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Indications for the use of various forms of the drug dicloberl. Detailed instructions for use on dicloberl Use during pregnancy and lactation

Lineup 1 candles Dicloberl 50 includes 50 mg diclofenac sodium
Lineup 1 candles Dicloberl 100 includes 100 mg diclofenac sodium . Additional substances: corn starch, 96% ethanol, propyl gallate, solid fat.

Release form

Torpedo-shaped light yellow candles with a concave base. 5 candles in a blister, 1 or 2 blisters in a cardboard box.

pharmachologic effect

Analgesic, anti-inflammatory, antipyretic action.

Pharmacodynamics and pharmacokinetics

Pharmacodynamics

The drug is a non-steroidal structure, has a strong analgesic and anti-inflammatory effect, and is also a blocker prostaglandin synthetase .

Pharmacokinetics

It is adsorbed quickly and reaches the highest concentration in the blood after an hour. The bioavailability of suppositories is comparable to the bioavailability of oral forms of the drug. After multiple doses, the pharmacokinetics diclofenac does not change. Accumulation of the drug when the recommended dosages are observed is not observed.

Binding to blood proteins is approximately 99.8%. Easily penetrates into the joint fluid, where its maximum concentration is recorded 3 hours later than in the blood. The half-life of the joint fluid is approximately 4-5 hours. Approximately 2 hours after the onset of the maximum concentration in the blood, the content of the active substance in the synovial fluid remains higher than in the blood. This phenomenon is observed for 12 hours.

It is metabolized by glucuronization, hydroxylation and methoxylation with the formation of a number of phenolic derivatives, the vast majority of which form complexes with glucuronic acid . The elimination half-life from the blood is approximately one and a half hours. About 60% of the dose taken is excreted in the urine, the rest is evacuated through the intestines, while no more than 1% is excreted unchanged. diclofenac .

Indications for use

(including juvenile form), , spondyloarthritis;
vertebrogenic pain syndromes;
rheumatic diseases affecting extra-articular soft tissues;
pain syndromes of post-traumatic and postoperative origin, accompanied by signs of inflammation, after orthopedic and dental interventions;
gynecological disorders accompanied by inflammation and pain syndrome;
seizures;
exacerbation;
severe diseases of the ENT organs of an inflammatory nature.

The underlying disease should be treated with basic therapy drugs. An increase in temperature in itself is an indication for taking diclofenac is not.

Contraindications

acute, bleeding or perforation of the intestine or stomach;
on 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 taking anti-inflammatory nonsteroidal drugs;
inflammatory bowel disease;
exacerbation, ulcer bleeding, including in the past;
third trimester of pregnancy;
congestive heart failure;
cerebrovascular disorders in survivors or cases ischemic attacks ;
hepatic or;
peripheral arterial disease;
cardiac ischemia in persons who have undergone or are suffering;
pain management before and after coronary artery bypass grafting ;
proctitis ;
on , or others anti-inflammatory nonsteroidal drugs .

Side effects

Reactions from hematopoiesis: pancytopenia, thrombocytopenia, leukopenia, agranulocytosis, anemia . The first symptoms of these disorders may be fever, superficial ulceration in the mouth, nosebleeds, apathy, skin bleeding.
Reactions from immunity: skin rash, allergic vasculitis , itching, .
Mental disorders: , disorientation , irritability, psychotic disorders, nightmares, other mental disorders.
Reactions from nervous activity: dizziness, headache, agitation, dizziness, drowsiness, sensory disturbance, fatigue, convulsions, memory impairment, anxiety, hallucinations, taste disorders, aseptic , confusion, general malaise.
Reactions from sensory organs: diplopia blurred vision, neuritis ophthalmic nerve, ringing in the ears, vertigo , hearing disorders.
Reactions from blood circulation: arterial hypotension , heart failure, chest pain, palpitations, vasculitis , .
Reactions from breathing: pneumonitis, .
Reactions from digestion: abdominal pain, vomiting, flatulence , nausea, anorexia , bleeding from the digestive system, stomach ulcer (with possible perforation or bleeding), disruption of the esophagus, intestinal stenosis, hepatitis , increasing the content transaminases , liver disorders, jaundice, hepatonecrosis, fulminant hepatitis , liver failure.
Reactions from skin: manifestations and erythema , Lyell's syndrome, Stevens-Johnson syndrome, exfoliative dermatitis, purpura , photosensitivity, itching.
Reactions from urogenital area: acute renal failure, edema, , hematuria, nephrotic syndrome, interstitial nephritis, papillary necrosis kidney tissue.
General or local disorders: secretion of mucus with blood impurities, local irritation, painful defecation.

Candles Dicloberl, instructions for use (Method and dosage)

Instructions for using candles Dicloberl 50 and instructions for candles Dicloberl 100 are identical and do not differ.

To reduce the risk of adverse reactions, the lowest possible effective dose should be used for the shortest period of time.

Candles are forbidden to be used inside, they are intended only for rectal administration. They should be placed in the rectum as deep as possible after a bowel movement.

