This is a drug related to non-steroidal anti-inflammatory drugs. In another way, the composition acts as a derivative of the substance of the phenylacetic acid group. In medicinal purposes, the drug is used in salt form. The creation of the substance falls on 1966. Initially, it was widely used in the treatment of rheumatological processes, and then the scope became wider. Today it is effective in traumatology, sports medicine, gynecology, oncology, ophthalmology. The article will consider Diclofenac, instructions for use, price, reviews, analogues. Only a competent approach will allow you to get the optimal therapeutic effect.

What does diclofenac help with?

The tool has several mechanisms of influence at the same time. It enhances the patient's immunity, makes blood vessels more elastic and has great potential in cancer therapy. By reducing metastases and consequences, the drug helps to develop in this area and is considered the most effective. It is related to a complex of vital compounds and involves production in several forms of release. Studying the basic properties of Diclofenac, which helps, it can be noted that it has anti-inflammatory, analgesic, antipyretic effects.

There is an extensive list of indications for this composition, and such conditions will be studied within the framework of this material.

1. Solution. It serves as the basis for the preparation of injections and is used for the short-term treatment of ailments of any etiology. These are sciatica, neuralgia, problems with the spine and inflammatory processes. In general, injections are given for serious disorders and lack of effectiveness from other drugs.
2. Candles. Suppositories are indicated for the implementation of symptomatic therapy in order to eliminate the pain syndrome and reduce the severity of inflammation processes. The tool has no effect on the progression of the disease.
3. Tablets. The composition is suitable for the symptomatic therapeutic process in different situations. It helps prevent pathologies associated with the musculoskeletal system and degenerative conditions. Also effective remedy for pain in the case of migraine, cancer, infections and inflammation.
4. Gel and ointment. This form helps to fight externally with an identical complex of diseases and inflammations. The advantage is the absence of visible contraindications and minimal harmful effects on the body.
5. Drops. They are dripped into the eyes in case of cataract surgery and other surgical interventions. They also fight inflammation and are suitable for the treatment and prevention of cystic swelling after surgical therapy.

It is important to consider some limitations and possible side effects and reactions.

Diclofenac injections instructions for use

One of the most common forms is injections, instructions for use will be discussed in the framework of this article. The solution is intended for intramuscular deep administration. A single dosage for patients is 75 mg, which is identical to one ampoule of the drug. Re-administration of the drug is allowed only after a 12-hour period. The course of treatment is no more than 2 days, side effects are reduced to zero. After that, the patient is recommended to switch to the use of tablets or suppositories to continue therapy. This form of medicine has effectively shown itself in neuralgia, as well as in pain in the lower back of a pronounced nature, in osteochondrosis of all departments. Pleases and the price of the drug, which is from 37 rubles.

Information about the drug Diclofenac, instructions for use, price, reviews, analogues are given for informational purposes only.

Diclofenac ointment instructions for use

Another effective medicine to combat a wide range of conditions is an ointment, instructions for use will be studied in this article. It is intended for external application in the amount of 2 to 4 grams in a thin layer. The multiplicity of the therapeutic process involves taking the composition 3-4 times a day. Effective remedy for hemorrhoids, applied to the anus. It has a special effect with bruises, with osteochondrosis. Helps to deal with unpleasant pain during sprains. It is worth noting that it is controversial to take medication while breastfeeding, since doctors have not yet come to a unanimous verdict. The price of packing the composition is from 70 rubles.

Diclofenac gel instructions for use

Another form of medication for the external method is a gel, instructions for use will also be studied in more detail. It must be applied to the affected skin areas using an external technique and washed hands. The distribution is carried out over the painful area very carefully. The gel has a concentration of 1% and is applied in an amount of 2-4 grams at a time.

As for the composition with a substance content of 5%, it is applicable in an amount of up to 2 grams. for 1 appointment. With varicose veins, adults and children over 12 years of age are shown 3 or 4 times a day. For young children, the composition is applied no more than twice in an identical period. The remedy is not suitable for lactation. The price of a gel pack is within 100 rubles.

Diclofenac tablets instructions for use

This dosage form of the drug is intended for internal use and is used half an hour before a meal. But this form of dosing is relevant if an immediate therapeutic result is needed. With toothache, with prostatitis, with hemorrhoids and a number of other conditions, the remedy is used in the process of eating or after it and washed down with water. Adult patients drink 25-50 mg three times a day, respectively - the maximum daily dose is 150 mg. When the effect comes, the dose is reduced to 50 mg per day. In childhood, a special dosing regimen of the drug is also expected.

