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Zerodol
Last reviewed: 03.07.2025
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Zerodol is an NSAID with antirheumatic properties.
Indications Zerodol
It is indicated for the elimination of pain symptoms and inflammatory processes developing in rheumatoid arthritis, osteoarthritis, and Bechterew's disease. In addition, it is also used for musculoskeletal pathologies that are accompanied by pain (for example, in the extra-articular type of rheumatism or in the scapulohumeral type of periarthritis).
As a pain reliever, the medicine is used to eliminate pain symptoms (toothache, pain in the lumbar region, as well as pain in primary dysmenorrhea).
Pharmacodynamics
The drug is an antirheumatic NSAID, a derivative of α-toluic acid, similar in composition to diclofenac. The substance aceclofenac has anti-inflammatory, analgesic and antipyretic properties.
The component slows down the activity of COX and also inhibits the synthesis of PG, thus influencing the pathogenesis of the inflammatory process, as well as the development of pain and fever.
In the treatment of rheumatic pathologies, the analgesic and anti-inflammatory properties of the active component help to relieve pain and reduce swelling and stiffness in the joints that occur in the morning. This helps to improve the functional state of the patient.
Pharmacokinetics
Aceclofenac is rapidly absorbed after oral administration, and the bioavailability index is almost 100%. The peak plasma concentration occurs 1.25-3 hours after taking the drug. The time interval required to reach the peak is extended if the drug is combined with food, but this fact does not affect the degree of absorption.
Synthesis of aceclofenac with protein is >99.7. The drug enters the synovium, and its concentration in it reaches 60% of the plasma indicator. The distribution volume is approximately 30 liters.
The plasma half-life is 4-4.3 hours, and the clearance rate is estimated to be 5 L/hour. About 2/3 of the dose is excreted in the urine as conjugated hydroxy metabolites. Only 1% of a single dose of the drug is excreted unchanged.
The active component is metabolized in the liver, resulting in its conversion into 4-hydroxyaceclofenac, as well as other breakdown products, including diclofenac.
Most likely, the metabolism of the substance occurs with the participation of the CYP2C9 element, which affects the main breakdown product 4-OH-aceclofenac, the clinical properties of which are quite insignificant. Diclofenac together with 4-OH-diclofenac are observed among the many breakdown products.
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Dosing and administration
The standard dosage of the drug is 100 mg twice a day – 1 tablet in the morning and evening.
For people with liver problems, the dose should be reduced to 100 mg once a day.
The tablets must be swallowed whole, without chewing, with water. The intake does not depend on food intake. The duration of the course is prescribed by the doctor for each person individually.
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Use Zerodol during pregnancy
The drug is prohibited to prescribe to pregnant women. Breastfeeding should also be discontinued during treatment with Zerodol.
Contraindications
Among the contraindications of the drug:
- history of gastrointestinal bleeding or ulcer perforation (which are associated with taking NSAIDs);
- concomitant bleeding or ulceration, present in the patient or in the past (2+ proven separate episodes with the presence of these disorders);
- problems with blood clotting or active bleeding;
- severe heart, kidney or liver failure;
- the patient has an intolerance to aceclofenac or another auxiliary element of the drug, and in addition, hypersensitivity to NSAIDs (causing acute rhinitis, asthma attacks, as well as urticaria or Quincke's edema) or aspirin;
- congestive heart failure (NYHA II-IV);
- IHD in people with angina pectoris or a history of myocardial infarction;
- cerebrovascular pathologies in people after a stroke or in those who have experienced episodes of microstrokes;
- pathologies associated with peripheral arteries;
- age under 18 years.