The initial dose is usually 100-150 mg per day. With mild symptoms, as well as with prolonged treatment, it is sufficient to use 75-100 mg of the drug per day.

Treatment migraine start at a dose of 100 mg with the development of the first signs of an attack. If necessary, it is allowed to use a second suppository (another 100 or 50 mg diclofenac ) in one day, as well as continue treatment on subsequent days, however, the daily dose should not exceed 150 mg and is divided into 2 or 3 doses.

Candles Dicloberl 100 in gynecology

During treatment primary the dosage is selected individually, as a rule, it is 50-150 mg of the drug per day. The initial dose is usually 50-100 mg per day, but if necessary, it can be increased within 2-3 menstrual cycles up to a limit of 200 mg diclofenac in a day. The use of the drug is recommended to start after the appearance of the first pain and continue for several days, depending on the degree of symptom relief.

Elderly patients

Anti-inflammatory nonsteroidal drugs should be used with caution in this group of individuals, as they are generally more prone to adverse reactions. Debilitated elderly patients or patients with low weight should be prescribed the smallest effective dose of the drug Dicloberl (Dicloberl).

Overdose

Signs of overdose: nausea, headache, epigastric pain, vomiting, bleeding from the digestive system, drowsiness, convulsions, dizziness, diarrhea , disorientation, , agitation, tinnitus, liver damage, .

Overdose treatment: symptomatic, cleansing enema (if no more than an hour has passed since the overdose). With frequent or prolonged convulsions, you need to enter.

Interaction

With simultaneous use, Dicloberl is able to increase the content lithium in blood. In such cases, concentration monitoring is recommended. lithium in blood.

When used together, it is possible to increase the concentration of the latter in the blood. In such cases, concentration monitoring is recommended. Digoxin in blood.

Joint application diclofenac With antihypertensive drugs and diuretics may lead to a weakening of their antihypertensive effect due to the suppression of the synthesis angiodilating prostaglandins . Patients need to receive the proper amount of fluid, and regular monitoring of kidney function after starting such treatment is also recommended.

Careful medical supervision is necessary when prescribing Dicloberl to patients with liver disease, due to the possible deterioration of their condition.

In the course of long-term treatment with the described agent, constant monitoring of liver function and the content of liver enzymes is prescribed. If liver dysfunction persists or worsens, or clinical signs appear that are presumably associated with the progression of the disease, Dicloberl should be discontinued immediately.

Since the therapy anti-inflammatory nonsteroidal drugs an increase in the frequency and severity of edema was recorded, special attention should be paid to people with, disorders of the heart or kidneys, in the elderly, receiving diuretics or nephrotoxic agents and before or after major operations.

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

Patients with peripheral arterial disease, ischemic heart disease , congestive heart failure, severe arterial hypertension , cerebrovascular disease it is not recommended to prescribe the drug, in extreme cases it can be used at a dosage of up to 100 mg per day.

With long-term use of this drug, regular monitoring of the blood test is necessary.

Patients with hemorrhagic diathesis, impaired hemostasis or hematological disorders should be closely monitored while taking Dicloberl.

In patients with chronic obstructive pulmonary disease, nasal polyps or chronic respiratory tract infections are more likely to have side effects (attacks asthma , angioedema, urticaria ) due to the reception anti-inflammatory nonsteroidal drugs . This also applies to persons with other substances such as itching, rash, hives .

With prolonged use painkillers headache may occur, which should not be treated with an increase in the dosage of medications.

With alcohol

With the joint use of alcohol and Dicloberl, undesirable reactions to the gastrointestinal tract or to the nervous system increase.

During pregnancy and lactation

In the first two trimesters of pregnancy, Dicloberl is allowed to be prescribed only if there are strict indications and under medical supervision, and the duration of therapy should be as short as possible. In the last trimester of pregnancy, the use of the drug is prohibited due to the risk of inhibition of the contractile activity of the uterus and early closure of the ductus arteriosus.

Diclofenac able to penetrate into milk during breastfeeding, so the drug should not be used during lactation to avoid a negative effect on the baby.

Dicloberl can also adversely affect fertility in women, so it is not recommended for women planning pregnancy.

In this article, you can read the instructions for using the drug Dicloberl. Reviews of site visitors - consumers of this medicine, as well as opinions of doctors of specialists on the use of Dicloberl in their practice are presented. A big request to actively add your reviews about the drug: did the medicine help or not help get rid of the disease, what complications and side effects were observed, perhaps not declared by the manufacturer in the annotation. Analogues of Dicloberl in the presence of existing structural analogues. Use for the treatment of arthritis, arthrosis and relief of pain in adults, children, as well as during pregnancy and lactation. The composition of the drug.

Dicloberl- non-steroidal anti-inflammatory drug (NSAID), a derivative of phenylacetic acid. The active substance of the drug is diclofenac sodium. It has a pronounced anti-inflammatory effect due to inhibition of prostaglandin synthesis. It has antipyretic, analgesic and anti-edematous (swelling of tissues during inflammation) action. Reduces the adhesive properties of platelets under the action of collagen and ADP.