• In the age limit of 6-7 years - 25 mg of the drug once a day;
• if we are talking about children 8-11 years old, 25 mg is also taken up to three times per daily period;
• for adolescents 12-14 years of age, up to 50 mg three times or four times a day is indicated.

Also, the remedy is used by adult patients with osteochondrosis and back pain. Women often use it during menstruation, and men practice therapy for gout. The affordable price of this dosage form, which is from 90 rubles per pack of pills, is also pleasing. We examined what Diclofenac is, instructions for use, price, reviews, analogues. Competent guarantees a favorable effect and an instant improvement in well-being.

Diclofenac suppositories instructions for use

Suppositories are a special dosage form; instructions for use imply a simple and convenient reception. They are relevant for providing rectal insertion and should be delivered as deeply as possible after going to the toilet. The official regimen suggests a dose of 50 mg twice a day. It can also be represented by the drug 100 mg once a day. The maximum therapeutic dosage is 150 mg of the drug. Rectal suppositories can have any duration of treatment, which is determined on an individual basis. For good absorption in case of prostatitis, hemorrhoids, in gynecology, they are introduced as a whole without cutting into pieces. The price of the drug is quite affordable and is within 100 rubles.

Diclofenac has been used everywhere in medicine for many decades, and during this time the drug has established itself as a reliable remedy, balanced in all respects. One of the significant forms of release of the drug are ampoules with a solution of diclofenac, used in particularly difficult clinical cases.

Composition and form of release

This drug is available in glass ampoules containing diclofenac solution for intramuscular injection. The key active ingredient in the composition of the drug is diclofenac sodium. One 3 ml (or 75 mg) ampoule contains, in addition to 25 mg of diclofenac, additional propylene glycol, mannitol, sodium disulfide, water and benzyl alcohol.

In the container, the solution is already ready for use; it is not necessary to dilute (dilute) it with anything.

Ampoules are placed in cardboard boxes with a capacity of 5 or 10 pieces. In Russia, the drug is most common under the brand name of the domestic company "Biochemist", however, medicines manufactured by companies are available:

• "Akos";
• "Ratiopharm";
• "Solofarm";
• "Eskom";
• "Grotex";
• "Sotex";
• "Hemofarm";
• "Ozone";
• "Alftarm" and others.

Which is better: Diclofenac tablets or injections?

If necessary, to stop unbearable pain as soon as possible, the use of intramuscular injections of Diclofenac for adult patients is indicated. Tablets (and capsules) in this case are a less preferred option due to the longer pharmacokinetics. This statement is doubly true for ointments, creams and suppositories, which are most effective when used topically, which is not always advisable for some diagnoses.

Pharmacological action and pharmacokinetics

The mechanism of action of Diclofenac can be described by three main qualities:

• anti-inflammatory;
• analgesic;
• antipyretic (antipyretic).

The principle of action of the drug is to slow down the production of prostaglandins, which are actively involved in the regulation of pain processes, inflammation and fever. In the case of a diagnosed pathology of a rheumatic nature, the drug can reduce pain at rest or when moving the joint, reduce its swelling and eliminate the characteristic stiffness after a long immobility (for example, in a dream).

The drug is no less effective in stopping the pain syndrome of non-rheumatic origin, suppressing discomfort just a few minutes after the injection. Additionally, Diclofenac solution is used for inflammatory processes resulting from trauma or surgery.

If at the same time it is combined with opiate drugs, Diclofenac can gradually replace them completely, gradually increasing the dosage for adults. Finally, the drug reliably helps to alleviate the symptom complex that occurs with frequent migraines.

With regard to pharmacokinetics, when injected into the thickness of the muscle, the drug begins to be absorbed immediately, and reaches the peak of its presence in the blood plasma after 20 minutes. The half-life of the substance is approximately 2-3 hours, and for the most part it is excreted by the kidneys, to a lesser extent - through the liver.

Indications for use

Mainly, Diclofenac is prescribed to patients with one of the complex or inflammatory pathologies of the musculoskeletal system:

• rheumatoid arthritis;
• gout attack;
• gynecological diseases;
• osteochondrosis;
• gouty arthritis;
• bursitis;
• tendovaginitis;
• various radiculitis, myalgia, back pain, infringement of the sciatic nerve.

In addition, the drug is relevant for the relief of sharp colic in the kidneys or gallbladder, and it is also prescribed to suppress inflammation after injuries or operations, or to eliminate the symptoms of migraine.

Method of application and dosage

Diclofenac is not an antibiotic or a hormonal drug, therefore its administration is possible to the widest groups of patients with the approval of the attending physician and provided that the minimum effective dosages are used.