Side effects Zerodol
Taking the pills can cause the following side effects:
- NS organs: visual disturbances, headaches, development of paresthesia, neuritis in the optic nerve area, and in addition to this, cases of aseptic meningitis (often develops in people with autoimmune disorders - mixed type of connective tissue pathology or Libman-Sachs disease). Also possible manifestations include neck muscle rigidity, vomiting, fever, nausea and disorientation. Tinnitus, hallucinations, confusion, depression, vertigo, drowsiness, severe fatigue, malaise, and dizziness may occur. Symptoms also include tremor with dysgeusia;
- kidneys: development of nephrotoxicity (tubulointerstitial nephritis), renal failure, and in addition, nephrotic syndrome;
- liver: development of jaundice or hepatitis, liver dysfunction;
- organs of the lymphatic and hematopoietic systems: suppression of bone marrow activity, development of anemia (as well as its hemolytic or aplastic forms), thrombocyto-, granulocyto- and neutropenia, as well as agranulocytosis;
- organs of the immune system: increased sensitivity (symptoms include non-specific allergic reactions, anaphylaxis, shock, reactive response of the respiratory organs (asthma)), and in addition, worsening of asthma, dyspnea, bronchial spasms and Quincke's edema;
- metabolic processes: development of hyperkalemia;
- mental states: strange dreams, depression, development of insomnia;
- visual organs: visual disorders;
- organs of hearing: the appearance of ringing in the ears, the development of vertigo;
- cardiovascular system: development of tachycardia, vasculitis, heart failure, and also increased blood pressure, hyperemia, edema, hot flashes. Certain NSAIDs (also with prolonged use of high doses) can increase the likelihood of thromboembolic complications (for example, myocardial infarction or stroke). Most of these reactions are reversible and mild;
- respiratory system: appearance of stridor breathing;
- digestive system: abdominal pain, dyspeptic symptoms, diarrhea, nausea, gastritis, bloating, as well as vomiting (sometimes with blood) and constipation. Stomatitis (including ulcerative form), non-specific form of ulcerative colitis, regional enteritis, gastric ulcer, pancreatitis with gastritis, as well as ulcers in the gastrointestinal tract may develop. In addition, exacerbation of colitis and perforation or bleeding in the gastrointestinal tract is possible;
- skin: the appearance of exanthema or rash on the skin, as well as itching, swelling of the face, development of urticaria or dermatitis. In addition, hemorrhagic rash and purpura, foliaceous or bullous dermatitis, photosensitivity, erythema multiforme, Lyell's syndrome and Stevens-Johnson syndrome;
- urinary system and kidneys: renal failure or development of nephrotic syndrome;
- local manifestations and general disorders: cramps in the calf muscles, as well as increased fatigue;
- laboratory test results: increased levels of liver enzymes and alkaline phosphatase, as well as blood urea and creatinine, and weight gain.
Overdose
The main symptoms of overdose are vomiting, headaches, nausea, diarrhea, irritation, epigastric pain and gastrointestinal bleeding. In addition, disorientation, a feeling of drowsiness or excitement, tinnitus, and dizziness may occur. A comatose state may develop, blood pressure may decrease, and the respiratory process may be disrupted. Loss of consciousness, seizures, or increased symptoms of other negative effects may occur. In severe intoxication, liver function may be impaired or acute renal failure may develop.
To eliminate the manifestations, treatment aimed at relieving the symptoms is needed, as well as supportive therapy according to the indications.
Within 1 hour after taking a large dose of the drug, you can drink activated charcoal. Alternatively, you can perform gastric lavage during the same period of time.
Specific drug methods such as hemoperfusion or dialysis are not effective enough in excreting NSAIDs because these drugs have a high rate of protein synthesis and extensive metabolic processes.
Treatment requires adequate diuresis, as well as careful monitoring of the liver and kidney function.
The patient must remain under medical supervision for at least 4 hours after taking an overdose of the drug. In case of prolonged and frequent convulsions, the patient must be given diazepam.
Other treatment measures depend on the clinical condition of the patient.
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Interactions with other drugs
The interaction of the active component of Zerodol with other drugs is similar in its properties to the action of other NSAIDs.
Aceclofenac is capable of increasing plasma digoxin levels with lithium and methotrexate, and in addition to this, it can enhance the activity of anticoagulants and, conversely, reduce it in diuretics. It also increases the nephrotoxicity of cyclosporine and suppresses attacks when combined with quinolones.
In case of combined use with potassium drugs, it is necessary to add weak diuretics to them, and also regularly monitor plasma potassium levels.
The combination of the active substance with hypoglycemic drugs can cause the development of hyper- or hypoglycemia.
The simultaneous use of aceclofenac and other NSAIDs, as well as corticosteroids, can increase the incidence of negative effects.
Methotrexate and NSAIDs should be prescribed with caution, because the latter increase plasma levels of methotrexate, thereby increasing its toxicity. It is necessary to take such drugs with an interval of 2-4 hours between doses.
Shelf life
Zerodol is permitted to be used for 2 years from the date of release of the drug.
Attention!
To simplify the perception of information, this instruction for use of the drug "Zerodol" translated and presented in a special form on the basis of the official instructions for medical use of the drug. Before use read the annotation that came directly to medicines.
Description provided for informational purposes and is not a guide to self-healing. The need for this drug, the purpose of the treatment regimen, methods and dose of the drug is determined solely by the attending physician. Self-medication is dangerous for your health.