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.

Compound

Diclofenac sodium + excipients.

Pharmacokinetics

After oral administration, diclofenac is completely absorbed from the intestine. After absorption from the intestine, first pass metabolism occurs due to the primary passage through the liver. 35-70% of the active substance enters the posthepatic circulation. After the introduction of the suppository into the rectum, Cmax in the blood plasma is observed after 30 minutes.

Approximately 30% of diclofenac is metabolized. Metabolic products are eliminated by the intestines. Inactive metabolites obtained by conjugation and hydroxylation by hepatocytes are eliminated by the kidneys. The half-life is 2 hours and does not depend on the functions of the kidneys and liver. Binds to blood proteins 99% of the drug.

Indications

Symptomatic treatment of pain and inflammation in:

acute arthritis (including attacks of gout);
chronic arthritis, in particular, rheumatoid arthritis (chronic polyarthritis);
ankylosing spondylitis (Bekhterev's disease) and other inflammatory rheumatic diseases of the spine;
painful tissue irritations in arthrosis and spondyloarthrosis;
inflammatory diseases of a rheumatic nature with damage to soft tissues;
edema with pain syndrome or post-traumatic inflammation;
fever and elevated body temperature.

Release forms

Tablets 50 mg.

Candles rectal 50 mg.

Solution for injection N 75 (injections in ampoules).

Long-acting capsules 100 mg (Dikloberl Retard).

Instructions for use and dosage

Ampoules

Adults. An injection of Dicloberl N 75 is performed once (75 mg of diclofenac sodium). For continuation of treatment use dosage forms for oral or rectal administration. In this case, even on the day of injection, the total dose of diclofenac sodium should not exceed 150 mg.

Method and duration of application

Dicloberl N 75 is injected intramuscularly deep into the buttocks. Injection of Dicloberl N 75 is performed once. Due to the potential risk of developing anaphylactic reactions (up to shock), the patient should be observed for at least an hour after the administration of Dicloberl 75; at the same time, the medical instruments necessary for the provision of emergency care and serviceable (functioning) must be at the ready. The patient should be explained the meaning of these measures.

The duration of the drug is determined by the attending physician.

Tablets

Dicloberl 50 tablets are taken orally during meals (to eliminate the irritating effect on the gastric mucosa), with a small amount of liquid. Do not chew. The daily dose - 50-150 mg - is divided into 2-3 doses. The duration of therapy is determined by the doctor individually.

Capsules Retard

The adult dose is 1 capsule of Dicloberl retard extended-release per day (equivalent to 100 mg of diclofenac sodium).

Dicloberl retard should be taken orally as a whole, without chewing, and washed down with plenty of liquid. Patients with a sensitive stomach are advised to take Dicloberl retard with meals.

The question of the duration of the drug is decided by the attending physician.

Therapy of rheumatic diseases may require long-term use of Dicloberl retard.

Undesirable effects can be reduced by prescribing the minimum effective dose of the drug for the shortest possible period of time necessary to stop the symptoms of the disease.

Candles rectal

Suppositories Dicloberl 50 are injected deep into the rectum after defecation. The dose is determined individually by the doctor, depending on the severity of the disease. Usually the daily dose should be in the range of 50-150 mg (for adults and pediatric patients over 15 years of age). The daily dose is administered in 2-3 doses.

Side effect

dyspepsia;
glossitis;
esophagitis;
liver damage;
exacerbation of gastrointestinal diseases;
pancreatitis;
constipation, diarrhea;
stomach ache;
nausea, vomiting;
loss of appetite;
slight gastrointestinal bleeding is possible;
in patients with gastrointestinal diseases, bleeding and ulcer perforation may occur;
melena;
hematemesis;
bloody diarrhea;
dizziness;
headache;
insomnia;
increased fatigue;
excitation;
taste changes;
sensitivity disorders;
changes in the perception of sounds;
visual impairment;
disorientation;
feeling of fear;
convulsions;
depression;
tremor;
neck stiffness (aseptic meningitis);
confusion;
skin rash;
bullous eruptions;
burning sensation at the injection site;
sterile abscess at the injection site;
Lyell's syndrome;
necrosis of subcutaneous adipose tissue at the injection site;
swelling of the tongue, face and larynx;
Stevens-Johnson syndrome;
anaphylactic shock;
bronchospasm;
thrombocytopenia, anemia, agranulocytosis, leukopenia;
chest pain;
heartbeat;
lowering blood pressure;
arterial hypertension;
pulmonitis.

Contraindications

hypersensitivity to the active substance or to any of the other components of the drug;
reactions in the form of bronchospasm, asthma, rhinitis or urticarial rash after taking acetylsalicylic acid or other nonsteroidal antirheumatic / anti-inflammatory drugs (NSAIDs) in history;
unexplained disorders of hematopoiesis;
current or past recurrent peptic ulcer/bleeding (at least two different episodes of confirmed peptic ulcer or bleeding);
history of gastrointestinal bleeding or perforation associated with previous NSAID therapy;
cerebrovascular or other current bleeding;
severe impairment of liver or kidney function;
severe heart failure;
last trimester of pregnancy;
children under the age of 15 (candles), up to 18 years (Retard capsules and injections).

