Components:
Treatment option:
Medically reviewed by Fedorchenko Olga Valeryevna, PharmD. Last updated on 23.03.2022
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Diclofenac
For Oral Solution, For Solution, Powder
back pain in inflammatory and degenerative diseases of the spine (sciatica, osteoarthritis, lumbago, sciatica),
febrile syndrome.
in the form of applications on the skin.
) designed for sticking on large painful areas.
do not chew, wash down with a sufficient amount of liquid.
Adults and adolescents over 15 years of age: Diclofe transdermal patch
If there is no improvement in the condition after 7 days and if you feel worse, you should consult your doctor.
, the capsule should be swallowed whole, washed down with water at the end or after a meal, usually in the morning. It is prescribed individually, taking into account the severity of the disease. Adults are usually prescribed 1 capsule. 75 mg 1-2 times a day. The maximum daily dose is 150 mg.
Pills:
, without chewing, washed down with a large amount of liquid, 100 mg/day, if necessary, up to 200-300 mg / day.
For adults, the recommended initial dose of the drug is 100-150 mg/day. In the case of moderate symptoms, it is usually sufficient to use a daily dose of 75-100 mg for coated tablets, or 50-100 mg in powder form to prepare a solution for oral administration. The daily dose should be divided into 2-3 doses for coated tablets and 3 doses for the powder for the preparation of the solution. The maximum daily dose of the drug should not exceed 150 mg/day.
hypersensitivity to diclofenac, a complete or incomplete combination of bronchial asthma, recurrent nasal polyposis and paranasal sinuses, and intolerance to acetylsalicylic acid and other NSAIDs (including in the anamnesis),
violation of hematopoiesis,
peripheral artery disease,
bronchial asthma,
diverticulitis,
The use of Diclofenac potassium with concomitant NSAIDs including cyclooxygenase-2 selective inhibitors should be avoided due to the absence of any evidence demonstrating synergistic benefits and the potential for additive undesirable effects.
Elderly
Caution is indicated in the elderly on basic medical grounds. The elderly have increased frequency of adverse reactions to NSAIDs especially gastro intestinal bleeding and perforation which may be fatal. In particular, it is recommended that the lowest effective dose be used in frail elderly patients or those with a low body weight.
Gastrointestinal
Close medical surveillance is imperative in patients with symptoms indicative of gastrointestinal disorders, with a history suggestive of gastric or intestinal ulceration, bleeding or perforation, with ulcerative colitis, or with Crohn's disease as these conditions may be exacerbated.
Patients with a history of GI toxicity, particularly when elderly, should report any unusual abdominal symptoms (especially GI bleeding) particularly in the initial stages of treatment.
GI bleeding (haematemesis, melaena), ulceration or perforation, which can be fatal, has been reported with all NSAIDs at any time during treatment, with or without warning symptoms or a previous history of serious GI events.).
Caution should be advised in patients receiving concomitant medications which increase the risk of ulceration or bleeding, such as oral corticosteroids, anticoagulants such as warfarin, selective serotonin-reuptake inhibitors or anti-platelet agents such as aspirin.
When GI bleeding or ulceration occurs in patients receiving diclofenac potassium, the treatment should be withdrawn.
Hypersensitivity reactions
As with other non-steroidal anti-inflammatory drugs, allergic reactions, including anaphylactic/anaphylactoid reactions, can occur without earlier exposure to the drug.
Infection
Like other NSAIDs, Diclofenac Potassium tablets may mask the signs and symptoms of infection due to their pharmacodynamic properties.
SLE and mixed connective tissue disease
In patients with systemic lupus erythematosus (SLE) and mixed connective tissue disorders there may be an increased risk of aseptic meningitis.
Cardiovascular, Renal and Hepatic Impairment
The administration of an NSAID may cause a dose dependent reduction in prostaglandin formation and precipitate renal failure. As fluid retention and oedema have been reported in association with NSAIDs therapy, including diclofenac, particular caution is called for in patients with impaired cardiac or renal function, history of hypertension, the elderly, patients receiving concomitant treatment with diuretics or medicinal products that can significantly impact renal function, and those patients with substantial extracellular volume depletion from any cause, e.g. before or after major surgery. Monitoring of renal function is recommended as a precautionary measure when using diclofenac in such cases. Discontinuation therapy is usually followed by recovery to the pre-treatment state.
Hepatic
Close medical surveillance is required when prescribing diclofenac to patients with impairment of hepatic function as their condition may be exacerbated.
As with other NSAIDs, including diclofenac, values of one or more liver enzymes may increase. During prolonged treatment with Diclofenac, regular monitoring of hepatic function is indicated as a precautionary measure. If abnormal liver function tests persist or worsen, clinical signs or symptoms consistent with liver disease develop or if other manifestations occur (eosinophilia, rash), Diclofenac Potassium tablets should be discontinued.
Hepatitis may occur without prodromal symptoms.
Use of Diclofenac Potassium tablets in patients with hepatic porphyria may trigger an attack.
Haematological
Diclofenac Potassium tablets may reversibly inhibit platelet aggregation. Patients with defects of haemostasis, bleeding diathesis or haematological abnormalities should be carefully monitored.
Long term treatment
All patients who are receiving long term treatment with non-steroidal, anti-inflammatory agents should be monitored as a precautionary measure eg renal function, hepatic function (elevation of liver enzymes may occur) and blood counts. This is particularly important in the elderly.