The duration of therapy is not limited, however, the instruction for the use of Diclofenac injections insists on the inadmissibility of using the drug for two days in a row - pauses must be made. If there is a need for daily administration of the drug, oral analogues or suppositories should be given to the patient instead of injections.

In no case should the solution be diluted with other medicines, and an open ampoule must be used immediately.

The drug is injected entirely deep intramuscularly into the upper outer quadrant of the buttock.

The section regulating the dosage of Diclofenac is based on the following rules:

• an adult patient is prescribed 75 mg once a day (one ampoule);
• in difficult cases, it is permissible to use two ampoules per day, the contents of which are injected into different muscles;
• it is recommended that instead of the second ampoule, the patient be given medicine in the form of a tablet or rectal suppository with a total daily content of Diclofenac of not more than 150 mg;
• during migraines, the solution should be used at the beginning of each attack, also supplementing it (if necessary) with Diclofenac rectal suppositories with a total daily volume of not more than 175 mg;
• injections are not prescribed for children and adolescents under 18 years of age due to complex dosage calculations;
• Elderly patients do not need to change the dosage.

Additionally, it can be noted that patients with pathologies of the liver or kidneys (up to a moderate degree) do not need to adjust the dose. The injection is not painful, so the medicine can be prescribed, among other things, to sensitive people.

Analogues and prices

Direct analogues of Diclofenac can be considered its generics, based on the same active ingredient: dichlorophenylamino-phenylacetic acid. Among the most famous competitors are Swiss Voltaren with the same dosage, domestic Diclofenac-AKOS and Diclofenac-Solofarm, as well as Israeli Diklonat.

As for analogues in action, which belong to the class of NSAIDs with analgesic effect, the following drugs are the most popular on the Russian market:

• Glucosamine;
• Don;
• Elbon;
• Xefocam;
• Movalis;
• Dexalgin;
• Artoxan;
• Kenalog;
• Meloxicam;
• Ketorolac;
• Artradol;
• Ketonal.

It should be noted that any anti-inflammatory drugs in ampoules can be bought at a pharmacy only according to a prescription. The approximate cost of medicines is contained in the following table:

Contraindications for use

The list of contraindications indicated in the instructions for use of Diclofenac in the form of injections is quite voluminous, and includes the following conditions:

• hypersensitivity to one of the components of the solution;
• bronchial asthma;
• peptic ulcer or bleeding of the gastrointestinal tract;
• intestinal inflammation in the acute phase;
• pathology of blood clotting;
• increased risk of thrombosis;
• diseases of the cardiovascular system;
• severe liver and kidney failure;
• hyperkalemia;
• age up to 18 years;
• III trimester of pregnancy and the period of breastfeeding.

With caution, the drug is prescribed in the I and II trimesters of pregnancy, with mild and moderate diseases of the liver and kidneys, arterial hypertension, alcohol consumption, long-term use of other NSAIDs and chronic edema or inflammation of the nasal mucosa.

Side effects

First of all, you need to pay attention to the most frequent, in terms of statistics, adverse reactions from the use of Diclofenac in ampoules. Thus, patients are at risk of:

• headaches;
• dizziness;
• vertigo;
• abdominal pain and dyspeptic complex;
• skin rash;
• pain at the injection site.

Infrequent adverse reactions include myocardial infarction, heart failure, and tachycardia. Experts note that in order to reduce the risk of unwanted side effects, the minimum effective dosages should be used and the course of treatment should be as short as possible.

Interaction

The interaction of Diclofenac with other drugs and substances is best analyzed by ordering groups of drugs:

• increases the level of lithium and digoxin in the blood;
• may reduce the hypotensive effect of appropriate drugs and diuretics;
• enhances the toxicity of cyclosporine to the kidneys;
• may cause convulsions in patients taking antibiotics from the quinolone class.

Additionally, researchers suggest an increase in the number of adverse reactions when combined with glucocorticosteroids, an increased risk of bleeding when combined with anticoagulants, and increased toxicity of Methotrexate when used simultaneously with Diclofenac.

special instructions

There is some likelihood of bleeding in the gastrointestinal tract when taking the medication, therefore, at the first sign of such a phenomenon, the course of therapy should be stopped. Patients with gastrointestinal diseases are recommended to take gastroprotectors simultaneously with NSAIDs. Some patients have developed an acute allergic reaction to diclofenac sodium.

Two or more types of NSAIDs should not be given at the same time. During long-term therapy, it is necessary to regularly check the function of the liver, as well as to monitor the likely development of fluid retention in the body. In the case of using Diclofenac, you should refrain from driving vehicles and mechanisms that require an acute psychomotor reaction.