Use during pregnancy and lactation

Pregnancy

Suppression of prostaglandin synthesis may adversely affect pregnancy and/or embryonic/fetal development. According to the results of epidemiological studies, in early pregnancy, the use of drugs that suppress the synthesis of prostaglandin may increase the risk of spontaneous abortion, the occurrence of heart disease in the fetus and abdominal wall non-closure. Thus, the absolute risk of developing malformations of the cardiovascular system increased from less than 1% to approximately 1.5%. It is believed that the risk of these phenomena increases with an increase in the dose of the drug and the duration of its use.

In animals, the use of a prostaglandin synthesis inhibitor contributed to an increase in pre- and post-implantation rejection and an increase in embryo-fetal mortality. In addition, in animals treated with a prostaglandin synthesis inhibitor during organogenesis, the incidence of various fetal malformations, including malformations of the cardiovascular system, increased.

The appointment of Dicloberl during the first and second trimester of pregnancy is possible only when there is an urgent need for it. In the case of the appointment of diclofenac, women planning a pregnancy, or in the first and second trimester of pregnancy, should choose the lowest possible dose and the shortest possible duration of treatment.

In the third trimester of pregnancy, all inhibitors of prostaglandin synthesis can lead to the development of the fetus:

phenomena of cardiopulmonary toxicity (eg, premature closure of the arterial duct and hypertension in the pulmonary artery system);
kidney dysfunction, which can progress to renal failure with the development of oligohydramnios;

at the end of pregnancy can lead to the mother and fetus to:

prolongation of bleeding time, antiaggregation effect, which can occur even when using very low doses of the drug;
suppression of the contractile activity of the uterus, which can lead to a delay or delay in labor.

In this regard, Dicloberl is contraindicated in the third trimester of pregnancy.

Lactation

The active substance diclofenac and its decay products pass into the mother's milk in small amounts. Since the harmful effects of the drug on newborns have not been established at present, as a rule, with short-term use of the drug, interruption of breastfeeding is not required. However, with long-term treatment with diclofenac or when using high doses in diseases of a rheumatic nature, the possibility of stopping breastfeeding should be considered.

Fertility

Dicloberl can reduce female fertility, and therefore it is not recommended for women planning a pregnancy. In women who have difficulty conceiving or who are being screened for infertility, discontinuation of Dicloberl should be considered.

Use in children

Contraindicated in children and adolescents under the age of 18 (injections, Dicloberl Retard capsules).

Contraindicated in children under 15 years of age (rectal suppositories).

Use in elderly patients

In elderly patients, the frequency of adverse reactions to NSAIDs is increased, especially gastrointestinal bleeding and perforation, including fatal ones.

special instructions

Gastrointestinal Precautions

Co-administration of Dicloberl and other NSAIDs, including selective cyclooxygenase-2 inhibitors, should be avoided.

Undesirable effects can be reduced by using the lowest effective dose for the shortest period necessary to relieve symptoms.

Gastrointestinal bleeding, ulcer and ulcer perforation

Gastrointestinal bleeding, ulceration, or perforation, sometimes fatal, has been reported for all NSAIDs at any stage of treatment, with or without warning symptoms, and regardless of the presence or absence of a history of serious gastrointestinal disease.

The risk of gastrointestinal bleeding, ulceration, or perforation increases with increasing dose of non-steroidal anti-inflammatory drug in patients with a history of an ulcer, especially complicated by bleeding or perforation, as well as in elderly patients. In such cases, treatment should be started with the lowest possible dose. For these patients, as well as for patients receiving low-dose aspirin or other drugs that increase the risk of gastrointestinal adverse events, combination therapy with drugs that have a protective effect on the gastrointestinal tract (for example, misoprostol or proton inhibitors) should be considered. pump).

Patients with a history of gastrointestinal toxicity, particularly the elderly, should report any unusual abdominal symptoms (especially gastrointestinal bleeding); this is of greatest importance for the initial stages of treatment. Caution should be exercised when prescribing diclofenac to patients concomitantly taking drugs that may increase the risk of ulcers or bleeding; these drugs include oral corticosteroids, anticoagulants, eg warfarin, selective serotonin reuptake inhibitors, or drugs that inhibit platelet aggregation (antiplatelet agents), eg. aspirin.

With the development of gastrointestinal bleeding during treatment with diclofenac, the drug should be discontinued.

Non-steroidal anti-inflammatory drugs should be used with caution in patients with a history of gastrointestinal diseases (ulcerative colitis, Crohn's disease) due to the risk of their exacerbation.

Effects on the cardiovascular system and cerebrovascular circulation

Diclofenac should be administered with caution to patients with arterial hypertension and / or decompensated heart failure from mild to moderate severity in history, since fluid retention and edema may develop in the treatment of NSAIDs.