Respiratory disorders
In patients with asthma, seasonal allergic rhinitis, swelling of the nasal mucosa (i.e. nasal polyps), chronic obstructive pulmonary diseases or chronic infections of the respiratory tract (especially if linked to allergic rhinitis-like symptoms), reactions on NSAIDs like asthma exacerbations (so called intolerance to analgesics / analgesics asthma), Quincke's oedema or urticaria are more frequent than in other patients. Therefore, special precaution is recommended in such patients (readiness for emergency). This is applicable as well for patients who are allergic to other substances, e.g. with skin reactions, pruritus or urticaria.
Like other drugs that inhibit prostaglandin synthetase activity, diclofenac sodium and other NSAIDs can precipitate bronchospasm if administered to patients suffering from, or with a previous history of bronchial asthma.
Cardiovascular and cerebrovascular effects
Appropriate monitoring and advice are required for patients with a history of hypertension and/or mild to moderate congestive heart failure as fluid retention and oedema have been reported in association with NSAID therapy including diclofenac.
Clinical trial and epidemiological data suggest that use of diclofenac, particularly at high dose (150mg daily) and in long term treatment may be associated with a small increased risk of arterial thrombotic events (for example myocardial infarction or stroke).
Patients with uncontrolled hypertension, congestive heart failure, established ischaemic heart disease, peripheral arterial disease, and/or cerebrovascular disease and with significant risk factors for cardiovascular events (e.g. hyperlipidaemia, diabetes mellitus, smoking) should only be treated with diclofenac after careful consideration.
As the cardiovascular risks of diclofenac may increase with dose and duration of exposure, the shortest duration possible and the lowest effective daily dose should be used. The patient's need for symptomatic relief and response to therapy should be re-evaluated periodically.
Dermatological
Serious skin reactions, some of them fatal, including exfoliative dermatitis, Stevens-Johnson syndrome and toxic epidermal necrolysis, have been reported very rarely in association with the use of NSAIDs, including Diclofenac Potassium. Patients appear to be at the highest risk of these reactions early in the course of therapy, the onset of the reaction occurring in the majority of cases within the first month of treatment. Diclofenac Potassium tablets should be discontinued at the first appearance of skin rash, mucosal lesions or any other signs of hypersensitivity.
Impaired female fertility
The use of Diclofenac Potassium tablets may impair female fertility and is not recommended in women attempting to conceive. In women who may have difficulties conceiving or who are undergoing investigation of infertility, withdrawal of Diclofenac Potassium tablets should be considered.
Undesirable effects such as dizziness, drowsiness, fatigue and visual disturbances are possible after taking NSAIDs. If affected, patients should not drive or operate machinery.
often-vertigo, very rarely-visual impairment (blurred vision, diplopia), hearing impairment, tinnitus, impaired taste sensations.
very rarely — thrombocytopenia, leukopenia, anemia (including hemolytic and aplastic anemia), agranulocytosis.
often-dizziness, very rarely-ringing in the ears, hearing impairment.
Coated tablets, 50 mg
often-increased blood pressure, sometimes-arrhythmia, cardialgia, decreased blood pressure, rarely - pain behind the sternum, nosebleeds, aggravation of congestive heart failure.
rarely — anaphylaxis and anaphylactoid reactions, anaphylactic shock (usually develops rapidly), bronchospastic allergic reactions.
provides anti-inflammatory and analgesic action at the site of application, eliminating pain and reducing swelling associated with the inflammatory process.
It leads to a decrease in pain (at rest and in motion), to a decrease in swelling in the joints and morning stiffness in rheumatic pains.
Emulsifier
Final T
in the synovial fluid, it is observed 2-4 hours later than in the plasma. Diclofenac is more slowly excreted from synovial fluid than from plasma.
from the synovial fluid is 3-6 hours, and its concentration in the synovial fluid after 4-6 hours after administration of the drug remains higher than in the plasma for another 12 hours.
It is metabolized in the liver. 50% of the active substance is metabolized during the" first pass " through the liver. Metabolism occurs as a result of multiple or single hydroxylation and conjugation. The P450 CYP2C9 enzyme system participates in the metabolism of the drug. The pharmacological activity of the metabolites is lower than that of diclofenac potassium.
Relevant information on the safety of Diclofenac Potassium Tablets is included in previous sections of this Summary of Product Characteristics.
Silica colloidal anhydrous
Sodium starch glycollate
Povidone
Starch maize
Calcium hydrogen phosphate anhydrous
Magnesium stearate
Tablet Coating:
Polyvinyl alcohol partially hydrolysed
Titanium dioxide E171
Talc
Lecithin Soya E322
Iron Oxide red E172
Iron Oxide yellow E172
Xanthan gum E415
NSAIDs and corticosteroids:
Antacids (e.g. aluminum and magnesium hydroxide):
Concomitant use with paracetamol increases the risk of developing the nephrotoxic effects of diclofenac potassium.
36 months
At a temperature not exceeding 25 °C.
Keep out of reach of children.
Shelf life of the drug Artrex5 лет.Do not use after the expiration date indicated on the package.
Gel containing 1% diclofenac sodium, in tubes of 50 and 100 g.
Not applicable.
Administrative dataAccord Healthcare Limited
Sage House
319 Pinner Road
North Harrow
Middlesex
HA1 4HF
United Kingdom
PL 20075/0682
January 2011
23/10/2017
However, we will provide data for each active ingredient
