Social Pharmacy. Dicloberl: instructions for use, analogues and reviews, prices in Russian pharmacies Dicloberl side effects

The drug Dicloberl is produced in several dosage forms, namely tablets intended for oral use and capsules, an ointment for external use and a solution for intramuscular administration. Such drugs belong to the group of non-steroidal anti-inflammatory drugs, often used to relieve pain. In some cases, the drug can provoke the appearance of adverse reactions. With prolonged oral and intramuscular administration, the development of addiction is possible, with the abolition of the drug, the clinical picture may be aggravated. There is a wide list of contraindications and indications for taking the remedy, which you should familiarize yourself with before use.

Dosage form

The drug Dicloberl is produced in the following dosage forms:

tablets and capsules for oral administration;
solution for infusion;
suppositories for rectal use.

Description and composition

Tablets have a light brown, yellow color, smooth surface, enteric-coated.

Also, the drug is produced in the form of gelatin capsules, a similar form of release is characterized by a prolonged action. Inside the capsules are round white granules. The capsule itself is cream in color.

The solution for injection is transparent, without sediment.

Rectal suppositories are torpedo-shaped, ivory in color.

The main active ingredient is sodium.

The list of auxiliary components included in the tablets:

sodium starch glycolate;
lactose;
corn starch;
magnesium stearate;
povidone;
methacrylate copolymer dysmetria;
polyethylene glycol;
emulsion;
talc;
hypromellose;
titanium dioxide;
iron oxide yellow.

The list of auxiliary components included in the composition of the capsules can be represented as follows:

corn starch;
sucrose;
shellac;
sodium hydroxide;
ammonium methacrylate copolymer;
titanium dioxide;
gelatin;
talc.

Auxiliary components in the composition of the solution are:

sodium hydroxide solution;
benzyl alcohol;
beckons;
propylene glycol;
acetylcysteine;
water for injections.

As part of a suppository for rectal use:

solid fat;
ethanol;
propyl gallate;
corn starch.

Regardless of the dosage form, the active ingredient is sodium. The given auxiliary components ensure the achievement of the desired shape.

Pharmacological group

Dicloberl is a non-steroidal anti-inflammatory drug with a pronounced antirheumatic, antipyretic effect. Such activity of the drug composition is due to the influence of the active component. The use of the medicinal composition, regardless of the form of release, eliminates the pain syndrome.

Indications for use

List of indications for the use of the drug:

rheumatic disorders of inflammatory and degenerative origin;
rheumatoid arthritis;
ankylosing spondylitis;
gout;
bursitis;
pain syndrome;
tendinitis;
dislocations;
fractures.

for adults

The use of a drug of this drug group by patients of mature age is possible if there are indications for admission. Before using the medicinal composition of Dicloberl, the patient and his attending physician must make sure that there are no contraindications. It is worth remembering that such a drug for elderly patients and people with impaired liver and kidney function is prescribed with caution.

for kids

The use of the drug in pediatric practice is not recommended. The composition can provoke the appearance of acute adverse reactions.

The use of the drug Dicloberl is possible in 1 and in the case. When the expected benefit to the mother significantly outweighs the risks to the child. In most cases, the composition is well tolerated, and only in small doses penetrates the placental barrier. Use in the third trimester is prohibited due to the risk of preterm birth. The use of the composition during breastfeeding requires the rejection of lactation.

Contraindications

The list of contraindications to the use of the drug:

acute ulcerative lesions of the stomach;
late pregnancy;
breast-feeding;
low weight.

Applications and doses

The drug in the form of capsules and tablets for oral administration is recommended to be taken after meals with plenty of water. The preparation in the form of a solution for injection and a suppository for rectal use can be used at any time.

for adults

The dosage of the drug is determined individually by the attending physician, depending on the dosage form used.

for kids

The use of the drug in pediatric practice is limited. The composition can provoke the appearance of developmental pathologies.

for pregnant women and during lactation

Dicloberl can be used in 1 and subject to indications for use. The drug can be used as prescribed by a doctor in limited doses. Before using the composition, it is necessary to weigh the expected benefit with the possible harm to the patient.

Side effects

Against the background of the use of the drug, the following adverse reactions can be traced:

hepatitis;
bloating;
spasm;
ulcerative lesions of the gastrointestinal tract;
melena;
cirrhosis of the liver;
liver damage;
colitis;
oket;
skin itching;
dermatitis;
pancreatitis.

The manifestation of these reactions indicates the need to consult a doctor.

Interaction with other drugs

Information about the interaction of the drug with other drugs should be checked with the attending physician.

special instructions

In the treatment of patients with a predisposition to the appearance of allergic reactions, it is worth observing the rules of increased caution.

You can use the drug only in one dosage form, the combination of doses can cause an overdose.

Prolonged use of the composition in normal doses can cause heart attack and stroke. A similar condition must be observed when using the composition for the treatment of the elderly.

When the first symptoms of allergic reactions appear, the drug should be stopped.

During the reception of the drug, the use of alcohol and any formulations containing ethanol is prohibited.

The drug may have effects on the central nervous system, therefore, the use of the drug may compromise the ability to drive a car.

Overdose

When using medications in dosages regulated by the instructions, the likelihood of overdose symptoms is minimized. In the case of using doses exceeding therapeutic, the following reactions are possible:

nausea;
headache;
confusion;
loss of consciousness.

If any reactions occur, seek medical attention. Such manifestations may indicate acute intoxication. There is no specific antidote, hemodialysis is ineffective. In severe cases, treatment is carried out in a hospital.

Storage conditions

The drug in the form of tablets and capsules for oral use should be stored in a dry, child-proof place at room temperature. The maximum shelf life is 3 years from the production date indicated on the blister. It is forbidden to use the medicinal composition after this period.