According to the results of clinical studies and epidemiological data, the use of diclofenac, especially at high doses (150 mg per day) and for a long time, may be accompanied by a slight increase in the risk of arterial thrombosis (for example, myocardial infarction or stroke).

Patients with uncontrolled arterial hypertension, heart failure, coronary heart disease, obliterating endarteritis and / or cerebrovascular pathology should be given diclofenac only after carefully weighing everything. The same questions should be addressed before initiating long-term treatment in patients with cardiovascular risk factors (eg, hypertension, hyperlipidemia, diabetes mellitus, smoking).

Skin reactions

Rare cases of serious skin reactions, sometimes fatal, including exfoliative dermatitis, Stevens-Johnson syndrome and toxic epidermal necrolysis (Lyell's syndrome) have been reported during treatment with NSAIDs. The risk of such reactions is highest at the beginning of treatment; most of the described phenomena were observed in the first months of therapy. Dicloberl should be discontinued at the first appearance of a skin rash, mucosal lesions or other signs of hypersensitivity.

Effects on the liver

Diclofenac should be used with caution in patients with hepatic impairment, as their condition may worsen during treatment. With long-term treatment or repeated administration of diclofenac, it is recommended - as a precautionary measure - to regularly check liver function. If clinical signs of liver pathology appear, the drug should be discontinued.

Other instructions

In the following cases, Dicloberl should be prescribed only after a thorough assessment of the benefit-risk ratio:

with congenital disorders of porphyrin metabolism (for example, with acute intermittent porphyria);
with systemic lupus erythematosus (SLE) and mixed collagenoses.

In the following cases, particularly careful monitoring by the attending physician is necessary:

with a decrease in kidney function;
in violation of liver function;
immediately after major surgery;
with pollen allergies, nasal polyps and chronic obstructive airway diseases, since these patients are at increased risk of allergic reactions. These reactions can be manifested by asthma attacks (so-called analgesic asthma), Quincke's edema or urticarial rash;
with allergies to other substances, since such patients have an increased risk of hypersensitivity reactions, including during treatment with Dicloberl.

Dicloberl should not be injected into the focus of inflammation or infection.

Very rarely, severe acute hypersensitivity reactions (eg, anaphylactic shock) have been observed. When the first signs of a hypersensitivity reaction appear, Dicloberl should be canceled and professional treatment should be started in accordance with the developed symptoms.

Diclofenac may temporarily suppress platelet aggregation. In this regard, it is necessary to monitor the condition of patients with bleeding disorders.

Like other NSAIDs, diclofenac may mask the manifestations of infection due to its pharmacodynamic properties. If, during treatment with Dicloberl, the symptoms of infection reappear or worsen, the patient is advised to immediately consult a doctor who will determine whether there are indications for anti-infective therapy or antibiotic therapy.

With long-term treatment with diclofenac, kidney function and complete blood count should be checked regularly.

With prolonged use of painkillers, a headache may occur. You should not try to eliminate the headache by increasing the dose of the drug.

With prolonged use of painkillers, especially when several analgesic active substances are combined, permanent kidney damage is possible with a risk of kidney failure (analgesic nephropathy).

With the combination of NSAIDs and alcohol, it is possible to increase the undesirable effects of the active substance of the drug, especially on the gastrointestinal tract or the central nervous system.

Influence on the ability to drive a car and maintain mechanisms

In the treatment of Dicloberl in high doses, side effects from the central nervous system such as increased fatigue and dizziness may occur; therefore, in some cases, patients may have a violation of the reaction and a deterioration in the ability to actively participate in traffic and to maintain mechanisms. These phenomena are aggravated by the combination of the drug with the intake of alcohol.

drug interaction

Other NSAIDs, including salicylates: The concomitant use of some NSAIDs may increase the risk of ulcers and gastrointestinal bleeding due to the synergistic effect of the drugs. In this regard, the combined use of diclofenac and other NSAIDs is not recommended.

Digoxin, phenytoin, lithium: When co-administered Dicloberl may increase the concentration of digoxin, phenytoin and lithium in the blood. In this regard, when treating with diclofenac, monitoring of serum lithium concentration is mandatory, and digoxin and phenytoin are recommended.

Diuretics, ACE inhibitors and angiotensin II antagonists: NSAIDs may reduce the effectiveness of diuretics and other antihypertensive drugs. In some patients with reduced renal function (eg, dehydration or elderly patients with reduced renal function), when taking ACE inhibitors or angiotensin 2 antagonists in combination with a drug that inhibits cyclooxygenase, further deterioration in renal function is possible, including the possible development of acute renal failure, which, however, is reversible in most cases. In this regard, these drugs should be used with caution in combination with diclofenac, especially in elderly patients. With the joint administration of diclofenac and these drugs, it is necessary to ensure that the patient takes an adequate amount of fluid, and it is also necessary to regularly monitor kidney function after the start of treatment.