Release form: Liquid dosage forms. Injection.

General characteristics. Compound:

Active substance: diclofenac sodium; 2-[(2,6-dichlorophenyl)amino]phenylacetate sodium; 1 ml of solution contains 25 mg of diclofenac sodium;
Excipients: benzyl alcohol, disodium edetate (Trilon B), sodium metabisulfite (E 223), water for injection. Basic physical and chemical properties: almost colorless, transparent liquid.

Pharmacological properties:

Pharmacodynamics. Diclofenac sodium is a non-steroidal anti-inflammatory drug, a non-selective cyclooxygenase blocker with anti-inflammatory, analgesic and antipyretic effects. The main mechanism of action of diclofenac is inhibition of prostaglandin biosynthesis. Prostaglandins play an important role in the genesis of inflammation, pain and fever.
In rheumatic diseases, the anti-inflammatory and analgesic properties of diclofenac sodium provide a clinical effect characterized by a significant reduction in the severity of symptoms and complaints such as pain at rest and on movement, morning stiffness and swelling of the joints.
In vitro, diclofenac sodium at concentrations equivalent to those achieved in the treatment of patients does not inhibit the biosynthesis of cartilage proteoglycans.
In post-traumatic and postoperative inflammatory phenomena, diclofenac sodium quickly relieves pain (both spontaneous and arising from movement), reduces inflammatory edema and swelling of the postoperative wound.
The drug causes a significant analgesic effect in moderate and severe pain syndrome of non-rheumatic origin. Diclofenac sodium is able to eliminate pain and reduce the severity of blood loss in primary dysmenorrhea. Diclofenac sodium, in addition, has a beneficial effect on the manifestations of seizures.

Pharmacokinetics. After intramuscular administration of 75 mg of diclofenac, absorption begins immediately. The maximum concentration in blood plasma, the average value of which is about 2.5 μg / ml (8 μmol / l), is reached after about 20 minutes. Immediately after its achievement, a rapid decrease in the concentration of the drug in plasma is noted. The amount of absorbed active substance is linearly dependent on the dose of the drug.
The area under the concentration-time curve (AUC) after intramuscular administration of diclofenac sodium is approximately 2 times greater than after oral or rectal administration, since in the latter cases about half of the amount of diclofenac is metabolized during the first passage through the liver. After repeated use of the drug, pharmacokinetic parameters do not change. Subject to the recommended intervals between injections of the drug, cumulation is not observed.
Distribution. Serum protein binding is (99.7%), it occurs mainly with albumin (99.4%). The volume of distribution is 0.12 - 0.17 l / kg of body weight.
Diclofenac penetrates into the synovial fluid, where its maximum concentration is reached 2 to 4 hours later than in the blood plasma. The half-life from the synovial fluid is 3-6 hours. After 2 hours after reaching the maximum concentration in the blood plasma, the concentration of diclofenac in the synovial fluid is higher than in the blood plasma, and its values ​​remain higher for 12 hours. The metabolism of diclofenac is carried out partially by glucuronidation unchanged molecule, but mainly through single and multiple methoxylation, which leads to the formation of several phenolic metabolites (3-hydroxy-, 4-hydroxy-, 5-hydroxy-, 4,5-dihydroxy- and 3- hydroxy-4-methoxydiclofenac), most of which are converted into glucuronide conjugates. Two of these phenolic metabolites are biologically active, but significantly less than diclofenac.
The total systemic plasma clearance of diclofenac is 263 ± 56 ml/min. The terminal half-life is 1-2 hours. The half-life of four metabolites, including two pharmacologically active ones, is also short and is 1-3 hours. One of the metabolites, 3-hydroxy-4-methoxydiclofenac, has a longer half-life, but this metabolite is completely inactive.
Withdrawal. About 60% of the applied dose of the drug is excreted in the urine in the form of glucuronic conjugates of the unchanged active substance, as well as in the form of metabolites, most of which are glucuronic conjugates. Less than 1% of diclofenac is excreted unchanged. The rest of the applied dose of the drug is excreted in the form of metabolites with bile and feces.
Pharmacokinetics in separate groups of patients. In patients with impaired renal function, no accumulation of diclofenac was observed when diclofenac sodium was prescribed in the usual single doses. In the event that creatinine clearance is less than 10 ml / min, the calculated equilibrium concentrations of diclofenac hydroxymetabolites are approximately 4 times higher than in healthy patients. But ultimately the metabolites are excreted in the bile.
In patients with chronic hepatitis or compensated liver cirrhosis, the pharmacokinetics of diclofenac are similar to those in patients without.