The drug in the form of a solution for intramuscular injection should be stored at a temperature of no more than 20 degrees in the original packaging. Before opening, it is worth checking the integrity of the glass ampoule. The maximum shelf life of the composition is 2 years. The formation of any sediment at the bottom of the ampoule indicates that the drug cannot be used.

Suppositories for rectal use should be stored at a temperature of no more than 20 degrees. Failure to comply with this rule may cause distortion of the form of the drug. You can not use the composition after the expiration date.

The drug is sold to the population through a network of pharmacies in free sale.

Analogues

The drug has a sufficient number of analogues according to the mechanism of action. Some drugs have an analogous composition and can act as full-fledged substitutes. Despite this, it is not permissible to replace the agent prescribed by the doctor with any analogue on your own. Such a replacement can cause acute reactions of the body.

Revmavek

The drug Revmavek has a pronounced analgesic and antipyretic effect. The remedy is often used in the treatment of arthrosis, gout and rheumatism. The main active ingredient is sodium. The drug is produced by pharmacological companies in the form of a solution for intramuscular injection, capsules and suppositories. The drug is not recommended for use during pregnancy and breastfeeding. The question of the possibility of application in pediatric practice is determined on an individual basis.

Price

The cost of Dicloberl is an average of 244 rubles.

Name:

Dicloberl @ N75, ampoules

INN: Diclofenac sodium / Diclofenac sodium

ATX code: M01AB05

Analogues:

Compound:

One ampoule contains

Active substances:

Diclofenac sodium 75mg

Excipients:

Propylene glycol, benzyl alcohol, acetylcysteine, mannitol, 1N sodium hydroxide solution, water for injection

Pharmacotherapeutic group

NSAIDs - Acetic acid derivatives and related compounds

pharmachologic effect

Pharmacodynamics

The anti-inflammatory effect is due to interference in various parts of the pathogenesis of inflammation: in addition to the main antiprostaglandin effect, increased permeability, microcirculation processes are normalized, the influence of histamine, bradykinin and other inflammatory mediators is reduced; the formation of ATP is inhibited, the energy of the inflammatory process is reduced, etc. Analgesic properties are due to the ability to weaken the algogenicity of bradykinin, antipyretic - a calming effect on the excitability of the heat-regulating centers of the diencephalon changed under the influence of the pathological process.

Pharmacokinetics

After oral administration, it is completely absorbed. Cmax in plasma is reached after 1-16 hours (with i / m administration - after 10-20 minutes, with rectal - after about 30 minutes). When administered orally, 35-70% enters the bloodstream unchanged (after passing through the liver). Plasma protein binding is about 99%. T1 / 2 - 2 hours. Approximately 30% is excreted from the body in the form of metabolites by the intestines. About 70% is metabolized in the liver and excreted through the kidneys in the form of inactive derivatives.

Indication for use

Rheumatism, rheumatoid arthritis;
Osteoarthritis;
ankylosing spondylitis;
Dystrophic diseases of the joints;
Gout;
Lumbago, neuralgia, myalgia;
Arthrosis, spondylarthrosis;
Pain syndrome in traumatic damage to the musculoskeletal system and soft tissues;
primary dysmenorrhea.

Dosage and administration

Enter deeply in / m once at a dose of 75 mg.

If it is necessary to carry out long-term therapy with Dicloberl N 75, it is continued using forms for oral or rectal use. On the day of injection of Dicloberl N 75, the total daily dose of diclofenac should not exceed 150 mg.

Suitable syringes:

Optimally: from 3 ml to 5 ml. Max 10ml

Contraindications

Hypersensitivity (allergy);
Hematopoietic disorders of unknown etiology;
Ulcer of the stomach and duodenum;
induced porphyrias;
Bronchial asthma;
Children and youth (up to 18 years).

Use during pregnancy and lactation
Do not use diclofenac sodium during the 1st and 2nd trimester of pregnancy, except in cases of emergency. If the drug is used when planning pregnancy or in the 1st and 2nd trimester of pregnancy, the minimum effective dose of the drug should be used for the shortest period. In the III trimester of pregnancy, the use of diclofenac sodium is contraindicated. The issue of discontinuation of the drug in women undergoing examination for infertility should be addressed. Diclofenac sodium and its metabolites pass into breast milk in small amounts, so it should not be used during breastfeeding.

Side effects:
From the side of the cardiovascular system:

Very rarely - chest pain, palpitations, edema, heart failure, myocardial infarction, stroke, hypertension.
From the blood system:

Very rarely - violation of hematopoiesis (anemia, leukopenia, thrombocytopenia, pancytopenia, agranulocytosis), hemolytic anemia, aplastic anemia. The first signs of these conditions may be fever, pharyngitis and sore throat, superficial ulcers on the oral mucosa, flu-like conditions, increased fatigue, epistaxis and skin bleeding. In such cases, the use of the drug should be stopped immediately and the patient examined. Patients should be warned that any self-medication with the use of painkillers and antipyretics should not be carried out.
From the nervous system:

Often - headache, dizziness, bouts of nausea, agitation, irritability or fatigue; rarely - drowsiness; very rarely - violation of sensitivity, taste, memory, disorientation, convulsions, tremor.
From the side of the organ of vision:

Very rarely - blurred vision and diplopia.
From the organ of hearing and vestibular apparatus:

Very rarely - tinnitus, transient hearing loss.
From the gastrointestinal tract:

Very often - nausea, vomiting, diarrhea, minor bleeding, which in some cases can lead to anemia; often - dyspepsia, flatulence, stomach cramps, lack of appetite, the formation of ulcers, which are sometimes accompanied by bleeding and perforation; sometimes - vomiting mixed with blood, black feces, diarrhea mixed with blood. If there is severe pain in the epigastric region, dark color of feces or blood in the feces, the use of the drug should be immediately stopped and the patient should be urgently examined; rarely - gastritis; very rarely - stomatitis, glossitis, damage to the esophagus, exacerbation of nonspecific ulcerative colitis or Crohn's disease, intestinal obstruction, constipation, pancreatitis, formation of adhesions and diaphragm-like strictures in the intestine.
From the urinary system:

