicity. These include antibacterial agents, antiepileptic drugs. There is no clinically significant interaction with other medicines due to the presence of small systemic absorption.

• Dolaren gel.

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

• Dolobien gel.

With the help of dimethylsulfoxide, the resorption of many substances that differ in the quality of poor penetration through the skin is increased. Perhaps the emergence of peripheral neuropathies in connection with the simultaneous use of drugs that have in their composition sulindac.

• Indomethacin.

Ointment is characterized by the quality of low systemic absorption, therefore, virtually no interactions with other drugs have been recorded. If other non-steroidal anti-inflammatory drugs are used together, their systemic effect may be enhanced, as well as an increase in the gastrotoxic effect.

Heparin enhances the analgesic and anti-inflammatory effect of the drug, if applied simultaneously and locally. Also increases the anti-coagulant effect of heparin.

Menthol, as well as drugs containing capsaicin and various essential oils, while applying to the skin, contribute to an increase in the analgesic effect.

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

• Ketonal.

Ketoprofen with simultaneous use 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 serum proteins. The active substance of the drug helps to reduce the excretion of methotrexate and increases the toxicity of the latter. Other drug interactions are not clinically relevant.

• Finalgon.

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

• Efkamon.

Do not describe the drug drug interactions with other drugs.

Conditions for storing the ointment for muscle pain

Each medical product requires certain conditions for its maintenance. Conditions for storing the ointment for muscle pain are as follows:

• Apizarthron - in a place to which there is no access for children and at a temperature that does not exceed twenty-five degrees Celsius.
• Ben-Gay - in a place that is inaccessible to children at an ambient temperature of no higher than twenty-five degrees Celsius.
• Bom-Benge - in a place that is not accessible to children of children at a temperature of no more than twenty degrees Celsius.
• Butadion - in a room where there is no access for children at a temperature of eight to fifteen degrees Celsius.
• Bystrumgel - in a dry place, which is protected from penetration of children and sunlight, at temperatures from fifteen to twenty degrees Celsius.
• Viprosal B - at a temperature of up to twenty-five degrees Celsius and not subject to freezing, in a place to which there is no access for children.
• Voltaren Emulgel - in a place that is inaccessible to children, at an ambient temperature of no higher than thirty degrees Celsius.
• Diclofenac - is placed in a dry place, which is not accessible to children of children, at a temperature of no higher than twenty-five degrees Celsius.
• Dolaren gel - in a dry and protected from direct sunlight, a place inaccessible to children at a temperature of up to twenty-five degrees Celsius.
• Dolobien gel - at an ambient temperature of no higher than twenty-five degrees Celsius and in a place that is not accessible to children.
• Indomethacin - in a place that is protected from light and penetration of children, at temperatures up to fifteen degrees Celsius.
• Ketonal - is contained in a room that children do not have access to, at ambient temperatures not exceeding twenty-five degrees Celsius.
• Finalgang - must be kept at room temperature inaccessible to children.
• Efkamon - stored in a dry and cool room, where there is no access for children.

[14],

Shelf life

Each medical preparation has a certain period of storage, over which it can not be used for medicinal purposes. Shelf life of medicines that help cope with muscle pain, is as follows:

• Apizarthron is thirty-six months after production.
• Ben-Gay - two years from the date of release.
• Bom-Benge - twenty-four months from the date of production.
• Butadion is five years from the date of issue.
• Bystrumgel - twenty four months from the date of production.
• Viprosal B - three years from the date of manufacture.
• Voltaren Emulgel - thirty-six months from the date of issue.
• Diclofenac - two years from the date of release.
• Dolaren gel - three years from the date of release.
• Dolobien gel is two years from the date of issue.
• Indomethacin is thirty-six months from the date of release.
• Ketonal is five years from the date of issue.
• Finalgon - four years from the date of release.
• Efkamon is three and a half years since its release.

Ointment for muscle pain is a modern group of medicines that will help to effectively cope with muscle pain and other violations of the musculoskeletal system. Therefore, in case of any problems and pains, it is necessary to resort to using the drugs presented above, which will help to remove unpleasant symptoms and improve the patient's condition.