Indications for use:

Inflammatory and degenerative forms of rheumatic diseases (rheumatoid, ankylosing spondylitis, osteoarthritis, spondyloarthritis), pain in the spine, extra-articular soft tissues, acute attack, post-traumatic and postoperative pain syndromes accompanied by inflammation and edema, migraine attacks, renal and biliary colic.

Important! Get to know the treatment

Dosage and administration:

Applied to adults in the form of intramuscular injections. Do not use diclofenac sodium injections for more than 2 days in a row. If necessary, continue treatment, the drug is used in the form of tablets or rectal suppositories.
When conducting intramuscular injections, in order to avoid damage to nerves or other tissues at the injection site, it is recommended to adhere to the following rules:
the drug should be injected deep intramuscularly into the upper outer quadrant of the gluteal muscle, the dose is usually 75 mg (contents of 1 ampoule) 1 time per day, in severe cases (for example, with colic), as an exception, 2 injections of 75 mg can be made with an interval of several hours (the second injection must be made in the other buttock); alternatively, the solution can be combined with other dosage forms of the drug (tablets, rectal suppositories), while the maximum daily dose should not exceed 150 mg.

Incompatibility. Diclofenac sodium solution should not be mixed with solutions of other drugs for injection.

Application Features:

During treatment with diclofenac sodium, an ulcer of the gastrointestinal tract may occur or develop at any time, sometimes complicated by perforation; and far from always there are symptoms-harbingers of these complications or the presence of anamnestic information about a peptic ulcer. More serious consequences of these complications may occur in elderly patients. In some cases, when these complications develop in patients receiving diclofenac sodium, treatment with the drug must be discontinued.
In patients who have not previously received diclofenac sodium, during the period of treatment with the drug, as well as during therapy with other NSAIDs, allergic reactions, including anaphylactic and anaphylactoid reactions, may develop in rare cases.
Diclofenac sodium, due to its pharmacodynamic properties, can mask complaints and symptoms characteristic of infectious and inflammatory diseases.
Perhaps the development of hypersensitivity reactions to sodium metabisulfite, which is part of the injection solution.
During the use of diclofenac sodium, careful medical supervision of patients with diseases of the gastrointestinal tract or a history of ulcerative lesions of the stomach or intestines is necessary; patients with ulcerative colitis or Crohn's disease, as well as patients with impaired liver function.
During the use of diclofenac sodium, as well as other NSAIDs, the level of one or more liver enzymes may increase. Therefore, with long-term therapy with diclofenac sodium, a regular study of liver function is necessary. If violations of the functional parameters of the liver persist or increase, complaints appear or symptoms develop that indicate liver disease, and also if other side effects occur (for example, rash, etc.), diclofenac sodium should be discontinued. It must be borne in mind that while taking diclofenac sodium, it can occur without prodromal phenomena.
Caution is necessary when prescribing diclofenac sodium to patients with hepatic porphyria, since the drug can provoke seizures. Since prostaglandins play an important role in maintaining renal blood flow, special care is required in the treatment of patients with impaired cardiac or renal function, elderly patients, patients receiving diuretics, and patients who have a significant decrease in circulating plasma volume of any etiology, for example in the period before and after massive surgical interventions. In these cases, during the use of diclofenac sodium, regular monitoring of renal function is recommended as a precautionary measure. Discontinuation of the drug usually causes the restoration of kidney function to its original level. With prolonged use of diclofenac sodium, like other NSAIDs, a systematic monitoring of the peripheral blood picture is shown.
Diclofenac sodium, like other NSAIDs, can temporarily inhibit platelet aggregation. Therefore, in patients with impaired hemostasis, careful monitoring of relevant laboratory parameters is necessary.
Given the general medical provisions, caution when using diclofenac sodium is also necessary in elderly patients. This is especially true in elderly patients who are weakened or have insufficient body weight, they are advised to prescribe the drug at the minimum effective dose.
You should be especially careful when intramuscularly administering diclofenac sodium to patients with bronchial asthma (because of the risk of increased severity of the symptoms of the disease), as well as patients with allergic rhinitis (including seasonal) and polyps of the nasal mucosa.

The ability to influence the reaction rate when driving vehicles or working with other mechanisms. When using the drug, you should refrain from driving and performing other potentially hazardous activities that require increased attention and speed of psychomotor reactions.

Use during pregnancy or lactation. During pregnancy, the use of the drug is contraindicated. If necessary, the appointment of the drug during lactation, breastfeeding should be stopped.