Sometimes - the occurrence of edema, especially in patients with hypertension or renal insufficiency; very rarely - damage to the renal tissue (interstitial nephritis, papillary necrosis), which may be accompanied by the development of acute renal failure, proteinuria and / or hematuria; nephrotic syndrome. Reduced diuresis, fluid retention in the body (edema), as well as a deterioration in general well-being can be signs of kidney disease, including kidney failure. If the above symptoms appear or increase, the use of the drug should be stopped immediately, and the patient should be examined.
From the skin and subcutaneous tissue:

There have been reports of rare cases of exacerbation of infectious inflammatory diseases, such as the development of necrotizing fasciitis, associated with the systemic administration of NSAIDs, which may be due to their mechanism of action. In the event of the appearance or severity of symptoms of infectious diseases during the use of diclofenac sodium, the patient should immediately consult a doctor. It is required to resolve the issue of the need for antiseptic/antibiotic therapy. Very rarely, with the use of diclofenac sodium, the development of aseptic meningitis was observed with the appearance of symptoms such as stiff neck, headache, nausea, vomiting, fever and impaired consciousness. In autoimmune diseases (systemic lupus erythematosus, mixed connective tissue diseases), there is a tendency to develop aseptic meningitis.
From the immune system:

Often: hypersensitivity reactions such as skin rash and itching; sometimes - urticaria. If one of the above symptoms occurs, which are possible even with the first use of the drug, it is necessary to stop taking the drug and examine the patient. Very rarely - allergic vasculitis, pulmonitis, severe generalized hypersensitivity reactions, which can be manifested by swelling of the tongue, swelling of the face, internal swelling of the larynx with narrowing of the airways, difficulty breathing, tachycardia, as well as a decrease in blood pressure, up to the development of life-threatening shock.
Respiratory disorders: Asthma, including dyspnea.
From the side of the liver and biliary tract:

Often - an increase in the level of transaminases in the blood; sometimes - liver damage, especially with prolonged therapy, acute hepatitis, which is accompanied or not accompanied by jaundice (very rarely, a transition to fulminant hepatitis is possible, even without previous symptoms). In connection with the above, with prolonged use of the drug, it is necessary to regularly monitor the functional parameters of the liver.
Mental disorders:

Very rare: psychotic reactions, depression, anxiety, nightmares, insomnia.

Overdose

Symptoms:

May be manifested by CNS disorders - headache, dizziness, tinnitus, confusion or loss of consciousness (in addition, myoclonic convulsions are possible in children), as well as abdominal pain, nausea and vomiting, diarrhea, gastrointestinal bleeding is also possible, dysfunction of the liver and kidneys. Overdose can also lead to the development of arterial hypotension, respiratory depression and cyanosis.
Treatment:

There is no specific antidote. The stomach is washed, sorbents are used and, if necessary, symptomatic therapy. Forced diuresis, hemodialysis or hemoperfusion are ineffective, since the active substance is largely bound to blood proteins.

Drug Interactions

D other NSAIDs, including salicylates. The simultaneous use of several NSAIDs may lead to an increased risk of gastrointestinal ulcers and bleeding due to their synergistic effect, so this combination is not recommended.
Digoxin, phenytoin, lithium preparations. The simultaneous use of diclofenac sodium and digoxin, phenytoin and lithium preparations can lead to an increase in the concentration of these drugs in the blood plasma, therefore it is recommended to monitor the concentration in the blood plasma of lithium, digoxin and phenytoin.
Diuretics, ACE inhibitors and angiotensin II receptor antagonists. NSAIDs can reduce the effect of diuretic and antihypertensive drugs. In case of impaired renal function, for example, in dehydration or in the elderly, the simultaneous use of ACE inhibitors or angiotensin II receptor antagonists with drugs that suppress the action of COX-2 can lead to a deterioration in kidney function, the development of acute renal failure, which is often irreversible. In connection with the above, these combinations of drugs should be used with caution, especially in elderly patients. Patients should be warned about the need to drink enough fluids. Regular monitoring of renal function is also required after the start of the above combination therapy. The simultaneous use of diclofenac sodium and potassium-sparing diuretics can lead to the development of hyperkalemia, so it is necessary to regularly monitor the level of potassium in the blood plasma. GKS. The combined use of corticosteroids increases the risk of gastrointestinal ulcers and bleeding.
Antithrombotic agents and serotonin reuptake inhibitors. The combined use of these drugs with NSAIDs increases the risk of gastrointestinal ulcers and bleeding.
Methotrexate. The use of diclofenac sodium for 24 hours after taking methotrexate can lead to an increase in the concentration of methotrexate in the blood plasma and an increase in its toxic effect.
Cyclosporine. Diclofenac sodium, like other NSAIDs, can lead to an increase in the nephrotoxic effect of cyclosporine.
Anticoagulants. NSAIDs may increase the effect of anticoagulants such as warfarin.
Probenecid and sulfinpyrazone. Medicines containing probenecid and sulfinpyrazone may inhibit the excretion of diclofenac sodium.
Antidiabetic drugs. Clinical studies have shown that diclofenac can be used simultaneously with oral antidiabetic agents without affecting their clinical effect. However, isolated cases are known with both hypoglycemic and hyperglycemic effects, which require a change in the dosage of antidiabetic agents during treatment with diclofenac. This requires monitoring of blood glucose levels, which is a preventive measure during concomitant therapy.
Antibacterial quinolines. There are separate data on seizures, which may be the result of the combined use of quinolines and NSAIDs.
mifepristone. NSAIDs should not be used for 8-12 days after mifepristone administration, as NSAIDs may inhibit the action of mifepristone.
Colestipol and cholestyramine. The simultaneous use of diclofenac sodium with colestipol or cholestyramine reduces its absorption by approximately 30 and 60%, respectively, so they should be used with an interval of several hours.
Drugs that stimulate drug-metabolizing enzymes. Rifampicin, carbamazepine, phenytoin, St. John's wort ( Hypericum perforatum) are theoretically able to reduce the concentration of diclofenac sodium in plasma.