The concomitant use of Dicloberl and potassium-sparing diuretics can lead to the development of hyperkalemia. In this regard, it is recommended to control the concentration of potassium in the blood during the joint administration of these drugs.

Glucocorticoids: When co-administered with diclofenac, the risk of ulcers and gastrointestinal bleeding increases.

Drugs that inhibit platelet aggregation (eg, acetylsalicylic acid) and selective serotonin reuptake inhibitors (SSRIs): When co-administered with diclofenac, the risk of gastrointestinal bleeding increases.

Methotrexate: With the introduction of Dicloberl within 24 hours before or after the administration of methotrexate, an increase in the concentration of methotrexate in the blood and an increase in its toxic effects are possible.

Cyclosporine: NSAIDs (eg, diclofenac sodium) may increase the nephrotoxic effect of cyclosporine.

Anticoagulants: NSAIDs may increase the effect of anticoagulants such as warfarin.

Sulfonylureas: There are isolated reports of changes in blood glucose concentrations following the use of diclofenac, requiring dose adjustment of the antidiabetic drug. In this regard, with joint therapy, it is recommended to control the concentration of glucose in the blood.

Probenecid and sulfinpyrazone: Medicines containing probenecid and sulfinpyrazone may delay the excretion of diclofenac from the body.

Studies on the compatibility of diclofenac have not been conducted, so it should not be mixed with other drugs.

Analogues of the drug Dicloberl

Structural analogues for the active substance:

Veral;
Voltaren;
Diklak;
Diklo F;
Diklobene;
Dicloberl N 75;
Dicloberl Retard;
Diclovit;
Diclogen;
Diclomax;
Diclomelan;
Diclonac;
Diklonat P;
Dicloran;
Diclorium;
Diclofen;
Diclofenac;
diclofenac sodium;
Diclofenac retard;
Diclofenacol;
Difen;
Naklofen;
Naklofen Duo;
Ortofen;
Orthofer;
Rapten Duo;
Rapten Rapid;
Revmavek;
Revodina retard;
Remetan;
Sanfinak;
SwissJet;
SwissJet Duo;
Tabuk Dee;
Feloran 25;
Feloran retard;
Flotak.

In the absence of analogues of the drug for the active substance, you can follow the links below to the diseases that the corresponding drug helps with and see the available analogues for the therapeutic effect.

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 edema, 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 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.

One ampoule of Dicloberl contains 75 mg of diclofenac (active substance). Additional components: benzyl alcohol, sodium hydroxide.

The composition of the tablets also includes diclofenac sodium in a volume of 100 mg. Additional components: corn starch, talc, lactose monohydrate.

The suppository contains 50 mg diclofenac sodium, as well as ethyl alcohol and solid fat.

Medicinal properties

"Dikloberl" is a strong decongestant drug. Due to its substance - diclofenac, the drug has an analgesic and antipyretic effect.

After intramuscular injection, this drug is observed in the blood plasma after fifteen minutes. When taking the tablets, they are absorbed after three hours.

The drug is excreted by the kidneys. Most of the drug (more than 75%) is processed by the liver.

Indications for use

Dicloberl is prescribed for such diseases:

Pyogenic arthritis
Spondylosis
Arthrosis
Dysmenorrhea
Persistent lower back pain
spine fracture
Degenerative diseases of the joints and spine
Dystrophic diseases
Myalgia
Knee injuries
Neuralgia
Osteoarthritis
Tendenitis.

Dicloberl is available in the following dosage forms:

The average price is from 273 to 310 rubles.

Solution for injection "Dikloberl"

Dosage: in ampoules of 3 mg 75 mg. The carton contains 5 ampoules.

Mode of application

The injections are given intramuscularly. The permissible daily dose is 150 mg. The course of therapy lasts ten days, however, in severe conditions of the patient, the attending physician may extend the treatment for another five days. Such injections are administered slowly so as not to damage the muscle tissue.

The average price is from 280 to 300 rubles.

"Pills" Dicloberl "

Tablets for oral use. Dosage: 100 mg. 1 blister contains 10 or 20 soluble coated tablets

Mode of application

Means in tablets should be taken once a day after meals. They cannot be chewed. The total duration of treatment should be determined by the attending physician, depending on the severity of the patient's illness.

The average price is from 210 to 340 rubles.

Suppositories "Dikloberl"

Rectal suppositories 50 mg. In 1 blister, candles come in 5 or 10 pcs.

Mode of application

Candles are inserted deep into the rectum. The maximum dose per day is 150 mg of diclofenac. Such suppositories should remain in the rectum until completely dissolved and absorbed, so the patient should be in a supine position within the next two hours after the drug is administered.

Contraindications

"Dikloberl" is contraindicated in such diseases and conditions:

Chronic form of asthma
Age under 15
Pregnancy and lactation period
Individual intolerance to the components of the drug
Nasal polyposis
Anemia
Haemorrhoids
Alcoholism
Inflammatory processes of the rectum (if candles are used for treatment)
Hepatitis.