Children. Children under the age of 18 are prescribed diclofenac sodium in a different dosage form.

Side effects:

When assessing the frequency of various adverse reactions, the following gradations were used: often - > 10%, sometimes - > 1 - 10%, rarely - > 0.001 - 1%, in some cases -< 0,001 %.
From the gastrointestinal tract: sometimes - pain in the epigastric region, abdominal cramps, bloating,; rarely - gastrointestinal bleeding (bloody vomiting, melena, diarrhea mixed with blood), gastric and intestinal ulcers, which are accompanied or not accompanied by bleeding or perforation; in some cases - aphthous, changes in the esophagus, the formation of diaphragm-like strictures in the intestines, disorders of the lower intestine, such as nonspecific hemorrhagic, exacerbation or Crohn's disease, constipation,.
From the side of the central nervous system: sometimes -,; rarely - drowsiness; in some cases - sensitivity disorders, including paresthesia, disorientation, insomnia, irritability, sensation, nightmares, psychotic reactions, aseptic.
From the senses: in some cases - visual impairment (blurred vision,), hearing impairment, taste disturbances.
Dermatological reactions: sometimes -; rarely - ; in some cases - rashes in the form of blisters, erythema multiforme, Stevens-Johnson syndrome, Lyell's syndrome (acute toxic epidermolysis), (exfoliative), hair loss, photosensitive reactions; purpura, including allergic.
From the side of the kidneys: rarely -; in some cases - acute, changes in urine sediment (hematuria and), interstitial; nephrotic syndrome; papillary.
From the side of the liver: sometimes - an increase in the level of aminotransferases in the blood serum;
rarely - hepatitis, accompanied or not accompanied by jaundice; in some cases - fulminant hepatitis.
From the hematopoietic system: in some cases -

Interaction with other drugs:

Lithium, digoxin. Diclofenac sodium may increase plasma concentrations of lithium and digoxin.
Diuretics. Diclofenac sodium, like other NSAIDs, can reduce the severity of the diuretic effect. The simultaneous use of potassium-sparing diuretics can cause an increase in the level of potassium in the blood serum (in the case of such a combination of drugs, this indicator should be monitored frequently).
NSAIDs. The combined systemic use of NSAIDs may increase the incidence of adverse events.
Anticoagulants. There are separate reports of an increased risk of bleeding in patients taking diclofenac sodium and anticoagulants at the same time. Therefore, in the case of such a combination, careful and regular monitoring of patients is recommended.
Antidiabetic drugs. Perhaps the simultaneous use of diclofenac sodium and antidiabetic drugs, while the effectiveness of the latter does not change. However, there are separate reports of the development in such cases of both hypoglycemia and hyperglycemia, which necessitated a change in the dose of sugar-lowering drugs during the use of diclofenac sodium.
Methotrexate. Caution should be exercised when prescribing NSAIDs less than 24 hours before or after taking methotrexate, since in such cases it is possible to increase the concentration of methotrexate in the blood and increase its toxic effect.
Cyclosporine. The effect of NSAIDs on the synthesis of prostaglandins in the kidneys may increase the nephrotoxicity of cyclosporine.
Antibacterial agents - quinolone derivatives. There are separate reports of the development of seizures in patients receiving both quinolone derivatives and NSAIDs.

Contraindications:

Hypersensitivity to diclofenac sodium and other components of the drug, as well as to other non-steroidal anti-inflammatory drugs. Erosive and ulcerative lesions of the gastrointestinal tract (in the acute phase), “acetylsalicylic” asthma, “acetylsalicylic” triad (simultaneous development of bronchial asthma, recurrent polyposis of the nose and paranasal sinuses, intolerance to acetylsalicylic acid and pyrazolone drugs), suppression of bone marrow hematopoiesis. During pregnancy and breastfeeding. Children's age up to 18 years.

Overdose:

Symptoms: dizziness, headache, clouding of consciousness, nausea, vomiting, pain in the epigastric region, tinnitus, agitation, respiratory depression, convulsions, impaired liver and kidney function,.
Treatment: Treatment of overdose of NSAIDs (non-steroidal anti-inflammatory drugs) is the basis of supportive and symptomatic therapy. Forced diuresis, or hemoperfusion, is ineffective for the elimination of NSAIDs, since the active substances of these drugs are largely bound to plasma proteins and are extensively metabolized.

Storage conditions:

Store in a place protected from light at a temperature not exceeding 25 ° C.
Keep out of the reach of children.

Shelf life - 3 years.