special instructions

The number of possible adverse reactions when using diclofenac sodium can be reduced by using the minimum effective dose of the drug for the shortest period necessary to eliminate the symptoms of the disease.
GIT. The simultaneous use of diclofenac sodium with other NSAIDs, including selective COX-2 inhibitors, should be avoided. With the use of any NSAID, there have been reports of cases of gastrointestinal bleeding and perforation, which can be fatal, especially in elderly patients who have an increased incidence of side effects from the gastrointestinal tract. These complications may occur at any stage of treatment, with or without warning symptoms, and are independent of a history of serious gastrointestinal disturbances. The risk of developing gastrointestinal bleeding and perforation increases with an increase in the dose of NSAIDs. In addition, the risk of these conditions is increased in patients with a history of gastrointestinal ulcers, especially complicated by bleeding and perforation. Therefore, these patients should be treated with the lowest dose. For these categories of patients, as well as for patients requiring additional therapy with low-dose acetylsalicylic acid or therapy with other drugs that may increase the risk of complications from the gastrointestinal tract, the possibility of prescribing combination therapy with the use of agents that protect the digestive tract mucosa, for example misoprostol or proton pump inhibitors. Patients with a history of toxic manifestations of the gastrointestinal tract in the appointment of NSAIDs, especially the elderly, should inform the doctor about all unusual symptoms from the gastrointestinal tract, especially the development of bleeding, especially in the initial phase of therapy. Diclofenac sodium is prescribed with caution to patients receiving concomitant therapy with drugs that increase the risk of ulcers and gastrointestinal bleeding, such as oral corticosteroids, anticoagulants, selective serotonin reuptake inhibitors or drugs that reduce platelet aggregation. If an ulcer or bleeding occurs, the drug should be discontinued immediately. In patients with a history of gastrointestinal diseases (ulcerative colitis, Crohn's disease), NSAID therapy is prescribed with caution, since it can lead to an exacerbation of these diseases. The patient should be instructed that if there is severe pain in the epigastric region, black feces or vomiting with blood, stop using the drug immediately and consult a doctor.
The cardiovascular system.

Patients with hypertension and / or mild to moderate heart failure in history require appropriate medical supervision, since there have been reports that in some cases NSAID therapy can lead to fluid retention in the body and the appearance of edema. The results of clinical studies and epidemiological data indicate that the use of diclofenac sodium, especially at high doses (100 mg / day) and with prolonged therapy, may cause a slight increase in the risk of arterial thrombosis, such as myocardial infarction and stroke, which is why it not recommended for the treatment of postoperative pain during coronary artery bypass surgery. Patients with uncontrolled hypertension, heart failure, confirmed diagnosis of coronary artery disease, peripheral arterial disease and / or cerebrovascular disease are prescribed diclofenac sodium only after a thorough analysis of the ratio of the probable benefit and risk of therapy. This tactic should be followed when prescribing diclofenac sodium to patients with risk factors for the development of cardiovascular diseases, such as hypertension, hyperlipidemia, diabetes mellitus, smoking.
Skin reactions.

There have been reports that, in very rare cases, the use of NSAIDs has been associated with the development of serious allergic skin reactions, exfoliative dermatitis, Stevens-Johnson syndrome, and toxic epidermal necrolysis, including. Reliably, the risk of developing such reactions is highest in the initial period of therapy, since in most cases these reactions develop during the 1st month of therapy. At the first signs of skin rash, mucosal lesions or other manifestations of hypersensitivity, drug therapy should be discontinued immediately.
Effect on liver function.

Prescribe diclofenac sodium to patients with impaired liver function should be used with caution, since its use may worsen the condition of patients. With prolonged therapy with the drug, regular monitoring of liver function is necessary, and if signs of deterioration appear, the use of the drug should be immediately discontinued.
Other instructions.

Diclofenac sodium should be prescribed only after a careful analysis of the ratio of probable benefits and risks in such conditions: congenital disorders of porphyrin metabolism, such as acute intermittent porphyria; systemic lupus erythematosus, as well as mixed connective tissue diseases. Diclofenac sodium should be used under especially careful medical supervision in case of impaired renal function and regularly monitored; with violations of liver function; immediately after significant surgical interventions; with hay fever, nasal polyps, COPD, as the risk of developing allergic reactions increases, which can be manifested by asthma attacks (the so-called aspirin asthma), Quincke's edema or urticaria; with allergic reactions of a different etiology, since this also increases the risk of hypersensitivity reactions when using diclofenac sodium. Very rarely, acute hypersensitivity reactions, such as anaphylactic shock, have been observed with the use of diclofenac sodium. The patient should be instructed that in the event of any hypersensitivity reactions, the drug should be discontinued immediately and the doctor should be consulted immediately. The dentist or surgeon must be informed before major surgery that the patient is using diclofenac sodium. Diclofenac sodium can temporarily suppress platelet aggregation, so it is necessary to monitor the condition of patients with blood clotting disorders. Diclofenac sodium, like other NSAIDs, can mask the symptoms characteristic of infectious and inflammatory diseases, therefore, if signs of infection appear or increase during the use of the drug, you should immediately consult a doctor to decide on the need for antibiotic therapy. Fever as such is not an indication for the use of diclofenac sodium. With prolonged therapy with diclofenac sodium, it is necessary to regularly monitor kidney function and hemogram. Diclofenac sodium, like other NSAIDs, can temporarily inhibit platelet aggregation, so patients with impaired hemostasis require laboratory monitoring of the coagulation system. It is necessary to use the drug with caution in the elderly, especially in debilitated patients or those with insufficient body weight. Such patients are recommended to use diclofenac sodium in the minimum effective dose. With prolonged treatment with painkillers, a headache may develop, which cannot be treated with an increase in the dose of these drugs. Frequent and habitual use of painkillers, especially combinations of several analgesics, can lead to persistent kidney damage, which is accompanied by the risk of kidney failure, the so-called analgesic nephropathy. The simultaneous use of alcohol can increase the undesirable effects that NSAIDs cause, especially from the gastrointestinal tract and central nervous system. Dicloberl retard contains sucrose, so it should not be prescribed to patients with hereditary fructose intolerance, glucose and galactose malabsorption syndrome, or sucrase or isomaltase deficiency.