During pregnancy and breastfeeding

The use of the drug "Dycloberl" during pregnancy (1st and 2nd trimester) is possible only when the expected benefits to the health of the mother will outweigh the likely risks to the fetus. In this case, treatment with this drug should be short-term and at a minimum dose. And it is best to use candles.

In the last months of pregnancy, this remedy is contraindicated, since it can negatively affect the development of the child.

When breastfeeding, this drug is contraindicated.

Precautionary measures

With caution, Dicloberl is prescribed for dyspepsia, diabetes mellitus, the presence of chronic diseases, or heart failure in a patient. Also, only under the supervision of a doctor, people with diseases of the heart and respiratory tract should be treated with this drug.

Interaction with other drugs

When co-treated with selective inhibitors or corticosteroids with this drug, the patient has an increased risk of internal bleeding.

Simultaneous therapy with antidiabetic drugs can provoke the development of hyperglycemia or hypoglycemia.

The interaction of this drug with antihypertensive drugs causes a decrease in their effectiveness.

Side effects

When taking Dicloberl, treatment with candles or injections, there is a risk of side effects.

In the digestive system:
- Hepatitis
- Bloating and spasms
- stomach ulcer
- Melena
- Burning in the anus
- Cirrhosis of the liver
- Colitis
- Liver damage
- Constipation - Want to know more? Read the article:
- Taste disturbance and loss of appetite
- Glossitis
- pancreatitis
Allergic reactions:
- Itchy skin
- Dermatitis
- Swelling of the tongue and larynx
Additional may cause cough, pulmonitis, vasculitis or fluid retention in the body.

Overdose

In case of an overdose, the patient may experience convulsions in the body, dizziness or general disorientation. In severe cases, internal bleeding may occur.

Terms and conditions of storage

It is necessary to store the drug in a dry and dark place, at a temperature not exceeding 25 degrees.
Expiration date: 36 months from the production date indicated on the package.

Analogues

"Dikloberl" has such medicinal analogues and synonyms:

Faran Laboratoris, Greece
Price from 240 to rub.

Main action: antipyretic and analgesic. It is prescribed for the treatment of exacerbations of arthrosis, padagra and rheumatism. Composition: one ampoule or capsule contains 75 mg of diclofenac sodium. Release form: solution for intramuscular injections, capsules and suppositories.

pros

Many forms of release, which makes it possible for different uses of the drug
Rectal suppositories are allowed for treatment (from 2 years)

Minuses

Prohibited during pregnancy
Has many side effects.

Pharma, Germany
Price from 230 rub. up to 390 rub.

Main action: anti-inflammatory, analgesic. Release form and composition: gel containing 1% diclofenac. Produced in tubes of 50 and 100 g.

pros

Thanks to external use, the patient can avoid systemic load in the body and deterioration of liver function.
The gel is quickly absorbed into the skin and begins to act on soft tissues.

Minuses

There is a risk of allergic reactions
Contraindicated in pregnancy.

Pharmstandard, Russia, etc.
Price from 30 to 80 rubles.

Main action: analgesic, decongestant. It is prescribed for arthrosis, arthritis, osteoarthritis and other diseases of the joints and spine. Release form: coated tablets, ampoules, gel and ointment.

pros

OTC dispensing from the pharmacy
low cost

Minuses

Possible side effects in the form of increased pressure and pain in the head
The drug is not recommended for treatment during pregnancy, as well as in childhood (up to 6 years).

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Novartis Consumer Health, Switzerland
Price from 50 to 450 rubles.

Main action: anti-inflammatory and analgesic. It is used to treat rheumatism, osteoarthritis, joint injuries, soft tissue swelling and sciatica. Composition: 100 g of the drug contains 1.30 mg of diclofenac. Release form: gel for topical application, 2%. The tube contains 50 or 100 g of gel.

pros

Leave without a prescription
Rapid anti-inflammatory effect

Minuses

Risk of dermatitis and other allergic reactions
The gel is contraindicated for use during pregnancy.

Berlin-Chemie AG, Germany
Price from 330 to 370 rubles.

"Dikloberl retard" is available in the form of suppositories and capsules of prolonged action. Released by prescription. The active substance is diclofenac.

pros

Small dosage of the active substance in the preparation - safe and suitable for long-term use
Has a complex therapeutic effect

Minuses

Often there are complaints of nausea, vomiting, diarrhea when taking the drug
Not to be used by children under 15 years of age.

Non-steroidal anti-inflammatory drugs are increasingly being used to treat various diseases. One of them is, whose analogues are quite numerous and are actively used to eliminate heat, pain and swelling. The original preparation contains diclofenac supplemented with sodium hydroxide and benzyl alcohol as a biologically active substance. Available in the form of a solution for injection, tablets and suppositories. The main indications for the use of the drug are such pathologies as arthrosis, spinal fractures, myalgia, neuralgia, dystrophy and injuries of the knee joints, osteoarthritis and some others.

The cost of a medication in Russia ranges from 400–500 rubles, which, taking into account its use in the course, looks like a rather expensive purchase for some people. In this case, experts recommend choosing analogues of the drug, many of which have a lower price. On the Russian market, you can buy medicines of domestic or foreign (including Belarusian, Ukrainian, etc.) manufacturers.