Leave conditions:

On prescription

Package:

3 ml in ampoules; 5 ampoules in a cardboard pack; 100 ampoules in a cardboard box.

Diclofenac is a non-steroidal anti-inflammatory drug (NSAID). It has anti-inflammatory, analgesic and antipyretic effects.

Pharmacological properties are due to the ability to inhibit the biosynthesis of certain prostaglandins as a result of inhibition of the enzyme prostaglandin synthetase.

By blocking the synthesis of prostaglandins, the drug eliminates or significantly reduces the severity of symptoms of inflammation. Diclofenac reduces the hypersensitivity of nerve endings to mechanical stimuli and biologically active substances formed in the focus of inflammation. It leads to a decrease in body temperature, preventing the action of prostaglandins on the hypothalamic link in the process of thermoregulation. Reduces the concentration of prostaglandins in menstrual blood and the intensity of pain in primary dysmenorrhea.

The use of Diclofenac injections helps to increase the range of motion in the affected joints, reduce pain at rest and during movement.

Suppresses platelet aggregation. With prolonged use, it has a desensitizing effect.

The composition of 1 ml solution for intramuscular injection includes:

• Active substance: diclofenac sodium - 25 mg;
• Auxiliary components: mannitol, propylene glycol, benzyl alcohol, sodium hydroxide, sodium sulfite, water for injection.

Quick page navigation

Price in pharmacies

Information about the price of Diclofenac injections (ampoules) in pharmacies in Moscow and Russia is taken from the data of online pharmacies and may differ slightly from the price in your region.

You can buy the drug in pharmacies in Moscow at a price: injections Diclofenac solution 25 mg / ml 3 ml 5 pcs. - from 48 to 67 rubles.

Conditions for dispensing from pharmacies - by prescription.

Store in a dark, dry place out of the reach of children at temperatures up to 25°C.

The list of analogues is presented below.

What do Diclofenac injections help with?

The drug Diclofenac is prescribed in the treatment of inflammatory and inflammation-activated degenerative forms of rheumatism:

• chronic polyarthritis;
• ankylosing spondylitis ();
• arthrosis;
• spondylarthrosis;
• neuritis and neuralgia, such as cervical syndrome, lumbago (backache), sciatica;
• acute attacks of gout.

Additionally:

• rheumatic lesions of soft tissues;
• painful swelling or inflammation after injury or surgery .;
• non-rheumatic inflammatory pain conditions;
• neuralgia;
• postoperative pain;
• post-traumatic pain syndrome, accompanied by inflammation.

Instructions for the use of Diclofenac injections, doses and rules

The use of an injection solution is indicated if it is necessary to achieve a quick effect, or it is impossible to take other forms of the drug (tablets / suppositories).

Introduction intramuscular or intravenous.

The standard dosage of Diclofenac injections, according to the instructions for use, is intramuscularly 75 mg \ 1 time per day. In severe cases, 2 times a day, 75 ml with a break of several hours.

Injections should be carried out at the lowest possible rate, with the transition to tablets or suppositories. The standard duration is up to 3 days.

For migraine attacks, intramuscular administration at a dose of 75 mg is recommended (at the very beginning of the attack), if necessary, suppositories at a dose of up to 100 mg can be added on the same day. The total daily dose should not exceed 175 mg.

A combination of a solution for injection with dosage forms for external use (gel, ointment) containing diclofenac sodium as an active ingredient is allowed.

Important information

Diclofenac in the form of a solution is injected intramuscularly into the outer upper quadrant of the buttock. The syringe needle should be inserted deep enough.

Diclofenac injections are prescribed for adults. This form is not recommended for children and adolescents, due to the difficulty in calculating the dosage.

For the elderly (65 years and older), no initial dose adjustment is required. In debilitated patients and with low body weight, it is recommended to administer minimum doses.

Use during pregnancy and lactation

Diclofenac injections are contraindicated during pregnancy.

During treatment, the issue of stopping breastfeeding should be resolved.

Application features

Before using the drug, read the sections of the instructions for use on contraindications, possible side effects and other important information.