Inflammatory processes are caused by the influence of pathogenic microorganisms that can cause other diseases. A drug from the group of non-steroidal anti-inflammatory drugs, Dicloberl, helps to fight the consequences of their activities.

For the treatment of diseases accompanied by an inflammatory process, Dicloberl or Dicloberl retard are best suited (a longer effect is provided after application).

Dicloberl instructions: composition and form of release

The drug in Russia is available in several forms, which can be used depending on which one is convenient or according to indications when prescribing a doctor.

Dicloberl 50 - tablets with enteric capsules, and the number next to the name indicates the presence of diclofenac sodium in the composition as the main substance in a dose of 50 mg. Auxiliary ingredients are:
talc;
simethicone emulsion;
macrogol 400, 6000;
povidone K-30;
magnesium stearate;
methacrylic acid;
hypromellose;
lactose monohydrate;
ethacrylate copolymer;
corn starch.

As additives to tablets for patients, E172 (iron oxide pigment), as well as E171 (titanium dioxide) is used. The drug is sold in the form of blisters of 50 and 100 pieces.

Dicloberl suppositories 50 and 100, respectively, contain diclofenac sodium in two dosages of 50 mg and 100 mg. As auxiliary substances, for the manufacture of this form is used:
propyl gallate;
hard fats;
ethyl alcohol (96%);
corn starch.

Suppositories may also be purchased in blisters (5 and 10 pieces).

Dicloberl 75 solution contains 75 mg of diclofenac. It is produced for intramuscular injection in 3 ml ampoules, and there are 5 of them in each box.
Dicloberl retard - a long-acting (prolonged) drug is available in capsules of 100 mg of diclofenac sodium. Diclober retard is available in blisters - 10, 20 and 50 capsules.

Action and from what is assigned

The medicine has pronounced anti-inflammatory, antipyretic, analgesic and antirheumatic properties. When the body is affected by rheumatism, the effect is manifested in the form of a decrease in stiffness in the joints in the morning, swelling over them and a decrease in the level of pain. Dicloberl is excreted in the urine, where 1% is unchanged diclofenac, and the rest is metabolites excreted in bile and feces.

The drug can be divided depending on the indications according to the forms that are convenient to take in one case or another:

Dicloberl in the form of tablets is used for rheumatic diseases (ankylosing spondylitis, spondyloarthritis, osteoarthritis); inflammatory pathology in gynecology, combined with pain syndrome (adnexitis); diseases of the upper respiratory tract with symptoms of inflammation and pain (otitis media). It is often prescribed in conditions after surgery (orthopedic or dental intervention) or trauma with signs of inflammation, pain; gout in the acute stage; the presence of pain syndrome in the defeat of the spine; soft tissue diseases after rheumatic injury.
Dicloberl in capsules allows you to relieve pain and reduce inflammation in musculoskeletal diseases (ankylosing spondylitis, gout attack, humeroscapular periarthritis, tendovaginitis and others). Often the remedy is used for injuries of various origins, such as: dislocations, fractures, sprains, providing a noticeable analgesic effect. After a minor dental or orthopedic intervention, the capsules can be used as an anti-inflammatory drug and to relieve pain.
Dicloberl in the form of injections is allowed to be injected with ankylosing spondylitis, osteoarthritis, rheumatoid arthritis, pain syndrome of vertebrogenic origin (osteochondrosis), non-articular form of rheumatism, renal and hepatic colic, mild forms of migraine attacks, pain syndrome, inflammatory process after receiving minor injuries.

In studies, it was found that the pharmacological effect is achieved by reducing to a large extent the synthesis of prostaglandins (responsible for inflammation, fever and pain syndrome). An analgesic effect is possible when it is used in case of pain that is non-traumatic in nature.

Application

Depending on the form of release, the drug must be used in different dosages, following an individual approach and only after a prescription has been prescribed by a doctor.

Dicloberl tablets are taken at the beginning of therapy in the most minimal dose in order to reduce the occurrence of side symptoms. They are taken 30 minutes or an hour before meals with water, and it is also forbidden to chew them when taken. The starting dose is not more than 150 mg / day. If the symptoms are not pronounced, then it is possible to prescribe 75 mg / day. The prescribed dose must be divided into several doses, but in case of pain at night, the administration of the rectal form of Dicloberl in the form of suppositories (50 mg) is allowed at bedtime.

If the drug is prescribed when establishing the diagnosis of primary dysmenorrhea, then the dosage should not exceed 100 mg / day. With the appearance of severe pain, it is allowed to increase it by the same amount, but for several menstruations. Treatment with Dicloberl is prescribed on the first day after the onset of pain.

There is a certain specificity in prescribing medication for the elderly. The appointment of the same dose does not affect the symptoms and the effect, but they are more prone to adverse reactions from the stomach or intestines.

Important! When prescribing therapy, it is necessary to monitor the condition for gastric bleeding due to a decrease in mucosal protective factors.