Analogues of Russian production

Domestic manufacturers offer many drugs that can replace Dicloberl solutions, ointments and suppositories, but the main ones are as follows:

Butadion is an inexpensive generic, the cost of which, depending on the dosage form, does not exceed 200 rubles. It is based on the biologically active substance phenylbutazone, which is similar in its characteristics to diclofenac. Used to relieve pain and relieve inflammation. Prohibited for use during pregnancy and lactation, in the presence of peptic ulcers and allergic diseases. Not recommended for children under 12 years of age.
Bystrum gel is an external medicine, the cost of which is about 350 rubles. It is slightly cheaper than the original medicine. Contraindications for use are: pregnancy in the 3rd trimester and lactation, dermatitis, the presence of wound surfaces on the skin, eczema, age up to 6 years.
Diclovit in the pharmacy network is presented in the form of capsules and suppositories. The price of a medicine ranges from 200-300 rubles. An effective remedy for eliminating pathologies of the musculoskeletal system. It is not recommended for use in the presence of gastric and duodenal ulcers, renal or hepatic insufficiency, during pregnancy and lactation.
Indomethacin is a drug based on the active substance of the same name, which is the cheapest analogue of Dicloberl. Contraindicated for use during pregnancy and breastfeeding, in the presence of allergies, peptic ulcer and in case of violation of the functionality of the cardiovascular system. Prohibited for use by children under 14 years of age.

Ukrainian-made substitutes

Preparations of pharmaceutical companies from Ukraine are distinguished by good efficiency and speed of action. At the same time, the substances that are the basis of medicines are considered safer for the human body.

The most popular include the following tools:

Algozan is a substitute in the form of a gel. Along with diclofenac, the basis of the drug is a dry extract of horse chestnut seeds. Recommended for use in rheumatism, muscle and soft tissue injuries, peripheral blood flow disorders.
Diclosan is a gel for external use containing diclofenac sodium in the composition. It is used for rapid pain relief in pathologies of the joints, ligaments and muscles of a traumatic or rheumatic nature. Not recommended for allergic reactions and hypersensitivity. It is forbidden during pregnancy and lactation, in case of asthma, urticaria or ulcer bleeding.
Diclofen gel is a white substance used as a means for the treatment and prevention of pathologies of the musculoskeletal system. Contraindications for use are malfunctions of the liver and kidneys, peptic ulcer of the gastrointestinal tract, allergic reactions.
Fort-gel is a drug based on ketoprofen, which has a pronounced anti-inflammatory and analgesic effect. It is recommended for patients suffering from the consequences of injuries of the musculoskeletal system. Prohibited for admission in acute pathologies of the gastrointestinal tract, dermatoses, allergies, during breastfeeding and pregnancy.

Preparations made in Belarus

Medicines produced on the territory of the Republic of Belarus can be presented in various dosage forms and differ in additional properties, which in some cases makes them more preferable than the original drug.

If injections are prescribed to the patient to relieve negative symptoms, any analogues can be chosen, but it is considered the best in this group.

It is a clear liquid enclosed in ampoules. The drug effectively treats pathologies of the musculoskeletal system caused by inflammatory processes, anesthetizes the affected tissues. Contraindications to the use of the generic are similar to those of the original drug.

To relieve the manifestations of osteo- or periarthritis, gout and inflammation of the joints, the non-steroidal analgesic agent Diclopentil is used. The cost of the drug does not exceed 300 rubles.
One of the cheapest substitutes for Dicloberl in ampoules is Naklofen. It is usually used to eliminate pain in inflammatory processes in the ligaments, muscles and joints. Taking the medication is prohibited for allergies, bleeding of various origins and ulcerative lesions of the gastrointestinal tract.

Other manufacturers

Despite the fact that many orthopedists consider it the No. 1 drug for eliminating disorders in the blood supply to the joints and ligaments, other medicines offered by foreign companies are also popular. They are quite modern and meet all the requirements of specialists for substances of this type.

It is necessary to pay attention to such drugs:

Voltaren. Differs in the presence of a minimum number of side effects, fast action. It is not recommended for admission in the last stages of pregnancy, during lactation and in the presence of peptic ulcer. The drug should not be used by children under 18 years of age.
Ultrafastin. Despite the low cost (about 100 rubles), a drug based on ketoprofen copes well with inflammatory processes and pain in the joints and soft tissues. Available in the form of a solution for injection and gel. Contraindicated in renal and hepatic insufficiency, skin infections and allergies. It is not recommended to use the product during childbearing and lactation.
Fastum gel is a substance for external use that actively affects inflammatory processes in muscles, ligaments and joints. The best analogue of Dicloberl produced by foreign companies. Prohibited for use during pregnancy and lactation, in case of dermatoses and allergies.

In order for the treatment of the disease to be as effective as possible, when choosing a drug, it is recommended to be based on the doctor's recommendations.