Voltaren (Diclofenac)

Active Ingredient: Diclofenac
Dosage: 100 g
Route of Administration: Oral
Dosage Form: Tablets
Quantity per package: 30

Voltaren is a nonsteroidal anti-inflammatory drug. It can treat pain, migraines, and arthritis. The drug works by reducing substances in the body that cause pain and inflammation.

Indications

The drug is used to treat the following conditions:

• back pain in inflammatory and degenerative diseases of the spine (radiculitis, osteoarthritis, lumbago, sciatica);
• joint pain (finger joints, knee joints, etc.) in osteoarthritis;
• muscle pain (due to sprains, overexertion, bruises, injuries);
• inflammation and swelling of soft tissues and joints due to injuries and rheumatic diseases (tendovaginitis, bursitis, lesions of periarticular tissues, radio-carpal tunnel syndrome).

Dosage and administration

Voltaren tablets should be used in the lowest effective dose for the shortest possible time required to reduce the severity of symptoms. Take tablets orally without chewing, during or after meals, with plenty of water. Take 1 tablet once a day. If an additional dose of the drug is required, take 1/2 tablet. The maximum daily dose is 150 mg.

Contraindications

• Hypersensitivity to the active substance (including other NSAIDs) or auxiliary components;
• Complete or incomplete combination of bronchial asthma, recurrent polyposis of the nose and paranasal sinuses, and intolerance to acetylsalicylic acid or other non-steroidal anti-inflammatory drugs (including a history);
• Erosive and ulcerative changes in the mucous membrane of the stomach or duodenum 12, active gastrointestinal bleeding;
• Inflammatory bowel disease (ulcerative colitis, Crohn’s disease) in the acute phase;
• The period after coronary artery bypass grafting;
• III trimester of pregnancy, breastfeeding period;
• Confirmed chronic heart failure (NYHA functional class II-IV);
• Cardiac ischemia;
• Lesion of peripheral arteries or cerebrovascular disorders;
• Uncontrolled arterial hypertension;
• Hematopoietic disorders, hemostasis disorders (including hemophilia);
• Severe liver failure or active liver disease;
• Severe renal failure (creatinine clearance less than 30 ml/min);
• Progressive kidney disease;
• Confirmed hyperkalemia;
• Sucrose/isomaltase deficiency, fructose intolerance, glucose-galactose malabsorption (the drug contains sucrose).
• Children under the age of 18.

Side effects

• Gastrointestinal tract: often – epigastric pain, nausea, vomiting, diarrhea, dyspepsia, flatulence, anorexia; rarely – gastritis, proctitis, gastrointestinal bleeding (vomiting of blood, melena, diarrhea mixed with blood), gastrointestinal ulcers (with or without bleeding or perforation); very rarely – stomatitis, glossitis, esophagitis, nonspecific hemorrhagic colitis, exacerbation of ulcerative colitis or Crohn’s disease, diaphragmatic strictures in the intestine, constipation, pancreatitis; frequency unknown – ischemic colitis;
• Liver and biliary tract: often – increased aminotransferase activity; rarely – hepatitis, jaundice, liver dysfunction; very rarely – fulminant hepatitis, liver necrosis, liver failure;
• Nervous system: often – headache, dizziness; rarely – drowsiness; very rarely – impaired sensitivity, incl. paresthesia, memory disorders, tremors, convulsions, anxiety, cerebrovascular disorders, aseptic meningitis;
• Mental health: very rarely – disorientation, depression, insomnia, nightmares, irritability, mental disorders;
• Sense organs: often – vertigo; very rarely – visual impairment (blurred vision, diplopia), hearing impairment, tinnitus, impaired taste;
• Kidneys and urinary tract: very rarely – acute renal failure, hematuria, proteinuria, interstitial nephritis, nephrotic syndrome, papillary necrosis;
• Blood and lymphatic system: very rarely – thrombocytopenia, leukopenia, hemolytic and aplastic anemia, agranulocytosis, eosinophilia;
  Immune system: anaphylactic/anaphylactoid reactions, including a marked decrease in blood pressure (BP) and shock; very rarely – angioedema (including the face);
• Cardiovascular system: very rarely – a feeling of palpitations, chest pain, increased blood pressure, vasculitis, heart failure, myocardial infarction;
• Respiratory system, chest and mediastinal organs: rarely – exacerbation of bronchial asthma, cough, laryngeal edema; very rarely – pneumonitis;
• Skin and subcutaneous tissue: often – skin rash; rarely – urticaria; very rarely – bullous rashes, eczema, Stevens-Johnson syndrome, Lyell’s syndrome, exfoliative dermatitis, pruritus, hair loss, photosensitization, purpura, incl. allergic;
• General disorders: rarely – edema.

Overdose

Symptoms: nausea, vomiting, epigastric pain, gastrointestinal bleeding, diarrhea, dizziness, headache, tinnitus, convulsions, decreased blood pressure, respiratory depression, with a significant overdose – acute renal failure, hepatotoxic effect.

Treatment: gastric lavage, activated charcoal, symptomatic therapy aimed at eliminating arterial hypotension, renal dysfunction, seizures, gastrointestinal tract damage, respiratory depression. Forced diuresis, hemodialysis are ineffective (due to the significant connection with proteins and intensive metabolism).

Interaction

Do not take Voveran if you are taking methotrexate and cyclosporine.

Avoid combining Voveran with anticoagulants (for example, warfarin), antiplatelet agents (for example, acetylsalicylic acid, clopidogrel), oral glucocorticosteroids (for example, prednisolone), selective serotonin reuptake inhibitors (for example, citalopram, fluoxetine, paroxetine).

Precautions

Use the drug with caution if you have any of the following conditions: anemia, bronchial asthma, confirmed NYHA functional class I chronic heart failure, arterial hypertension, edematous syndrome, hepatic or renal failure (creatinine clearance 30-60 ml/min), dyslipidemia, hyperlipoproteinemia, diabetes mellitus, smoking, inflammatory bowel diseases, condition after major surgical interventions, induced porphyria, diverticulitis, systemic connective tissue diseases, pregnancy I-II trimester, gastrointestinal ulcer disease, Helicobacter pylori infection, advanced age, prolonged use of NSAIDs, frequent alcohol consumption, severe somatic diseases, seasonal allergic rhinitis, edema of the nasal mucosa (including nasal polyps), chronic obstructive pulmonary disease, chronic respiratory tract infections (especially associated with allergic rhinitis-like symptoms), allergies to other drugs, a significant decrease in the volume of circulating blood.