When prescribing Dicloberl capsules, the recommended maximum dose is initially no more than 150 mg / day, Dicloberl retard - no more than 100 mg / day. As a rule, the maximum dosage (100 mg / day) of the prolonged form is sufficient to relieve the symptoms of pain and inflammation and is not recommended for treatment in children.

Dicloberl in the form of a solution for injection is not used for more than 2 days. If the need for further treatment persists, it is necessary to switch to tablets or suppositories. The drug is administered intramuscularly (1 ampoule), adhering to the minimum dose, if necessary, you can make an additional injection at the same dose, but observing an interval of at least 2-3 hours.

There are some nuances in the use of Dicloberl by patients with mild or moderate liver or kidney pathology. The maximum allowable dose is 150 mg / day, so that undesirable effects do not occur.

Contraindications

If the patient has one of the restrictions indicated in the list, it is necessary to choose an individual dose acceptable for him with constant monitoring, or prescribe another drug.

Intolerance to the drug or individual components in the composition.
Bleeding from the stomach or intestines, history of perforation.
Inflammatory bowel disease in the form of ulcerative colitis or Crohn's disease.
Ulcers of the stomach, duodenum.
Cerebrovascular disorders or diseases of the hematopoietic organs.
Pathology from the kidneys or liver in severe severity.
Pregnancy.
Previous myocardial infarction, history of angina pectoris.
Congestive heart failure.
In all cases when the patient has symptoms of bronchial asthma, Quincke's edema, acute rhinitis or urticaria against the background of the use of ibuprofen, aspirin.

Interaction

In case of need for simultaneous administration of lithium preparations, potassium-sparing diuretics, trimethoprim, cyclosporine, constant monitoring of the level of lithium or potassium is required. This is important due to the increase in their plasma concentration when combined with NSAIDs.

If diuretics, antihypertensive drugs and Dicloberl are required, then constant monitoring of blood pressure levels is necessary due to the possibility of enhancing the hypotensive effect. It is also important to monitor renal function due to the risk of nephrotoxicity.

Side effects

Undesirable effects after the use of Dicloberl are possible both after short-term use and as a result of long-term treatment from all organs and systems individually:

Perhaps the appearance of mental disorders in the form of irritability, insomnia, depression.
Side effects from the hematopoietic system are manifested in the form of anemia.
On the part of the immune system, there are characteristic signs of hypersensitivity, severe urticaria and itching on the skin.
The defeat of the respiratory system is manifested by bronchial asthma.
Violations of the visual system and auditory in the form of a decrease in their severity, ringing in the ears and fog before the eyes.
The digestive system is characterized by rich symptoms, which are characterized by: flatulence, pain in the abdomen, symptoms of gastritis, ulcers in the stomach or duodenum, constipation, stomatitis, glossitis and pancreatitis.
Tachycardia, palpitations, vasculitis, and a drop in blood pressure appear with disorders of the cardiac system.
On the part of the skin, alopecia, toxic epidermal necrolysis, erythema, Stevens-Johnson syndrome, itching and eczema are possible.
The renal system is disturbed in the form of edema, nephrotic syndrome.
At the injection site, with the introduction of Dicloberl solutions, infiltrates or abscesses appear.

The appearance of side effects is possible with long-term treatment with NSAIDs and on how much the drug is administered orally (more than 150 mg / day).

Analogues of Dicloberl, price

There is a large list of funds called Dicloberl analogue. The most commonly purchased drugs that are similar in pharmacological action and effects are the following:

Pentalgin (tablets), the cost of which is 100-150 rubles.
Voltaren emulgel (tablets, injections, ointment, patch). Price from 150 rubles.
Analgin (tablets, suppositories, injections, capsules) can be purchased cheaper than other means, costing from 50 rubles.
Nimesil (granules in sachets for the preparation of a suspension), it is possible to buy at a price of 630 rubles.

If we compare generics and original drugs, then the latter have the highest positive result due to their highest purity of structure and studies. Generic drugs are most often not subjected to experimentation, and therefore their final outcome is not clear.

In order to get acquainted with the instructions and effects in more detail, there is a forum where specialists from different specialties can answer questions of interest to patients.

Dicloberl is a derivative of phenylacetic acid, which has an anti-inflammatory effect. Diclofenac sodium is the active substance present in this preparation. It has a decongestant, antipyretic and analgesic effect. This drug has various dosage forms, it is also produced in the form of suppositories. Candles "Dicloberl" are not recommended for use by children under 15 years of age.

Use of a medicinal product

Candles "Dicloberl" can be used for the following ailments:

inflammation of the musculoskeletal system;
arthritis in all its manifestations;
rheumatism and osteoarthritis;
and Personage-Turner;
with migraine, neuralgia, toothache, sciatica and ossalgia (if there are painful sensations);
if you have an infection or a cold (if you have a fever) a;
adnexitis.

Many patients, feeling pain, acquire Dicloberl (candles). Instructions for use are inside each package.

Dosage and methods of application

Candles "Dikloberl" are used no more than several times a day, 50 mg each, and if the dosage is 100 mg, then only 1 time per day rectally. When a person feels the first signs of a migraine, you should immediately apply this drug. After emptying the bowel, it is necessary to insert the suppositories deep into the anus. The doctor must prescribe the correct treatment, which can be prolonged if there are diseases of a rheumatic nature.

Contraindications

There is an instruction in each pack of Dicloberl. Candles have the following contraindications. You cannot use them if:

There is an increased sensitivity to the components of the drug.
The person has diseases such as asthma, anemia and the triad.
There are ulcers and erosions in the stomach.
The rectum is injured and there are hemorrhoids.
Age of children up to 6 years.

Candles "Dicloberl" have many contraindications, so they should be used with extreme caution. Women in position should not use this drug, as spontaneous miscarriage may occur in the early stages of pregnancy. In a child, the remedy causes the development of heart disease and non-closure of the anterior abdominal wall.

