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Zerodol
Last reviewed: 23.04.2024
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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 with rheumatoid arthritis, osteoarthritis, as well as with Bekhterev's disease. In addition, it is also used for OA pathologies, which are accompanied by painful manifestations (for example, with extra-articular type of rheumatism or with periarthritis type of periarthritis).
As an anesthetic, the medicine is used to eliminate pain symptoms (dental pain, pain in the lumbar region, as well as pain in primary dysmenorrhea).
Pharmacodynamics
The drug is an antirheumatic NSAID, an α-toluic acid derivative, 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 affecting 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 ingredient help to ease the pain and reduce the swelling and stiffness that occurs in the joints in the morning. This helps improve the functional state of the patient.
Pharmacokinetics
Aceclofenac is rapidly absorbed after oral administration, and bioavailability is almost 100%. The peak of plasma concentration occurs 1.25-3 hours after drug use. The time interval necessary to reach the peak is prolonged in the case of a combination of drugs with food, but this fact does not affect the degree of absorption.
Synthesis of aceclofenac with protein is> 99.7. The medicine passes into synovia, and its concentration in it reaches 60% of the plasma index. The distribution volume is approximately 30 liters.
The half-life of plasma is 4-4.3 hours, and the coefficient of purification, according to estimates - 5 liters / hour. About 2/3 of the dosage is excreted together with urine in the form of conjugated hydroxymetabolites. Only 1% of the once-taken dose of drugs is unchanged.
Metabolism of the active component is carried out in the liver, as a result of which it is converted to 4-hydroxyacetylfenac, and in addition other decomposition products, among which also diclofenac.
Most likely, the metabolism of the substance occurs with the participation of the element CYP2S9, which acts on the main product of the decay of 4-OH-aceclofenac, the clinical properties of which are rather insignificant. Diclofenac along with 4-OH-diclofenac are observed among a variety of decay products.
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Dosing and administration
The standard dosage of drugs is 100 mg twice a day - the first pill in the morning and in the evening.
For people who have disorders in the work of the liver, the dose should be reduced to 100 mg once a day.
Tablets are required to swallow whole, without chewing, with water. The reception is not dependent on eating. The duration of the course is prescribed by the doctor for each person individually.
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Use Zerodol during pregnancy
The medicine is forbidden to be prescribed to pregnant women. Also, breastfeeding should be abolished during treatment with Zerodol.
Contraindications
Among the contraindications of drugs:
- presence of bleeding in the gastrointestinal tract or ulcer perforation in the anamnesis (which are associated with the intake of NSAIDs);
- concomitant bleeding or an ulcer present in the patient now or in an anamnesis (2+ proven individual episodes with the presence of these disorders);
- problems with blood coagulability or active bleeding;
- severe form of heart failure, kidney or liver;
- the patient has an intolerance to aceclofenac or to another auxiliary element of the drug, and in addition, increased sensitivity to NSAIDs (causing acute colds, asthmatic attacks, and hives or Quincke edema) or aspirin;
- congestive heart failure (NYHA II-IV);
- IHD in people with angina or transferred myocardial infarction;
- cerebrovascular pathologies in people after a stroke or in those who have had episodes of micro-strokes;
- pathology associated with peripheral arteries;
- age less than 18 years.
