Active Ingredient: Diclofenac
Dosage: 100 mg
Route of Administration: Oral
Dosage Form: Tablets
Quantity per package: 30
Voltaren SR (Diclofenac) is a non-steroidal anti-inflammatory drug that has analgesic, anti-inflammatory and antipyretic effects.The main mechanism of its action is the indiscriminate inhibition of the enzyme cyclooxygenase 1 and 2 activity. It contributes to a decrease in acidic acid metabolism. The synthesis of prostaglandins in the kidneys, gastric mucosa and synovial fluid decreases. It is most effective for inflammatory pain.
Inflammatory and degenerative diseases of the musculoskeletal system (rheumatoid arthritis, ankylosing spondylitis, osteoarthritis, spondyloarthrosis, etc.);
- Rheumatic diseases of the periarticular soft tissues;
- Acute gouty arthritis;
- Pain in the spine;
- Pain and inflammatory syndrome after surgery;
- Gynecological diseases;
- Renal or biliary colic.
Dosage and administration
Oral administration. The tablets should be swallowed whole without chewing, washing down with plenty of water during or after meals. These are extended-release tablets. 100 mg should be used for long-term therapy. The initial and maintenance doses are 1 tablet per day.
- Hypersensitivity to diclofenac;
- Bronchial asthma;
- Recurrent polyposis of the nose and paranasal sinuses and intolerance to acetylsalicylic acid and other NSAIDs (including in history);
- Period after coronary artery bypass grafting;
- Erosive and ulcerative changes in the mucous membrane of the stomach or duodenum, active gastrointestinal bleeding;
- Inflammatory bowel disease, in the acute phase (ulcerative colitis (UC), Crohn’s disease);
- Cerebrovascular bleeding or other bleeding and hemostasis disorders;
- Severe liver failure or active liver disease;
- Severe renal failure (creatinine clearance less than 30 ml/min), including confirmed hyperkalemia, progressive kidney disease;
- Decompensated heart failure;
- Inhibition of bone marrow hematopoiesis;
- III trimester of pregnancy, period of breastfeeding;
- Children’s age (up to 18 years old).
- The nervous system and sensory organs: headache, dizziness, increased fatigue; in rare cases – tinnitus, irritability, sleep disturbance, anxiety, depression, mental disorders, convulsions, blurred vision, diplopia.
- The cardiovascular system and blood (hematopoiesis, hemostasis): in some cases – thrombocytopenia, leukopenia, agranulocytosis, anemia; in isolated cases, chest pain, tachycardia, increased blood pressure.
- The digestive tract: pain and spasms in the epigastrium, flatulence, decreased appetite, liver dysfunction, including hepatitis; rarely – erosive and ulcerative lesions with bleeding and perforation, aphthous stomatitis, esophagitis; in some cases – ulcerative colitis, Crohn’s disease.
- The genitourinary system: rarely – edema; in some cases – hematuria, proteinuria, interstitial nephritis, acute renal failure, nephrotic syndrome.
- The skin: skin rash, urticaria, bullous rashes, eczema, Stevens-Johnson syndrome, Lyell’s syndrome, erythroderma, alopecia, photosensitivity.
- Others: induration, in some cases – abscess or necrosis at the injection site, redness, burning sensation or tingling sensation when applied topically; rarely – attacks of bronchial asthma, systemic allergic reactions.
Symptoms: vomiting, nausea, abdominal pain, he gastrointestinal tract bleeding, diarrhea, headache, dizziness, tinnitus, increased excitability, hyperventilation phenomena with increased convulsive readiness, convulsions, with a significant overdose – acute renal failure, hepatotoxic effect.
Treatment: gastric lavage, activated charcoal, symptomatic therapy aimed at eliminating an increase in blood pressure, impaired renal function, seizures, irritation of the gastrointestinal tract, respiratory depression. Forced diuresis, hemodialysis are ineffective (significant connection with proteins and intensive metabolism).
Voltaren SR (Diclofenac) increases plasma concentration of digoxin, methotrexate, lithium preparations and cyclosporine. This drug reduces the effect of diuretics, on the background of potassium-sparing diuretics, the risk of hyperkalemia increases; on the background of anticoagulants, antiplatelet and thrombolytic drugs (alteplase, streptokinase, urokinase), the risk of bleeding (more often the gastrointestinal tract) increases.
It reduces the effect of antihypertensive and hypnotic drugs and increases the likelihood of side effects of other NSAIDs and glucocorticosteroids (gastrointestinal bleeding), methotrexate toxicity and cyclosporine nephrotoxicity. Acetylsalicylic acid reduces the concentration of diclofenac in the blood.
Concomitant use with paracetamol increases the risk of developing nephrotoxic effects of diclofenac. Hypoglycemic agents – hypo- or hyperglycemia may occur. With this combination of funds, it is necessary to control the concentration of glucose in the blood.
Cefamandol, cefoperazone, cefotetan, valproic acid, and plicamycin increase the incidence of hypoprothrombinemia. Cyclosporine and gold preparations increase the effect of diclofenac on the synthesis of prostaglandins in the kidneys, which is manifested by an increase in nephrotoxicity.
Selective serotonin reuptake inhibitors increase the risk of gastrointestinal bleeding. The simultaneous appointment with ethanol, colchicine, corticotropin and St. John’s wort increases the risk of bleeding in the gastrointestinal tract. Medications that cause photosensitization increase the sensitizing effect of diclofenac to ultraviolet radiation.
Drugs that block tubular secretion increase the plasma concentration of diclofenac, thereby increasing its toxicity. Antibacterial drugs from the quinolone group – the risk of seizures.