Important Points

Elderly people and persons who have heart and kidney failure, as well as those who use diuretics, should use Dicloberl only under the special supervision of a physician. The state of the kidneys must be constantly monitored.

Exceeding the dosage of this drug can cause:

fainting;
headache;
bleeding in the gastrointestinal tract;
disorientation;
stomach ache;
nausea.

Candles "Dikloberl" 100 and 50 mg are sold in blisters of 5 or 10 suppositories.

Concurrent use with other drugs

Doctors are allowed to combine Dicloberl (candles) with other drugs. Instructions for use, however, states that interaction with certain agents can lead to various consequences.

When using the drug "Dikloberl" in conjunction with diuretics, the effect of diclofenac on the body is weakened. When they are used together with inhibitors, kidney function is impaired in the body. Probenecid together with this drug slows down the excretion of diclofenac from the human body.

The use of "Dikloberl" in gynecology

Candles "Dikloberl" in gynecology are usually used for inflammation of the ovaries. Many girls and women at the very beginning of menstruation may have severe pain that makes them unable to work. These candles are successfully used in this area. Under the influence of internal temperature, the suppositories inserted into the vagina quickly dissolve inside and immediately enter the diseased organ, which speeds up the healing process. They need to be used every 6 hours.

Usually, inflammation of the ovaries is treated for a rather long time and can become chronic. This drug in the initial stages of the disease effectively relieves pain and tension in the inflamed tissues of the female body.

Candles "Dikloberl" helped many patients to establish a normal passage of the menstrual cycle. Having tried them once, the ladies advise this drug to their friends who have the same gynecological problems.

Dicloberl is a non-steroidal anti-inflammatory drug with anti-inflammatory and analgesic effects. The active substance is diclofenac.

Diclofenac belongs to the NSAID group of phenylacetic acid derivatives. It has a pronounced anti-inflammatory, analgesic and antipyretic effect, reduces tissue swelling during inflammation. These effects are associated with the ability to block the synthesis of prostaglandins (inflammatory mediators). Inhibits platelet aggregation caused by ADP and collagen.

The use of Dicloberl for the treatment of rheumatic diseases contributes to a significant reduction in the severity of pain at rest and during movement, morning stiffness of the joints, and their swelling.

In the treatment of inflammation caused by trauma or surgery, the anti-inflammatory and analgesic effect of Dicloberl is manifested by the rapid elimination of pain, a decrease in inflammation and swelling of damaged tissues. Also, the drug reduces the need for opioids to eliminate postoperative pain.

Indications for use

What helps Dicloberl? According to the instructions, the drug is prescribed in the following cases:

rheumatic diseases of inflammatory and degenerative origin, including rheumatoid arthritis, ankylosing spondylitis (Bekhterev's disease), acute attacks of gout, osteoarthritis, spondyloarthritis;
rheumatic diseases of extra-articular soft tissues, including humeroscapular periarthritis, tendonitis, tendovaginitis, bursitis;
pain syndromes from the spine;
inflammation after injuries, including sprains, dislocations, fractures.

Dicloberl tablets, capsules and suppositories are used to relieve pain of post-traumatic and postoperative genesis, which is accompanied by inflammation and swelling, including conditions after orthopedic and dental surgeries.

Additional indications for Dicloberl tablets and suppositories:

primary dysmenorrhea, adnexitis and other gynecological pathologies accompanied by inflammation and pain syndrome;
severe form of pharyngotonsillitis, otitis media and other inflammatory diseases in otorhinolaryngology, accompanied by severe pain syndrome (as an adjunct in complex therapy).

Instructions for use Dicloberl, dosage

Dicloberl injections are administered intramuscularly. The average daily dosage, according to the instructions for use - 1 ampoule Dicloberl 75 mg.

The maximum allowable daily dose should not exceed 150 mg (2 ampoules).

Candles

Candles Dicloberl are injected deep into the rectum (only after the act of defecation). The dosage is determined individually by the attending physician, depending on the severity of the disease.

The daily dose is from 50 to 150 mg \ 2-3 times a day.

Primary dysmenorrhea - 50 to 150 mg per day. In the absence of the desired therapeutic effect, the initial daily dose can be increased to 200 mg over several menstrual cycles. The use of suppositories should be started when the first pain symptoms appear. The duration of treatment depends on the dynamics of regression of the pain syndrome.
Migraine attacks - initial dose of 100 mg per day. To achieve a clinical effect, repeated administration of the Dicloberl 100 mg suppository is allowed on the first day of treatment. In the following days, if necessary, treatment can be continued (the daily dose should not exceed 150 mg, it is divided into 2-3 injections).
Juvenile rheumatoid arthritis - children over the age of 14 are prescribed Dicloberl 50 suppositories at the rate of not more than 3 mg per 1 kg of the child's weight. The maximum daily dose is 150 mg.

Capsules

Capsules Dicloberl retard take 100 mg (one capsule) once a day. If necessary, other forms of the drug may be additionally prescribed.

If the symptoms of the disease are most pronounced at night and in the morning, the capsules should be taken in the evening.

Tablets

Dicloberl tablets are taken orally during meals with a small amount of liquid.

According to the instructions, the daily dose is from 50 to 150 mg (1-3 tablets of Dicloberl 50 mg) - 1 tablet 2-3 times a day. The maximum dosage is 200 mg per day.

The duration of treatment is determined by the attending doctor.

special instructions

To reduce the risk of side effects of diclofenac, it is recommended to use the minimum effective dose of Dicloberl for a short period of time.

The doctor prescribes the dosage form, dose and period of treatment individually, taking into account clinical indications.

For the treatment of elderly patients, debilitated patients or patients with low body weight, it is recommended to use the lowest effective dose.