Side effects Zerodol
The taking of tablets can cause such side effects:
- organs of the National Assembly: vision disorders, headaches, development of paresthesias, neuritis in the eye nerve, and in addition cases of aseptic form of meningitis (often develops in people with autoimmune disorders - a mixed type of connective tissue pathology or Liebman-Sachs disease). Also, such manifestations as stiff neck stiffness, vomiting, fever, nausea and orientation disorder are possible. There may be noise in the ears, hallucinations, confusion, depression, vertigo, a feeling of drowsiness, severe fatigue, malaise, and dizziness. Among the symptoms is still a tremor with dysgeusia;
- kidney: development of nephrotoxicity (tubulointerstitial nephritis), kidney failure, and in addition to nephrotic syndrome;
- liver: development of jaundice or hepatitis, a disorder in the liver;
- organs of the lymphatic and hematopoietic systems: suppression of bone marrow activity, the development of anemia (as well as its hemolytic or aplastic forms), thrombocyto-, granulocyte and neutropenia, as well as agranulocytosis;
- organs of the immune system: hypersensitivity (among the symptoms of nonspecific allergic manifestations, anaphylaxis, shock, reactive respiratory response (asthma)), and in addition worsening of asthma, dyspnoea, bronchial spasms and Quincke edema;
- metabolic processes: the development of hyperkalemia;
- mental states: strange dreams, depression, development of insomnia;
- visual organs: visual disturbances;
- the organs of hearing: the appearance of tinnitus, the development of the vertigo;
- organs of the cardiovascular system: the development of tachycardia, vasculitis, heart failure, and in addition, increased blood levels, the emergence of hyperemia, swelling, tidal flare. Individual NSAIDs (also with prolonged use of large doses) can increase the likelihood of developing thromboembolic complications (eg, myocardial infarction or stroke). Most of these reactions are reversible and weak;
- organs of the respiratory system: the appearance of stridorous respiration;
- digestive system: abdominal pain, dyspepsia, diarrhea, nausea, gastritis, bloating, as well as vomiting (sometimes with blood) and constipation. Can develop stomatitis (including ulcer form), nonspecific form of ulcerative colitis, regional enteritis, gastric ulcer, pancreatitis with gastritis, as well as ulcers in the gastrointestinal tract. In addition, there may be an exacerbation of the flow of colitis and perforation or bleeding in the gastrointestinal tract;
- skin: the appearance on the skin of exanthema or rash, as well as itching, swelling on the face, the development of urticaria or dermatitis. In addition, hemorrhagic rash and purpura, leaf-shaped or bullous form of dermatitis, photosensitivity, erythema polyforma, Lyell and Stevens-Johnson syndromes;
- urinary system and kidneys: kidney failure or development of a nephrotic syndrome;
- local manifestations and common disorders: cramps in the calf muscles, as well as increased fatigue;
- values of laboratory tests: an increase in such indicators as the activity of liver enzymes and alkaline phosphatase, as well as urea and creatinine levels in the blood, and in addition weight gain.
Overdose
The main manifestations of an overdose: vomiting, headaches, nausea, diarrhea, irritation, epigastric pain and bleeding in the gastrointestinal tract. In addition, there is disorientation, a feeling of drowsiness or excitement, noises in the ears, dizziness. It can develop a coma, lower blood pressure, disturb the respiratory process. Possible loss of consciousness, the development of seizures or increased symptoms of other negative effects. With severe intoxication, a disorder of the hepatic function or the development of an acute form of kidney failure may occur.
To eliminate symptoms, treatment is needed to get rid of the symptoms, as well as maintenance therapy according to the indications.
Within 1 hour after consuming a large dose of drugs, you can drink activated charcoal. As an alternative in the same period of time - perform gastric lavage.
Such specific medicinal methods, as hemoperfusion or dialysis, are not effective enough for excretion of NSAIDs, because these drugs have high protein synthesis, as well as extensive exchange processes.
The treatment requires adequate diuresis, as well as careful monitoring of the liver and kidneys.
The patient should stay under medical supervision for a minimum of 4 hours after taking the dose of the drug. With prolonged and frequent convulsions, it is required to administer diazepam to the patient.
Other medical 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 properties to that of other NSAIDs.
Aceclofenac is able to increase digoxin plasma levels with lithium and methotrexate, and in addition to increase the activity of anticoagulants and vice versa to reduce it in diuretics. It also increases the nephrotoxicity of the substance cyclosporine and inhibits seizures when combined with quinolones.
In the case of combined use with potassium drugs - it is required to add to them weak diuretics, and also regularly monitor plasma potassium indices.
The combination of the active substance with hypoglycemic drugs can cause the development of hyper- or hypoglycemia.
Simultaneous use of aceclofenac and other NSAIDs, as well as corticosteroids, can increase the incidence of adverse effects.
Caution should be given to methotrexate and NSAIDs, because the latter increase plasma methotrexate, thereby increasing its toxicity. It is required to drink such medications with an interval between uses in 2-4 hours.
Shelf life
Zerodol is allowed 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.