Side effects of diclofenac

Instructions for use warns of the possibility of developing side effects of Diclofenac injections:

• Digestive system - nausea, vomiting, abdominal pain, diarrhea, bloating (flatulence), loss of appetite, the appearance of erosions in the stomach or duodenum, the development of gastrointestinal bleeding, which is accompanied by the appearance of blood in the stool or its black color. The activity of hepatic transaminase enzymes (ALT, AST) may also increase, indicating damage to hepatocytes. An inflammatory process develops in the oral cavity - stomatitis.
• Nervous system - dizziness, diffuse headache, sleep disturbances, increased excitability and irritability, the appearance of a feeling of fear, anxiety, nightmares. On the part of the sense organs, impaired vision and hearing, the appearance of tinnitus. Tremor (trembling) of the hands, increased convulsive readiness of the striated skeletal muscles, paresthesia (impaired skin sensitivity) are also possible.
• Blood and red bone marrow - a decrease in blood clotting, a decrease in the number of platelets (thrombocytopenia) and leukocytes (leukopenia), the development of anemia (anemia).
• Urinary system - inflammation of the tissues of the kidneys (interstitial nephritis), a decrease in the functional activity of the kidneys, the appearance of blood in the urine (hematuria).
• Skin and subcutaneous tissue - the development of erythema (reddening of the skin), increased sensitivity of the skin to light (especially to sunlight), alopecia (hair loss), rash and itching of the skin.
• Respiratory system - very rarely, pneumonitis can develop.
• Cardiovascular system - increased systemic blood pressure, the appearance of tissue edema due to retention of sodium and water ions in the body.

At the injection site, a local inflammatory reaction may develop with reddening of the skin, pain and the development of an infiltrate.

Contraindications

It is contraindicated to use Diclofenac for injections in the following diseases or conditions:

• Erosive and ulcerative lesions of the gastrointestinal tract (in the acute phase);
• Hematopoietic disorders;
• "Aspirin" asthma;
• Pregnancy and lactation;
• Age up to 18 years;
• Hypersensitivity to the components of the solution (including other non-steroidal anti-inflammatory drugs).

With caution, the solution should be used in elderly patients, as well as in induced acute hepatic porphyrias, heart failure, severe impairment of kidney and liver function.

Overdose

Overdose symptoms - headache, clouding of consciousness, dizziness, hyperventilation, disorders of the kidneys and liver, disorders of the digestive tract, myoclonic convulsions in children.

List of analogues Diclofenac

If necessary, replace the drug, there are two options - choosing another drug with the same active ingredient or a drug with a similar effect, but with a different active substance. Drugs with a similar effect are united by the coincidence of the ATX code.

Diclofenac analogues for injections, list of drugs:

• Dicloberl.

ATX code matches:

• Veral,
• Voltaren,
• Diklak,
• Diklobene,
• Diklovit.

When choosing a replacement, it is important to understand that the price, instructions for use and reviews of Diclofenac do not apply to analogues. Before replacing, you must obtain the approval of the attending physician and do not replace the drug yourself.

If we analyze reviews of Diclofenac injections, we can conclude that at least 20% of patients develop quite serious complications during treatment. And this is the main drawback of the drug, despite its high anti-inflammatory and analgesic activity. According to doctors, Voltaren injections are a safer analogue of Diclofenac. Despite the same active substance, the drug is better tolerated.

Special Information for Healthcare Professionals

Interactions

With the simultaneous use of antihypertensive drugs, their action may be weakened.

There are isolated reports of the occurrence of seizures in patients taking NSAIDs and antibacterial drugs of the quinolone series at the same time.

With simultaneous use with GCS, the risk of side effects from the digestive system increases.

With the simultaneous use of diuretics, a decrease in the diuretic effect is possible. With simultaneous use with potassium-sparing diuretics, an increase in the concentration of potassium in the blood is possible.

When used simultaneously with other NSAIDs, the risk of side effects may increase.

There are reports of the development of hypoglycemia or hyperglycemia in patients with diabetes mellitus who used Diclofenac simultaneously with hypoglycemic drugs.

With simultaneous use with acetylsalicylic acid, a decrease in plasma concentration is possible.

Although clinical studies have not established the effect of the drug on the action of anticoagulants, isolated cases of bleeding have been described with the simultaneous use of Diclofenac and warfarin.

With simultaneous use, an increase in the concentration of digoxin, lithium and phenytoin in the blood plasma is possible.

With simultaneous use, it is possible to increase the concentration of methotrexate in the blood plasma and increase its toxicity.

With the simultaneous use of diclofenac may not affect the bioavailability of morphine, however, the concentration of the active metabolite of morphine may remain elevated in the presence of diclofenac, which increases the risk of side effects of the morphine metabolite, incl. respiratory depression.

With simultaneous use with pentazocine, a case of the development of a large convulsive seizure is described; with rifampicin - a decrease in the concentration of diclofenac in the blood plasma is possible; with ceftriaxone - increased excretion of ceftriaxone with bile; with cyclosporine - it is possible to increase the nephrotoxicity of cyclosporine.