The total daily dose when using several dosage forms of Dicloberl should not exceed 150 mg of diclofenac.

Side effects

The instruction warns of the possibility of developing the following side effects when prescribing Dicloberl:

From the side of the central nervous system - headache, dizziness, fatigue, insomnia, agitation, impaired sensitivity, change in taste, impaired vision and perception of sounds, a sense of fear, disorientation, convulsions, depression, nightmares, confusion, stiff neck muscles.
From the digestive system - glossitis, dyspepsia, esophagitis, pancreatitis, liver damage, exacerbation of diseases of the gastrointestinal tract, abdominal pain, constipation, diarrhea, nausea, vomiting, minor gastrointestinal bleeding, decreased appetite. Bloody diarrhea, hematemesis and melena can sometimes be observed.
From the cardiovascular system - palpitations, chest pain, arterial hypertension, lowering blood pressure, palpitations, pain in the chest.
On the part of the hematopoietic system - agranulocytosis, anemia, leukopenia, thrombocytopenia.
Allergic reactions - bullous rash, skin rash, burning sensation at Dicloberl injection sites, Lyell's syndrome, swelling of the face, larynx and tongue, Stevens-Johnson syndrome, bronchospasm, anaphylactic shock.

Candles after the introduction often cause a burning sensation in the anus.

Contraindications

Dicloberl is contraindicated in the following cases:

acute ulcer, bleeding or perforation of the intestine / stomach;
allergy to the components of the drug;
increased risk of postoperative bleeding, hemostasis disorders, cerebrovascular bleeding or hematopoietic disorders;
bleeding or perforation of the digestive organs in the past associated with the use of anti-inflammatory non-steroidal drugs;
inflammatory bowel disease;
exacerbation of peptic ulcer, peptic ulcer bleeding, including in the past;
third trimester of pregnancy;
congestive heart failure;
cerebrovascular disorders in persons who have had a stroke or cases of ischemic attacks;
liver or kidney failure;
peripheral arterial disease;
ischemic heart disease in people who have had a heart attack or suffering from angina pectoris;
children's age up to 14 years for the appointment of suppositories at a dose of 50 mg;
age up to 18 years.
treatment of pain syndrome before and after coronary artery bypass grafting;
allergic reactions to ibuprofen, aspirin or other non-steroidal anti-inflammatory drugs.

Under medical supervision, it is recommended to use Dicloberl for porphyria, systemic lupus erythematosus, mixed collagenoses, high blood pressure (BP), heart failure, impaired renal function, severe liver dysfunction, hay fever, nasal polyps or obstructive airway diseases, in patients with ulcerative colitis, Crohn's disease or peptic ulcer of the stomach and intestines (including history), in the period after major surgery.

Overdose

It is manifested mainly by disorders of the nervous system - headache, dizziness, disorientation and loss of consciousness (in addition, myoclonic convulsions may occur in children), as well as abdominal pain, nausea and vomiting, gastrointestinal bleeding, impaired liver and kidney function.

Treatment is symptomatic - there is no specific antidote.

Dicloberl analogues, price in pharmacies

If necessary, you can replace Dicloberl with an analogue of the active substance - these are drugs:

Diclovit,
Diklak,
Almiral,
bioran,
Argett Rapid,
Diklobru.

When choosing analogues, it is important to understand that the instructions for use of Dicloberl, the price and reviews of drugs of similar action do not apply. It is important to consult a doctor and not to make an independent replacement of the drug.

Price in Russian pharmacies: Dicloberl 75mg ampoules - from 290 to 479 rubles, 10 suppositories 50 mg - from 250 to 284 rubles.

Store at a temperature: tablets - up to 30 ° C, capsules, solution, suppositories - up to 25 ° C. The solution should be stored in a place protected from light, do not allow freezing. Shelf life - 3 years. Conditions for dispensing from pharmacies - by prescription.

special instructions

During long-term treatment, constant monitoring of liver function and the content of liver enzymes is prescribed. In case of violation of the work of the organ or aggravation of problems, the use of Dicloberl should be stopped immediately.

The use of diclofenac may be associated with an increased likelihood of thrombotic events (heart attack or stroke).

With long-term use of Dicloberl, regular monitoring of the blood test should be carried out.

Patients who experience vertigo, blurred vision, impaired nervous activity, drowsiness, fatigue, lethargy during treatment with the drug should not drive a car.

Interaction with other medicines

Dicloberl increases the plasma concentration of digoxin, methotrexate, lithium preparations and cyclosporine.

Reduces the effect of diuretics, against the background of potassium-sparing diuretics, taking Dicloberl increases the risk of developing hyperkalemia; against the background of anticoagulants, antiplatelet and thrombolytic drugs (alteplase, streptokinase, urokinase), the risk of bleeding (often the gastrointestinal tract) increases.

Reduces the effect of antihypertensive and hypnotic drugs.

Treatment with Dicloberl increases the likelihood of side effects of other NSAIDs and corticosteroids (bleeding in the gastrointestinal tract), methotrexate toxicity and cyclosporine nephrotoxicity.

ASA reduces the concentration of the drug in the blood. Simultaneous use with paracetamol increases the risk of developing nephrotoxic effects of Dicloberl.

Reduces the effect of hypoglycemic drugs.

Cefamandol, cefoperazone, cefotetan, valproic acid and plicamycin increase the incidence of hypoprothrombinemia.

Cyclosporine and Au preparations increase the effect of the drug on Pg synthesis in the kidneys, which is manifested by an increase in nephrotoxicity.

Simultaneous administration with ethanol, colchicine, corticotropin and St. John's wort increases the risk of bleeding in the gastrointestinal tract.

Medications that cause photosensitivity increase the sensitizing effect of the drug to UV radiation.

Drugs that block tubular secretion increase the plasma concentration of Dicloberl, thereby increasing its effectiveness and toxicity.